Trump’s administration released a new rule on June 19, 2018 that would allow businesses sharing a common industry or geographic area to join together in purchasing health insurance. On August 2, 2018, attorney generals from 11 states (including New York and New Jersey) filed a suit against the Department of Labor. They allege that the new rules violate the Affordable Care Act (ACA), also known as Obamacare, and the Employee Retirement Income Security Act (ERISA). The complaint filed by the attorney generals alleges that the AHP rule is unlawful because it undermines the statutory structure in the ACA that applies protections to individuals and small group markets. Proponents of the AHP rule argue that the rule is good because it will benefit small business owners who cannot afford traditional coverage.

Despite controversy, the Association Health Plan rule took effect August 20, 2018.