CounselorsEmpowerACA Government Affairs Blog

The ACA Government Affairs team strives to keep the counseling community connected with important legislative news, updates, and announcements that affect the profession. Questions? Want to get involved in our advocacy efforts? Email us at 


Jan 16, 2018

White House Supports Additional Type of Group Health-Care Insurance Plan

Late last month, the White House proposed new rules that would make it easier for small businesses, sole proprietors, and individuals to group together in “association” to buy insurance in the large group market. These association plans, as they are known, would be exempt from many of the consumer protections—including required mental health coverage—that are mandated by the Affordable Care Act, which now provides coverage for some of the same types of customers.

The Labor Department predicts that as many as 11 million people may join these plans. A 60-day period for public comment on the proposal is currently underway. The opportunity for public comment ends March 6, 2018.  The American Counseling Association urges professional counselors to submit their comments on this proposed rule change before March 6, 2018.  Comments can be submitted online by clicking on the following link

An association plan has no connection with the American Counseling Association or other professional associations. The name refers to a group of consumers associating with each other for the purpose of obtaining insurance.

The President outlined this proposal in a recent New York Times interview: “Now here’s the good news. We’ve created associations, millions of people are joining associations. Millions. That were formerly in Obamacare or didn’t have insurance. Or didn’t have health care. Millions of people. That’s gonna be a big bill, you watch. It could be as high as 50 percent of the people. You watch. So that’s a big thing. And the individual mandate. So now you have associations, and people don’t even talk about the associations. That could be half the people are going to be joining up.”

Association health plans are not a new idea. These plans have been opposed by consumer groups, state officials, and Blue Cross and Blue Shield plans because the association plans tend to attract groups with younger, healthier workers, leaving behind older, sicker people in more comprehensive, more expensive plans that fully comply with the Affordable Care Act. This is likely to drive up premiums for older and sicker consumers.

Association plans could provide an alternative for those who don’t want insurance through an Affordable Care Act insurance exchange, including counselors. Affordable Care Act premiums are designed to be the same for everyone who signs up, regardless of their health status, with subsidies that vary based on income level. Association plans don't have to do the same.

Association plans aren’t allowed to explicitly discriminate against individual applicants on the basis of their health history, but experts say there are ways they can attract healthy customers and discourage sick ones. In many cases, association plans would be free to customize their benefits packages and avoid covering expensive treatments. A plan that doesn’t cover substance-abuse treatment might be cheaper for a consumer, but would push people who know they need those therapies into the Affordable Care Act market instead, where all plans have to cover a set of essential health benefits.

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