Sen. Rand Paul (R-Ky.) may be a doctor, but he obviously doesn’t have the cure for what ails small businesses. During a discussion on health care policy in his home state, Paul said President Donald Trump is likely to legalize association health plans on the federal level, which would allow more groups of similar businesses to band together to purchase insurance. Paul claims this would allow small businesses to negotiate lower rates and insure more people, but what he and others who support this idea fail to understand is that these plans would actually do the opposite.
Some lawmakers, including Sen. Mike Enzi (R-Wyo.) and Paul, have long touted association health plans as a great solution to the health care needs of small businesses. Unfortunately, Enzi and Paul simply don’t understand what would actually happen to insurance markets if these plans were ever widely available. Small businesses frequently buy plans through the small-group market, which is subject to different rules and protections than the large-group market. The regulatory difference between the two is significant. As a report by the Kaiser Family Foundation noted, plans sold in the large-group market can charge people more based on their health status, and they’re not required to cover essential health benefits like prescription drugs, emergency services or maternity care. However, Obamacare-compliant plans in the small-group market provide protections against being charged more based on health, age or gender and include these essential benefits.
As President Donald Trump and congressional leadership stump for tax reform, it is becoming increasingly clear they do not understand why most small businesses will not benefit from drastically slashed corporate tax rates.
House Speaker Paul Ryan’s (R-Wis.) tax blueprint, for example, calls for reducing the corporate rate to a flat 20 percent because he believes this will help small employers.
President Trump, meanwhile, has floated a maximum corporate rate of 15 percent, saying recently that he intends to “dramatically reduce the tax rate for America’s small businesses, which have created more than 60 percent of new private-sector jobs in the recent past.” He claimed this rate reduction would bring relief to millions of entrepreneurs.
Despite months of speeches, speculation and tweets suggesting that the federal government would not continue to provide critical payments that support the Affordable Care Act (ACA) marketplaces, President Trump still has yet to announce a final decision on the future of cost-sharing reduction subsidies (CSRs), which help reduce out-of-pocket healthcare costs for low and moderate-income enrollees. While the president did agree to make the CSR payments for August, there is no telling what he will do in coming months, and his ongoing rhetoric about wanting to let the ACA collapse is hardly reassuring to small business owners and their employees who depend on the exchanges for coverage. This is why lawmakers must act now to pass bipartisan legislation that will strengthen the ACA marketplaces.
The Republican Party’s healthcare game is a long con. For six years, conservatives demonized the Affordable Care Act (ACA) without offering a viable alternative. Then, when they gained control of Congress and the White House, they came up with the disastrous American Health Care Act (AHCA), which would strip 23 million Americans of their health insurance.
The cynic in me believes this deeply unpopular proposal is part of a plan to play chicken with our healthcare system, allowing Republicans to finally destroy their ACA nemesis. Unfortunately, this reckless strategy is unfolding at the expense of tens of millions of Americans, including the small businesses at the heart of the U.S. economy.