New York, Massachusetts and Vermont have already taken steps to defang the AHP strategy, and other states have indicated their opposition to the GOP strategy. (Image: Shutterstock)

Frustrated in their attempts to demolish in one fell swoop the Affordable Care Act, Republicans have turned to a “one thousand small cuts” strategy to disable the act. Among the largest of those small cuts: expansion and promotion of association health plans, or AHPs, via a White House written rule. But if several state authorities have their way, this cut, if not healed, may be wrapped in legal bandages.

Compared to the myriad other attacks, the AHP strategy offers more long-term promise for undermining Obamacare. The Trump Administration has marketed the “skinny” plans as a solution for “the little guy”—meaning small business owners—to provide affordable insurance to employers and small business owners themselves. The key to the affordability: Such plans don't have to meet the full requirements of the act.

But AHPs can be regulated by states, and several aren't going along with the GOP plan willingly. At present, resistance is strongest in the upper East Coast. New York, Massachusetts and Vermont have already taken steps to defang the AHP strategy. But other states have indicated their opposition to the GOP strategy. And compelling reasons exist to support a states revolt.