President’s Message

Final Federal Association Health Plan Rule

HBA President, Darrel Bullock Sioux City Building Inspection Services

The Trump administration issued its final rule today on association health plans (AHPs) that will help small businesses – including home building firms and local HBAs – rein in skyrocketing health care costs and provide better health coverage for workers. Iowa has been especially difficult to put anything together, thanks to all of the large companies that have a significant presence in the “insurance state.”

Of particular importance to the home building industry, the rule will allow sole proprietorships and independent contractors to participate in the program, expanding access to affordable health coverage to small employers and self-employed individuals. The final rule expands the ability of small businesses to join together locally or across state lines through a bona fide industry, professional, or trade association to become large purchasers of health insurance. This ability to establish AHPs across state lines will provide additional flexibility if HBAs seek to set up such a program and could help participating member businesses attract and retain talented workers by offering competitive benefits.

The new rule also grandfathers existing regulations, so that HBAs that are already running successful AHPs can continue to offer affordable health coverage to their employees under their current system or choose to operate their program under the new definitions of the final rule.

The Congressional Budget Office estimates the final rule will allow 4 million Americans, including 400,000 who otherwise would lack insurance, to join an AHP by 2023. To minimize disruption to the health care market, there will be a staggered rollout of the new rule as follows:

  • All associations (new or existing) may establish a full-insured AHP on Sept. 1, 2018.
  • Existing associations that sponsored an AHP on or before the date the final rule was published may establish a self-funded AHP on Jan 1, 2019.
  • All other associations (new or existing) may establish a self-funded AHP on April 1, 2019.

For more information on this story or for a link to the legislative bill, visit

– Darrel Bullock, President, HBA of Greater Siouxland


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