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House Passes Legislation to Establish Association Health Plans for Small Businesses

On June 19, the House passed, 262-162, a bill (H.R. 660) designed to make health care more affordable for small businesses. The House Education and the Workforce Committee approved the bill on June 11 (see The Source, 6/13/03).

Sponsored by Rep. Ernie Fletcher (R-KY), the Small Business Health Fairness Act of 2003 would allow small businesses to come together to form associations 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 association health plans (AHP) would be overseen by the Department of Labor, rather than the states.

Many Democrats opposed the bill because it would allow AHPs to choose who would be covered, and it would bypass state mandates covering specific diseases such as breast cancer and diabetes. Rep. Nydia Velázquez (D-NY), one of only 36 Democrats to vote for the bill and a cosponsor, rejected the opposition’s argument. “If Members take one thing away from today’s debate, it should be that H.R. 660 is simply about fairness, fairness for small business owners to offer health insurance to their employees just as large corporations and unions already do,” she said.

Rep. Charlie Norwood (R-TX) was the only Republican to oppose the bill, voicing concern that it would increase premiums for small firms that already offer health insurance coverage to their employees. He claimed that “small firms would be returned to the unstable and erratic marketplace of the 1980sbefore states imposed small group reform protections.”

Rep. Ron Kind (D-WI) and Rep. Robert Andrews (D-NJ) offered a substitute amendment that would have replaced AHPs with a Small Employee Health Benefits Plan (SEHB) similar to the established Federal Employees Health Benefits Plan (FEHBP). Under the substitute, all employers with fewer than 100 employees would be eligible for the SEHB. Employers 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 amendment was defeated, 196-226.

A comparable bill (S. 545) has been introduced by Sen. Olympia Snowe (R-ME) in the Senate.

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