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New York case to challenge association health plan regulation

On Behalf of | Oct 3, 2018 | Health Care Investigations |

New York v. Acosta could change the administration of association health plans throughout the country. This New York case questions a regulation by President Trump’s administration. The regulation allegedly makes it easier for smaller groups to buy association health plans that do not meet Affordable Care Act (ACA) standards.

The group behind the challenge state this regulation is in violation of the ACA and ultimately hurts those who need medical care.

Who is the group that is challenging the regulation? The parties behind the challenge note in the complaint filed with the courts that the responsibility to protect the health and welfare of citizens is that of the state. As such, a number of states including the State of New York through its Attorney General as well as the Commonwealth of Massachusetts and District of Columbia have officially challenged the regulation.

How will this case impact health care law in the United States? The challenge is based on the foundations established through ERISA in 1974. Congress enacted ERISA to help protect employees by imposing fiduciary obligations on those who administer employee benefit plans, including group health plans. The group contends the regulation removes these protections by allowing a “broad range of associations to offer health plans that do not have to comply with various Affordable Care Act protections.”

Ultimately, the group is asking the court to vacate the rule and enjoin the Department of Labor (DOL) and anyone acting in concert with the agency from “implementing, applying, or taking action whatsoever under” the rule.

Will the challenge succeed if it gets to the Supreme Court? As noted in a recent analysis published by the Los Angeles Times, it is too early to tell. The case was filed this past July and is currently waiting a hearing within a federal district court in Washington D.C.

How does this impact physicians? Physicians and other medical professionals are likely following the evolution of the ACA under the new administration because changes to the law could impact regulatory and compliance matters. As such, it is wise to keep an eye on this and similar cases that will impact the health care system.

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