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House Committee Supports Association Health Plans for Small Businesses

On March 16, the House Education and the Workforce Committee approved, 25-22, a bill (H.R. 525) aimed at making health care more affordable for small businesses.

Chair John Boehner (R-OH) said that “while our economy has created more than three million new jobs since August 2003, many small businesses still can’t afford to provide health insurance to their workers because of rising premium costs,” adding, “The best patient protection for uninsured working families is access to affordable health care benefits, and this bipartisan bill responds to the needs of uninsured Americans.”

Sponsored by Rep. Sam Johnson (R-TX), the Small Business Health Fairness Act would allow small businesses to form association health plans (AHPs) for the purpose of purchasing health insurance at more affordable group rates. The bill would establish rules governing these associations, including certification, sponsorship, participation, coverage, contribution rates, benefit options, and termination. Regulation of AHPs would be overseen by the Department of Labor, rather than the states.

During consideration of the bill, Rep. Ron Kind (D-WI) offered a substitute amendment that would have created a Small Employer Health Benefits Program modeled after the Federal Employee Health Benefits Program. Under the substitute, employers with fewer than 100 employees would be required to offer coverage to all employees who have completed three months of service and to pay at least 50 percent of the cost of the premium. The substitute was defeated, 21-22.

The committee also rejected the following amendments:

  • an amendment by Rep. Betty McCollum (D-MN) that would have required AHPs to cover pregnancy, childbirth, and child health supervision if such services are required by state law, 17-24;
  • an amendment by Rep. Carolyn McCarthy (D-NY) that would have included in AHPs a federal mandate for breast and cervical cancer coverage, including mastectomies, 21-23;
  • an amendment by Rep. Chris Van Hollen (D-MD) that would have required AHPs to provide direct access to obstetric, gynecological, and pediatric services if such direct access is required by state law, 21-23;
  • an amendment by Rep. Rush Holt (D-NJ) that would have required AHPs to cover contraceptive services, including all contraceptive drugs and devices approved by the Food and Drug Administration, if such services are required by state law, 19-22;
  • an amendment by Rep. Charlie Norwood (R-GA) that would have prohibited insurers from setting premiums and contribution rates based on the claims experience of the AHP, 24-24; and
  • an amendment by Rep. Rush Holt (D-NJ) that would have required AHPs to provide equitable mental health and substance abuse treatment if mental health parity is required by state law, 21-23.

 

The House approved identical legislation in June 2003, but the Senate did not act on the measure before the end of the 108th Congress (see The Source, 6/20/03).