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Education, Workforce, and Retirement

Blocking the Biden-Harris Rule to Kill AHPs

A Case Study in Effectively Using the CRA

Education, Workforce, and Retirement Policy Rapid Response BlogSeptember 10, 2024 By Brittany Madni

Background

The House Education and Workforce Committee is slated to mark up a series of legislative proposals, including H.J. Res. 181, a Congressional Review Act resolution to stop the Biden-Harris rule limiting access to association health plans (AHPs). This Congressional Review Act (CRA) resolution was introduced by Congressman Tim Walberg (R-MI-05) “to block President Biden’s Department of Labor from rescinding a Trump-era rule that expanded association health plans (AHPs).”

The Value of Association Health Plans

An association health plan is not a novel form of medical insurance. Rather, it is an instrument that provides a group of small businesses access to coverage in the existing large group insurance market. This large group coverage is typically less expensive than the options available in the small group market. Large group health plans are primarily governed by Employee Retirement Income Security Act (ERISA), and ERISA health plans cover 134 million Americans, making it the single largest insurance market in the country. These lower-cost ERISA plans provide a way to reverse the decline in small business insurance coverage. High costs have led to a decline in the number of small firms offering health insurance in the twenty-first century. In 2000, the Agency for Healthcare Research and Quality reported 47.2 percent of private sector firms with fewer than 50 employees offered health insurance. By 2023, only 30.1 percent offered these benefits. The Biden-Harris rescission of the 2018 association health plan rule allows large businesses to retain access to lower-cost ERISA health coverage, while small businesses see their access constrained. This unfairness raises questions about whether this reflects the Biden-Harris Administration’s bias against small businesses or signals their hostility toward employer-based health insurance in general, foreshadowing future restrictions on the market and Americans’ health care choices.

Congressional Assertion of Article I to Support Working Americans

Congress should generally assert its Article I authority through enhanced use of the CRA tool. In this case, it would be fiscally responsible to overturn the Biden-Harris Administration’s efforts to restrict working Americans’ health care options. Like other final rules, the Biden-Harris Labor rule on AHPs is subject to the Congressional Review Act. If this resolution of disapproval is ultimately enacted, the 2018 rule would be reinstated, thus reopening the option to the American people of association health plans and enabling small businesses to participate fully in lower-cost ERISA health coverage. Ultimately, the 2018 AHP rule reflected the will of Congress under the Employee Retirement Income Security Act (ERISA). A more flexible definition of “employer” for the purposes of affordable, desirable health care coverage is in line with the statutory authority granted to the U.S. Department of Labor under ERISA. Further, ensuring more employer-based options in the market reduce the likelihood of greater dependence by American families on government-sponsored or subsidized health care. This CRA resolution of disapproval, therefore, would simply return the regulation to a pro-growth interpretation that meets with Congressional approval and benefits the American people – as is appropriate in the Legislative Branch’s execution of its oversight responsibilities.

A Pattern of Biden-Harris Regulatory Overreach

The decision to roll back the pro-growth rule from 2018 is nothing new for the Biden-Harris Administration. According to the latest tally from the American Action Forum, the total cost of all final rules (so far!) in the Biden-Harris Administration is a staggering $1.68 trillion dollars. This is on top of the 324.7 million hours of paperwork imposed. Even the Obama Administration – which previously held the record – only imposed $322.4 billion of new regulatory costs and 260.1 million hours of paperwork, and that was over eight years, not three and a half. The Trump Administration was able to achieve a net regulatory cost reduction across the entire Executive Branch for all four years, and it did so by advancing pro-market reforms like the AHP rule from 2018. Reinstating that rule is a positive step in undoing Biden-Harris regulatory overreach.

The House Seizes an Opportunity

H.J. Res. 181 represents an important opportunity to reassert Congress’s prerogative and push back against government intervention in Americans’ personal lives. Overturning this damaging Biden-Harris Labor rule and reinstating the 2018 rule expanding access to Association Health Plans would improve health care options, reduce costs, and support small businesses. Taken together, these improvements have a positive effect on the economy and working Americans.

Author

Brittany A. Madni

Brittany A. Madni

Executive Vice President

Brittany A. Madni is the Executive Vice President of the Economic Policy Innovation Center (EPIC). She served as a Congressional aide and trusted senior advisor for a decade on Capitol Hill, developing a nuanced understanding of the legislative process with an emphasis on budget and appropriations strategy. Prior to joining EPIC, Madni was Deputy Chief of Staff and Legislative Director for Congresswoman Ashley Hinson (R-IA). Madni helped Rep. Hinson start her office in 2021, where she was instrumental in developing the Congresswoman’s policy priorities and spearheading her work on the House Appropriations Committee. Before serving with Rep. Hinson, Madni served as a senior policy advisor at the U.S. House Budget Committee under Congressman Steve Womack (R-AR) and Congressman Diane Black (R-TN). There, she managed the health and tax policy functions, as well as oversight of the Congressional Budget Office. During her tenure on the Committee, she played a critical role in developing the 2017 Republican health reform bill, along with several enacted federal budgets. Madni also served as first Legislative Director for Congressman Troy Balderson (R-OH), where she helped shape the then-freshman Congressman’s policy platforms and built his legislative team. She began her time as Congressional staff working for Congressman Tom McClintock (R-CA), where she handled budget and health care policy, among other issues. Madni’s first jobs in Washington were a series of internships on Congressional committees, where she assisted with oversight of the administration. Madni holds an M.P.S. in legislative affairs from The George Washington University’s Graduate School of Political Management and a B.A. in English and political science from Boston College. Originally from Florida, she now lives in Virginia with her husband, their son, and their dog, Pepper.

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