Impacts Of The House Bill On The Employees And Their Families In Self-Insured Plans.
The House bill will apparently erode the federal protections for individuals with catastrophic medical costs in self-insured plans. https://www.wsj.com/articles/little-noted-provision-of-gop-health-bill-could-alter-employer-plans-1493890203
States are generally precluded from regulating the benefits offered by large self-insured employer plans under a federal law known as ERISA. The ACA eliminated lifetime and annual caps on employer benefits whether offered through traditional employers or self-insured plans. Caps on benefits were reasonably common before the ACA.
The amendments to the House bill allow waivers of essential benefits and of the rules governing pricing of coverage for those with preexisting conditions. If one state gets such a waiver, a self-insured plan can apparently then choose to base its coverage on the benefit rules in that state. And oops, there goes the protections for self insured plan employees in the other 49 states. https://www.brookings.edu/2017/05/02/allowing-states-to-define-essential-health-benefits-could-weaken-aca-protections-against-catastrophic-costs-for-people-with-employer-coverage-nationwide
Prepared by: Lucien Wulsin
dated: 5/4/17