Two states attempt to help small businesses reduce their health care costs.

(This post originally appeared on The Washington Post)

Healthcare insurance remains one of the most important benefits to an employee. Yet the rising cost of providing this benefit continues to be a major headache for most businesses — particularly small businesses. What’s worse is that in this low-unemployment environment, small businesses that are vying for talented workers with larger organizations offering more generous plans are oftentimes coming up short.

Whether Washington can help remains a question mark. After failing to repeal and replace the Affordable Care Act last year, the Trump Administration is continuing its campaign to chip away at the legislation. Among the potential options under review is allowing businesses to form buying “associations,” increasing states’ oversight of Medicare and freezing the funding for certain programs under the act. In the meantime, at least two states are taking matters into their own hands.

This week, legislators in Wisconsin are preparing to voting on a way to help small businesses reduce their health care costs by helping them to pool together and form buying groups. Shannon Zimmerman, the bill’s sponsor in the state’s assembly, told Wisconsin Public Radio that his bill is targeted toward smaller companies that “don’t have the economies of scale to purchase cost-effectively.”

It sounds promising, but opponents say there’s one major sticking point: the bill allows those owners to bypass the state’s rules for providing workers with certain essential health benefits — like certain cancer screenings and co-payments for chemotherapy. Zimmerman has said he’s open to changing the proposal to include such requirements before a scheduled vote of the state’s full assembly later this week.

Meanwhile, legislators in Idaho have gone one step further. Representatives in that state just a few weeks ago passed legislation to allow businesses to offer lower-cost health insurance plans to their workers. Like Wisconsin’s, these plans also are not required to meet the essential health benefits plus other requirements of the Affordable Care Act. Although the rule, according to this NPR report, is considered by one expert to be “crazypants illegal,” legislators and some insurance companies are moving ahead with their plans, confident that their law will stand up in court.

Both Idaho’s and Wisconsin’s plans are controversial and lawsuits are almost guaranteed. But if either of these two states prevail then it could have an enormous impact on health costs for small businesses and…well…who knows where it could end? “It will mean other … states will do the same thing,” Robert Laszewski, a consultant and former insurance industry executive told NPR. “If a state can ignore federal law on this, it can ignore federal law on everything.”