Lobbyist Attention Spikes on Small Business Health Plans

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By Jasmine Ye Han and Madison Alder

Lobbying activity on small business health plans spiked in the past few quarters, according to a Bloomberg Law analysis of Senate lobbying disclosures.

The increase in lobbying related to small business health plans came as the Labor Department in January introduced a proposed rule that would expand access to a type of small group insurance called association health plans. The rule, which could be finalized as early as this summer, would open up association plans to more people by changing the definition of “employer” to allow more small businesses to band together in associations by industry or geography to create a health insurance plan.

At least 84 lobbying disclosures filed on behalf of 75 organizations included association health plans or related legislation as an issue between Jan. 1 and March 31. The first-quarter reporting period ended April 20.

The push for association health plan expansion and other small business health-care options has been accelerating for decades. The DOL’s proposed rule, which was produced after the department was asked to explore the expansion in an executive order, circumvents congressional approval because the agency is revising its own interpretation of “employer” to affect the change. As a result, many of the filings included the DOL as a lobbying target.

More than 30 groups specified that they lobbied on small group health insurance every quarter since early 2017. Anthem Inc., the U.S. Chamber of Commerce, and the Society for Human Resource Management were among the groups that consistently lobbied on small group health insurance. The three groups shared their thoughts on association health plans with the DOL during the comment period ended in March, with each offering general support and several suggestions for the final rule.

There also were some new groups lobbying on the issue.

Uber Technologies, Lyft Inc., and UnitedHealth Group were among the 18 groups lobbying on association health plans or related issues for the first time since early 2017. All three groups had meetings scheduled with the head of the DOL’s benefits agency, Preston Rutledge, during his first two months in the post, according to documents recently obtained by Bloomberg Law.

UnitedHealth, which offers association health plan and small group plan products, generally supported the proposed rule in its comments to DOL but asked the agency to address several concerns. These included clarifying treatment of association plans that would cross state lines, grandfathering existing association plans, and establishing a test for self-employed individuals who would be classified under the plan as working owners. UnitedHealth and its lobbyist Fierce Government Relations didn’t respond to Bloomberg Law’s request for comment.

Uber didn’t actively lobby on association health plans in the first quarter, but the issue likely was included in the filing to reflect a letter the ride-share giant submitted to the DOL on the proposed association health plan rule, a company spokeswoman told Bloomberg Law. In its letter, Uber asked the DOL to consider gig economy workers in the final rule.

The disclosure included the association health plans issue alongside independent contractor benefits, which Uber has actively sought. Uber is “very open” about its efforts to advance portable benefits for individual contractors, the spokeswoman said.

“Issues affecting association health plans” was the only specific reference in Lyft’s lobbying report for issues related to labor, antitrust, and workplace, according to a disclosure filed by its lobbyist from Eris Group LLC. Lyft and Eris Group didn’t respond to Bloomberg Law’s request for comment.

—With assistance from Jorge Uquillas (Bloomberg Government).

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