Trump administration seeking feedback on how to support grandfathered ACA group plans

Document titled, Affordable Care Act
The Trump administration issued an RFI on grandfathered ACA plans late Thursday. (Getty/Designer491)

The Trump administration is seeking feedback on ways that it can assist insurers and employers in maintaining grandfathered ACA group plans.

In a request for information, the Department of Labor, the Department of the Treasury and the Department of Health and Human Services is asking for additional details challenges to maintaining grandfathered status and the reasons employers and payers continue to offer such plans.

As there is “limited information available” about these plans, the departments are seeking to determine if there are “opportunities ... to assist such plans and issuers, consistent with the law, in preserving the grandfathered status of group health plans and group health insurance coverage.”

Grandfathered plans were available before the Affordable Care Act was enacted in 2010, and federal rules prohibit these plans from making significant changes to their benefits or cost-sharing, and new employees can enroll as long as there was at least one person enrolled each year.

The plans were extended by the Obama administration in 2015 following backlash to the ACA, which promised that people could remain on their insurance plans if they wanted to. These plans are generally not compliant with ACA benefits requirements.

RELATED: CMS seeking feedback on ways to address ACA exchange ‘silver loading’

The Trump White House extended these “transitional” plans in both the individual and group insurance markets in early 2017. Later that year, President Donald Trump issued an executive order that pushes HHS to find regulatory paths to roll back the ACA, which is the likely genesis of the new RFI.

Once a plan loses grandfathered status, it cannot regain it, and research suggests that the number of grandfathered plans has indeed dwindled of late. The Kaiser Family Foundation found that about 20% of employers offered at least one such plan in 2018, down from 23% in 2017.

About 16% of workers were enrolled in a grandfathered plan last year, KFF found, on par with 2017 but down from 25% in 2015 and 36% in 2013.

If the Trump administration takes action to bolster these plans, it would be the latest in a string of changes aimed at providing alternatives to ACA plans. HHS expanded the length of short-term health plans to 12 months and has also issued rules aimed at expanding association plans.