White House wants to hear about insurers' challenges with grandfathered ACA plans

The Trump administration wants to know what challenges employer and group health plans face in maintaining grandfathered status for Affordable Care Act plans.

The Treasury and Labor departments and HHS issued the request for information late Thursday. The request comes as the number of grandfathered plans fall.

The agencies want to understand "whether there are opportunities for the departments to assist such plans and issuers," the rule said.

President Donald Trump signed an executive order when he first entered office that directed federal agencies to reduce any financial burden from the ACA, and the request for information is a result of that order.

The ACA grandfathered certain group health plans and insurance coverage existing as of March 23, 2010. These plans don't have to meet the full requirements of ACA plans as long as they maintain their grandfathered status.

For instance, a grandfathered plan would not have to offer birth control at no out-of-pocket cost, a requirement for non-grandfathered plans.

The request for information states the number of grandfathered plans has fallen every year since the ACA was enacted. The agencies only want comments on the challenges that grandfathered employer or group health plans face, as there are very few individual market customers that have grandfathered plans compared to the employer-sponsored market.

In 2018, 20% of employers offering health benefits offered at least one grandfathered plan and 16% of covered workers are enrolled in such a plan, according to a survey from the Kaiser Family Foundation.

The foundation said that some companies, smaller businesses in particular, had trouble determining whether or not a plan is grandfathered.

The foundation's 2017 survey found that 23% of employers offered grandfathered plans.

The request also seeks information on why participants and beneficiaries stayed in grandfathered health plans even if alternatives were available.

The administration has made several moves to present alternatives to ACA-compliant plans.

HHS adopted regulations last year that expanded access to certain health plans that are cheaper than plans that are sold on the ACA's exchanges on the individual market. The administration expanded the duration of short-term plans from 90 days to nearly 12 months and expanded access to association health plans.

Both plans are cheaper than a plan sold on the individual market because they do not have to meet all insurance requirements such as mandatory coverage of pre-existing conditions and essential health benefits.