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From our Expert Voices conversation on plans for health care reform after Trump's executive order:

The executive order calls for broadening the definition of a "bona fide group or association" to allow a greater number of small employers that are members of local chambers of commerce or a national trade association to form fully insured "large group" or self-insured "group" association health plans.

While it's true that association health plans would not be subject to the ACA's "essential health benefits" and "actuarial value" requirements — rules that apply to "small group" and "individual" market plans — this exemption has been misrepresented to suggest that these plans can (1) deny a person coverage if they have a pre-existing condition, (2) refuse to cover preventive services, and (3) impose annual and lifetime limits on the essential health benefits.

All three claims are false. Those practices are prohibited under ACA "group health plan" standards that continue to apply. And others remain in force too — most notably, coverage for adult children up to age 26, free access to emergency care, and protections against rescinded coverage except in cases of fraud.

A fully insured association health plan is also subject to state benefit mandates, most of which are as good if not better than the federal "essential health benefit" standard. Penalties may apply to self-insured association health plans that do not cover specific "essential health benefits," including hospitalization and physician services.

Why it matters: Association health plans are by definition required to provide adequate coverage, and additional federal protections apply, including fiduciary responsibilities, a rigorous appeals process, and prohibitions against basing premium rates on an individual participant's health condition.

Other voices in the conversation:

  • James Capretta, resident fellow at the American Enterprise Institute and former associate director for health programs at the OMB: Alexander-Murray deal a flawed first attempt at bipartisanship
  • John McDonough, professor at the Harvard T.H. Chan School of Public Health and former Senate adviser on health reform: Obamacare is dead. Long live the Affordable Care Act.
  • Jeanne Lambrew, senior fellow at the Century Foundation and deputy assistant to the president for health policy in the Obama White House: Health care fix today could be undone tomorrow
  • Tevi Troy, CEO of the American Health Policy Institute and former deputy secretary of HHS: Expanding HRAs would bolster individual market

Go deeper

"Atmospheric river" swings Northern California from drought to flood

Satellite view of the bomb cyclone swirling off the coast of the Pacific Northwest and the atmospheric river affecting California on Oct. 24. Photo: CIRA/RAMMB

A series of powerful "atmospheric river" storms are delivering historic amounts of rainfall across parts of drought-stricken California and the Pacific Northwest.

Why it matters: The atmospheric river, packing large amounts of moisture, was causing Northern California to whiplash from drought to flood, as it slowly moved south overnight. It's triggered widespread power outages, flooding and mudslides.

Updated 1 hour ago - World

U.S. threatens to cut aid to Sudan after military takeover

Sudanese Prime Minister Abdallah Hamdok during a 2020 news conference in Khartoum, Sudan. Photo: Mahmoud Hjaj/Anadolu Agency via Getty Images

Sudan's civilian Prime Minister Abdalla Hamdok was put under house arrest and several other ministers were detained Monday in what appears to be a military coup in the country, per local reports.

The latest: The head of the military faction of the Sudanese government, Gen. Abdul Fattah al-Burhan, said in a statement that he is announcing a state of emergency, suspending several parts of the interim constitution and dissolving the civilian government and interim sovereignty council — the highest governing body in the country.

Facebook's pivotal week

Illustration: Aïda Amer/Axios

They're battening down the hatches at Facebook headquarters this week as the company faces a trifecta of tumult: a continuing wave of negative press coverage fueled by document leaks, a critical earnings report Monday and a reported name change looming.

The big picture: All this is unfolding as Mark Zuckerberg tries to transform Facebook from a social network into the prime mover behind a new "metaverse" of VR- and AR-driven remote work and play.

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