MARCH 2, 2006 -- The Senate Health, Education, Labor and Pensions (HELP) Committee has scheduled a March 8 markup for legislation that may break the logjam of proposals to permit small businesses to pool their purchasing power and buy insurance for their workers.
"Working with a diverse group of senators and business groups representing small business, we've bridged the gap between small business proponents of traditional AHPs (association health plans) and state-based interests worried about the prospects of dramatic regulatory changes in health insurance markets," HELP panel chairman Michael B. Enzi, R-Wyo., said last week in a statement. His co-sponsors are Ben Nelson, D-Neb., and Conrad Burns, R-Mont.
Like other pending legislation to permit association health plans, Enzi's bill (S 1955), would allow business and trade associations to band together to offer group health coverage on a statewide or national basis. But Enzi's measure would force those plans to cover any mandated benefits already required by at least 45 states, a provision not included in either the House (HR 525) or Senate (S 406) versions of legislation to permit AHPs.
While the House has passed AHP legislation it faces stiff opposition in the Senate.
AHP supporters, including small business and trade associations, say the plans would help drive down the cost of insurance for small businesses and employees, and that market demands would persuade insurers to cover such services.
But AHP opponents, which include insurance and patient advocacy groups, have said that such plans would do little to cover the uninsured and would erode state laws that require insurers to cover preventative health care services such as well-child care and mammography screening.
AHP critics have also said that the plans would destroy an array of state-mandated consumer protections such as limits on premium price hikes when an employee gets sick and requirements that consumers get independent reviews when care is denied.
To allay such concerns, Enzi's measure would leave supervision of the plans with state officials, rather than turning it over to the Department of Labor, which AHP opponents said did not have the resources to regulate the plans. While Enzi's bill would permit business and trade associations to pool their members independently, they would not be allowed to establish self-insured plans, but would rather have to provide benefits through a fully funded plan.
Enzi has been receptive to hearing about the unintended consequences of AHPs, said Mary Nell Lehnhard, senior vice president of the Blue Cross Blue Shield Association, a group which has opposed AHPs.
"I feel all of our concerns have been listened to," Lehnhard said Thursday. "The process has been amazing." Her group is not supporting the measure but is not lobbying against it, either, Lehnhard said.