HR2528119th CongressWALLET

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.

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  • 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.

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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