Health care is fast becoming an unsustainable expense for American families. This year the total cost of insurance for the typical family of four eclipsed $28,000, according to the Milliman Medical Index. Rising insurance premiums are also eroding worker compensation, as companies shift increased costs to employees.

Health care in the U.S. suffers symptoms of what Justice Louis Brandeis once termed the problem of “Other People’s Money.” Often a patient ordering and receiving medical care mistakenly believes he is not the one paying for it. This misconception is due in large part to the employer tax exemption for health insurance, which conceals the true cost of coverage from most workers.

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The Las Vegas Metro Chamber of Commerce would like to get back into the health insurance business.

Such a move became more likely Tuesday when the Trump administration announced a rule that would let small businesses or associated groups band together to purchase what are known as association health plans. The U.S. Department of Labor said the move will enable groups that share a commonality — such as an industry or geographic location — to obtain more affordable coverage.

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Small-business owners and their employees often struggle to find affordable health-care options. A major reason is that ObamaCare, among other laws, makes coverage more expensive for small businesses than large companies. That’s why the Trump administration is expanding access to association health plans, or AHPs, beginning Tuesday.

ObamaCare imposes starkly different rules on large companies and small businesses. Companies with 50 or fewer employees are subject to the law’s benefit mandates and rating restrictions, while large companies are not. This is backward. Small businesses should face the same regulatory burden as large companies, if not a lighter one. AHPs will help level the playing field.

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One perverse effect of the Affordable Care Act is that corporate America escaped some of the onerous mandates that hurt small enterprises. The Trump Administration is now trying to mitigate that inequity with a rule on association health plans, or AHPs, and perhaps the result will be a durable and popular alternative to ObamaCare coverage.

On Tuesday the Labor Department rolled out a final rule on AHPs. The point is to allow more small businesses to join forces to offer health insurance, using economies of scale to reduce costs and diversify risk. This is how corporations and unions manage health insurance in the large group market, either by paying an outside issuer or self-insuring.

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The Republican-led Michigan Legislature on Thursday gave final approval to a bill requiring able-bodied adults in the state’s Medicaid expansion program to meet work or job-related requirements, sending it to Gov. Rick Snyder for his expected signature.

Starting in 2020, adults age 18 to 62 would have to show workforce engagement averaging 80 hours a month — through work, school, job or vocational training, an internship, substance abuse treatment or community service. Michigan would first seek a federal waiver to implement such requirements that have been embraced by President Trump’s administration.

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The Obama administration sold the Affordable Care Act as a boon to small businesses and the 59 million Americans they employ. It hasn’t worked out that way.

The ACA outlawed basic insurance plans and required businesses with 50 or more full-time workers to provide gold-plated coverage most didn’t need. Almost immediately, companies began restructuring payrolls, converting full-time employees to part-time. Some took away insurance from workers who were previously covered. Walmart , for example, discontinued health care for 30,000 employees because of ObamaCare.

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President Donald Trump has found one part of the federal health law palatable: He’s allowing Obamacare rules that require chain restaurants to post calorie counts to go into effect Monday.

The rules, which are among the final pieces of the 2010 Affordable Care Act to be implemented, require restaurants to list calories on all menus and menu boards. Restaurants will also have to provide on-site additional nutritional information, such as fat and sodium levels.

The law, intended to nudge Americans to eat healthier, applies to chains with at least 20 stores.

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The Trump administration hopes to move forward with a rule expanding alternatives to ObamaCare plans by this summer, Secretary of Labor Alex Acosta said Monday.

The rule allows for small businesses and self-employed individuals to band together to buy insurance as a group in what are known as association health plans.

“We hope to have that by this summer,” Acosta said Monday during a tax reform event alongside President Trump in Florida.

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The state’s antitrust lawsuit against Sutter Health is a welcome move to stop Sutter from inflating health care costs across the Northern California market.

The lawsuit alleges that Sutter has illegally used its market power to compel commercial health plans to contract with all or none of its hospitals, extract exorbitant prices and prohibit use of financial incentives to encourage use of lower-cost providers.

The problem is not just Sutter, however, but insurance-contracted provider networks (preferred provider organizations and health maintenance organizations), where insurers negotiate medical service prices, keep those prices hidden and make other private deals that maximize revenue at purchaser and consumer expense.

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Late last year, President Trump issued Executive Order 13813, “Promoting Healthcare Choice and Competition Across the United States.” The goal was to help more Americans access additional affordable health care options. The executive order prioritizes three areas for improvement: association health plans (AHPs), short-term insurance, and health reimbursement arrangements (HRAs).

Enhancing additional affordable options are important given emerging news stories about non-subsidized families and individuals facing crushing insurance premiums and out of pocket costs and increases under the ACA.

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