Association Health Plans Act
Sponsored By: Representative Walberg
In Committee
Summary
Treats certain employer associations as employers for group health plans. This bill would let qualifying groups or associations sponsor association health plans across industries and sets rules on who can join, how plans must be run, and how self-employed people are treated.
Show full summary
- Workers and families: Employees of member employers would be aggregated into a single multiple employer welfare arrangement. Plans must cover at least 51 employees across all members to qualify.
- Self-employed individuals: People with no common-law employees who own a business and work at least 10 hours per week (or 40 hours per month) could join if the plan board certifies and later monitors their eligibility. If the board finds someone no longer qualifies, coverage may be withheld for the following plan year but can be reinstated with proof of eligibility.
- Associations and employers: A group must exist at least 2 years, be formed for purposes other than buying medical care, not condition membership on health factors, and have a governing board with at least 75 percent of members being participating employer members.
- Legal effect: Offering coverage through these association plans would not be used to infer employer or joint-employer status under federal or state law.
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Bill Overview
Analyzed Economic Effects
4 provisions identified: 3 benefits, 0 costs, 1 mixed.
Health protections for association plan enrollees
If enacted, association plans could not set eligibility or charge more based on your health status. They could not deny coverage for pre‑existing conditions. These plans would still need to follow ERISA and Public Health Service Act rules, keeping current federal protections in place.
More access to association health plans
If enacted, more employer groups could be treated as a single employer to sponsor a health plan. The group would need at least 51 employees in total, be active for 2 years, and have a board where most members are employers. It could not be set up mainly to sell medical care or be owned by an insurer. Self‑employed people with no employees could join if they own a real business, earn wages or self-employment income, and work at least 10 hours a week (or 40 hours a month). The plan’s board would check and monitor eligibility; if you lose eligibility, you would not get coverage the next plan year unless you later qualify again.
New premium rules for association plans
If enacted, these plans could set a pooled base premium using all claims, then adjust each employer’s share for that employer’s risk. State law could limit or block these pricing methods. If a group has only self‑employed members and at least 20 people, everyone in that group would be in one risk pool and pay the same rate.
Plan coverage not proof of employment
If enacted, giving someone association plan coverage would not, by itself, count as proof of an employer or joint‑employer relationship. Courts and agencies could not use plan participation alone to show one business employs that person.
Sponsors & CoSponsors
Sponsor
Walberg
MI • R
Cosponsors
Allen
GA • R
Sponsored 4/1/2025
Onder
MO • R
Sponsored 4/1/2025
Crenshaw
TX • R
Sponsored 4/1/2025
Bice
OK • R
Sponsored 4/1/2025
Kiley (CA)
CA • R
Sponsored 4/1/2025
Grothman
WI • R
Sponsored 4/1/2025
Mackenzie
PA • R
Sponsored 4/1/2025
Huizenga
MI • R
Sponsored 4/1/2025
Owens
UT • R
Sponsored 4/3/2025
Harris (NC)
NC • R
Sponsored 4/3/2025
Thompson (PA)
PA • R
Sponsored 4/21/2025
Hill (AR)
AR • R
Sponsored 4/24/2025
Smith (NE)
NE • R
Sponsored 4/30/2025
Biggs (AZ)
AZ • R
Sponsored 5/29/2025
Cuellar
TX • D
Sponsored 6/5/2025
Van Drew
NJ • R
Sponsored 6/5/2025
Weber (TX)
TX • R
Sponsored 6/5/2025
Fischbach
MN • R
Sponsored 6/25/2025
Hunt
TX • R
Sponsored 6/25/2025
Goldman (TX)
TX • R
Sponsored 6/25/2025
Gosar
AZ • R
Sponsored 6/25/2025
Messmer
IN • R
Sponsored 6/25/2025
Smith (NJ)
NJ • R
Sponsored 7/2/2025
Ciscomani
AZ • R
Sponsored 7/16/2025
Hamadeh (AZ)
AZ • R
Sponsored 7/25/2025
Bishop
GA • D
Sponsored 8/15/2025
Meuser
PA • R
Sponsored 11/7/2025
Barr
KY • R
Sponsored 11/7/2025
Dunn (FL)
FL • R
Sponsored 11/20/2025
Calvert
CA • R
Sponsored 12/3/2025
Fitzgerald
WI • R
Sponsored 12/4/2025
Schweikert
AZ • R
Sponsored 12/12/2025
Roll Call Votes
No roll call votes available for this bill.
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