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Examining room as seen during a ribbon cutting event at Dignity Health West Flamingo Campus, 9892 W. Flamingo Road, on Thursday, Aug. 10, 2017. (Jeff Scheid/The Nevada Independent)

By Scott Muelrath

Nevada leads the country in chamber of commerce-affiliated Association Health Plan (AHP) enrollment. It is not even close. If we can set aside the national politics – which may not be possible – we also have an opportunity to provide a new health plan solution for our small business community. For nonprofits and for-profits, for working owners and 1099 contractors — and their families.

Nevada’s burgeoning chamber AHP industry – led by the Henderson Chamber of Commerce and it’s collaborative partnering associations, including the Latin, Asian Urban and Boulder City Chambers of Commerce (collectively the Clark County Health Plan Association, or CCHPA) – has recently been stalled out because of understandable but painfully frustrating partisan politics. 

But there is hope. 

In just eight months, CCHPA, in partnership with UnitedHealthcare, has enrolled more than 10,000 people in its array of health plan offerings, including HMO, PPO and POS plans. Other chambers in Nevada have followed suit. There are more than 20,000 people enrolled nationally in chamber-sponsored association plans; 60 percent are in Nevada. 

All chamber-affiliated Nevada-based AHPs are fully insured products. They are Obamacare-care compliant. They cover pre-existing conditions. And it is all being done in a cost-effective manner, saving participants and their families up to 30 percent on annual premiums — and in some cases providing health-care coverage for working owners that was previously non-existent. 

These AHP plans offer great coverage to enrolled members – at least until the contracts begin to expire next year. And as it stands now, no new members may enroll. The benefits and savings currently cannot be extended to new plan participants. 

What happened?

On March 28 of this year, a federal district judge vacated a Labor Department rule that the Secretary of Labor — using rulemaking authority — had issued in June of 2018 to expand access to association health plans to small businesses, whereby small businesses, through an association (such as a chamber of commerce), could band together and provide large-group pricing and benefits to its members. In response, CCHPA formed and carefully and thoughtfully crafted its AHP, launching on September 1, 2018. 

We had anticipated the legal challenge, which is why the CCHPA and other Nevada AHPs sought to cover the afore-mentioned plan provisions mandated by Obamacare. It was a middle ground move, and a win-win: for politicians and the enrolled members who are receiving improved health-care coverage options at a lower cost. 

Now we need either a judicial or political resolution, a pathway for chamber AHPs to continue. But in this no safety-bar, no height-restriction reverse circular roller-coaster that is our national political landscape, it is difficult to predict which will occur.

Door number one is the judicial pathway, a lawful conclusion (hopefully this fall) of an expedited appeal process now underway with the Department of Justice. The outcome may well create a framework that can satisfy all definitions under ERISA (the Employee Retirement Income Security Act of 1974), but with some (likely) sacrifices being made by both sides to pass legal muster. 

Door number two is a political compromise, at a time when such compromise is nearly impossible to envision. Credit is due to our entire Nevada delegation in a bi-partisan effort to bring Democratic support to a Republican-spawned measure (Senate Bill 1170). This bill attempts to amend ERISA with additional criteria allowing for AHPs under certain guidelines, if certain Obamacare provisions are covered. Credit is also due to our state insurance commissioner who allowed the State of Nevada to take a guiding role in the process. 

There has been too much progress to not find a pathway forward. Health-care coverage for more than 14,000 Nevadans with AHP plans — many of whom had limited or prohibitively expensive healthcare options before Nevada became the national leader in improving healthcare delivery options — is at stake.

Scott Muelrath is the Henderson Chamber of Commerce (HCC) President and CEO. He has lived in Southern Nevada since 1991.

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