N.C. Farm Bureau asks state lawmakers to OK coverage that skirts ACA

The North Carolina Farm Bureau is hoping to follow Tennessee and Iowa organizations in creating a cheaper health plan that eschews Affordable Care Act rules by varying the price of coverage based on a person's health status.

Larry Wooten, president of the Raleigh-based North Carolina Farm Bureau, asked a state Senate healthcare committee on Thursday to pass legislation allowing the organization to launch an association health plan that bypasses ACA rules.

"We have many of our farmers, our insurance agents who are independent business people, and independent agribusiness that are really suffering under the extreme cost for health insurance," Wooten said in a Facebook video posted by the state's farm bureau. "We are asking the general assembly to allow us to proceed with a health insurance plan for Farm Bureau members that we've been working on for almost two years."

Wooten was not immediately available on Thursday for an interview. Details on the plan so far are sparse, but Wooten was quoted Wednesday by North Carolina Health News saying the health insurance plan would be medically underwritten, meaning the price would be varied based on a member's health conditions or medical history. The ACA banned the practice.

The North Carolina Farm Bureau's pitch to lawmakers comes after the Trump administration in January proposed a rule to allow more small businesses and self-employed workers to band together to buy insurance through association health plans and allow them to bypass some ACA consumer protections. It will soon release a final rule.

Critics of the proposed rule argue it would weaken the individual health insurance market by siphoning away younger, healthier people, leading to increased premiums for those who remain. They also worried that the new association health plans would exclude certain health benefits, like prescription drugs or mental health, from coverage, putting members at risk.

The N.C. Farm Bureau has other states to look to for a roadmap. Iowa passed a law in April that allows the Iowa Farm Bureau to partner with Wellmark Blue Cross and Blue Shield to sell so-called health benefit plans, which don't have to comply with ACA rules requiring essential benefits, barring medical underwriting, and prohibiting annual or lifetime benefit limits. Tennessee similarly allows the Tennessee Farm Bureau to sell unregulated health plans.