The effort to repeal and replace the Affordable Care Act (ACA) has been raging nationally for years, but in Tennessee, many state lawmakers have also been vocal about obtaining state control of healthcare. If the American Health Care Act (AHCA) becomes law, Tennessee could have the opportunity to do just that.
Under the AHCA, Tennessee would be able to opt out of two ACA regulations: the mandate that all health plans must cover 10 essential health benefits (EHBs) and the community rating requirement that says healthcare premiums cannot be based on a consumer’s health status. For small business owners, the taxes and mandates included in the ACA have resulted in fewer choices and increased costs, and NFIB has endorsed the AHCA as a first step toward healthcare reform that works for small businesses.
If Tennessee opts out of the EHB and community rating regulations, it would mean returning to the operation of a high-risk insurance pool, which provided coverage for those who would otherwise not be able to obtain it. Before ACA, Tennessee was one of 35 states that had this. It was called AccessTN, ran from 2007 to 2010, and covered approximately 4,000 Tennesseans. Under this system, Tennessean contributor and Bernard Health founder Alex Tolbert writes, enrollment was periodically closed and premiums could be more than $1,000 per month, so debate will likely be centered around making the system more efficient.
However, the AHCA would still have to get through the Senate, which has been drafting its own bill for a vote soon, and it’s unclear if the Senate version would also include an opt-out of the EHB and community rating mandates.
