Affordable Health Care

The need for more affordable health insurance options is a top concern among REALTORS®. DAAR believes there should be more health insurance options available that will provide necessary coverage at affordable prices.

DAAR Recommendations

DAAR believes there should be more insurance options available that will provide necessary coverage at affordable prices.

  • DAAR supports efforts to expand options and help REALTORS® find cost-effective health insurance plans.
  • DAAR supports legislative and regulatory changes to allow small business owners and trade associations to offer association health plans to their employees and members.

Overview

The need for more affordable health insurance options is a top concern among REALTORS®. According to a 2018 National Association of REALTORS® (NAR) member survey, when REALTORS® and brokers forgo health insurance, the primary reason cited is the cost of health insurance. That same study concluded that 14% of REALTORS® are uninsured. Without health insurance, REALTORS® and other self-employed individuals are unable to seek necessary medical attention and/or face significant financial burdens when they or their dependents need medical care.

Because most REALTORS® are independent contractors, they must pay for their own business expenses and health insurance coverage. Unfortunately, the options available in the current health insurance market are inadequate for people who are self-employed or small employers.

As part of efforts to address the health insurance needs of members, NAR advocates for reform of health insurance markets and Association Health Plans (AHPs). AHPs allow self-employed individuals and small employers to purchase health insurance through professional or trade associations, such as NAR. If implemented, NAR and other large groups would be able to provide coverage to all of its members, regardless of the member’s geographic location. These plans are also subject to different rules than plans in the individual and small group insurance markets and tend to be less costly.

One argument against AHPs is the fear that people will enroll in an AHP instead of enrolling in a state or federal health insurance exchange. However, this fear might not come to fruition. The 2018 NAR survey found that only 12% of its members with health insurance obtained it through a state or federal health insurance exchange.

While efforts have been made at the national and state levels to help increase the availability of health insurance for REALTORS®, many challenges still exist in addressing this situation. NAR and REALTOR® associations throughout the county will continue to advocate for creation of AHPs as an option for its members.

Background: AHPs at the Federal Level

On June 21, 2018, the U.S. Department of Labor (DOL) issued a new rule opening the door for small employers and self-employed individuals, including real estate professionals, to participate in Association Health Plans (AHPs). Shortly thereafter, more than a dozen states filed suit to overturn the rule.

On March 28, 2019, the U.S. District Court for the District of Columbia struck down parts of the AHP rule.  On May 31, 2019, the Department of Justice filed an appeal in the case.  On June 7, 2019, NAR filed an amicus brief (friend of the court brief) in support of DOL’s Appeal. Because many states created AHPs prior to the court’s decision, the potential impact of the decision remains to be analyzed. On June 21, 2018, the U.S. Department of Labor (DOL) issued a new rule opening the door for small employers and self-employed individuals, including real estate professionals, to participate in Association Health Plans (AHPs). Shortly thereafter, more than a dozen states filed suit to overturn the rule. On March 28, 2019, the U.S. District Court for the District of Columbia struck down parts of the AHP rule. On May 31, 2019, the Department of Justice filed an appeal in the case.

On June 7, 2019, NAR filed an amicus brief (friend of the court brief) in support of DOL’s Appeal. Because many states created AHPs prior to the court’s decision, the potential impact of the decision remains to be analyzed. In 2021, NAR issued a letter of support for federal legislation (H.R. 4547 and S. 896) that would expand access to AHPs to independent contractors (including real estate professionals). It would accomplish this by amending the Employment Retirement Income Security Act of 1974 to establish additional criteria for determining when employers may join in an association of employers for the purposes of obtaining a group health plan.

As of March 2021, the senate version of the AHP bill has stalled in the Committee on Health, Education, Labor, and Pensions. It has also stalled in the lower chamber as of July 2021.

Background: AHPs in Virginia

In Virginia, the 2019 General Assembly passed legislation that would have permitted AHPs and increased health care options for Virginia REALTORS®. However, the legislation was not signed into law.

Small employers in Virginia have achieved more success in the health care insurance arena. In 2018, one-person business owners (sole proprietor, single member, and single shareholder corporation) were able to access group plans and purchase coverage for qualified dependents. In 2019, single member limited liability companies were also included. These legislative victories allow single member businesses to have access to group plans that were previously only available to employer groups.

In 2021, the Virginia General Assembly passed the Association Health Plan bill, SB 1341, and was ultimately referred to the Virginia Joint Commission on Health Care for further recommendations/study. The possibility for the bill to be reconsidered in 2022 is likely, and DAAR will continue to monitor and support such legislation should efforts to reintroduce the bill commence.