Final association health plan (AHP) rules spell trouble for consumers. AHPs have been around for a long time, but the new federal rules allow more groups to become AHPs and forego coverage of the essential health benefits while offering premiums varying not based on health, but on factors like geographic location, age, marital status and/or gender. Washington consumers will be protected from the worst of these plans by existing state rules that limit the formation of “self-funded” AHPs. But the new rules will allow insurance carriers to insure a wider variety of groups that were not previously considered “associations.” The AHPs may make coverage even more expensive for people with pre-existing conditions by attracting young and healthy people away from the Exchange. An Avalere analysis of the proposed rules highlighted a potential 2.7 to 4.0% premium increase in the individual market, which would ultimately increase the number of uninsured by up to 140,000 people. Washington State Insurance Commissioner Mike Kreidler says, “the damage [the AHP rule] will do to consumers everywhere who rely on stable, affordable insurance markets is profound.” The Office of the Insurance Commissioner is keeping a close eye on the potential development of new AHPs. They will be reviewing filings and ratings in an effort to protect consumers from discrimination by insurers as they implement the broader definition of “association.”