Senate To Debate Association Health Plan Bill

Debate in the Senate is set to begin Tuesday on the association health plan bill (S 1955) being proposed by Sen. Mike Enzi (R-Wyo.), the AP/Atlanta Journal-Constitution reports (Freking, AP/Atlanta Journal-Constitution, 5/9).

The bill would allow small businesses and trade associations to form association health plans across state lines. Under the bill, insurers would be permitted to sell plans to businesses and individuals that do not meet current state benefits requirements. However, they then also would have to offer a plan with benefits provided under a state employees' plan in one of the five most heavily populated states -- California, Florida, Illinois, New York and Texas.

In addition, the bill would preempt state laws that limit how much insurers can vary premiums from one small business to another (California Healthline, 5/3). According to the AP/Journal-Constitution, the vote is expected to be close and fall primarily along party lines, with Republicans in favor and Democrats opposed.

Democrats are expected to offer a competing bill Tuesday that would also allow small businesses to join together to purchase health insurance. Sponsored by Sens. Dick Durbin (D-Ill.) and Blanche Lincoln (D-Ark.), the program would be set up like the Federal Employees Health Benefits Program (AP/Atlanta Journal-Constitution, 5/9).

Sen. Olympia Snowe (R-Maine) said she is crafting a possible amendment to small business health care legislation that would require insurers to provide coverage for medical treatments mandated by two-thirds of states.

In addition, Sen. Susan Collins (R-Maine) said she would offer an amendment to the Enzi bill that would require health plans not to discriminate against a provider on the basis of license or certification. She said the Enzi bill's current form could restrict patients' access to qualified professionals who are licensed or certified by state law, such as nurse practitioners or physician assistants (Carey, CQ HealthBeat, 5/8).

The House has passed legislation that is similar to Enzi's bill (Olson, St. Paul Pioneer Press, 5/9).

Enzi estimates that about one million currently uninsured workers would obtain coverage through the measure. Business groups, such as the National Federation of Independent Businesses, support the legislation, while groups such as AARP and the American Cancer Society oppose it (AP/Atlanta Journal-Constitution, 5/9).

NFIB argues that the bill would give small businesses the same buying power as big corporations and unions. However, opponents say the measure would override state laws and remove consumer protections for people buying insurance individually or through their employers (Isaac, Orlando Sentinel, 5/8).

Leaders of AARP and ACS said the measure might expand coverage but it would give people diluted benefits (St. Paul Pioneer Press, 5/9).

Ron Pollack, Families USA director, said the bill is "one of the most harmful anti-consumer health bills in recent memory" because "it leaves millions of people at the mercy of health insurance companies by eliminating a range of state laws that protect the consumer and regulate insurance company behavior."

Families USA released a report Monday stating that more than 85 million U.S. residents would lose consumer protections as a result of the legislation (CQ HealthBeat, 5/8).

Two editorials and an opinion piece were published Tuesday addressing the Enzi bill. Summaries appear below.

• Wall Street Journal: "When Ron Pollack of Families USA starts screaming, Republicans must be doing something right about health care. And so they finally are," a Journal editorial states. It adds that the measure "would increase the number of people who have" health insurance, "and that's exactly what such government-run health care advocates as Mr. Pollack ... don't like." The editorial says the "claims that the Enzi bill would allow for worthless policies and fly-by-night insurers are unfounded." It says, "Let's hope Republicans recognize the stakes in today's vote. They badly need something to show voters this fall, ... and making health care more affordable will resonate with Americans everywhere." The editorial adds, "[W]e hope [the White House is] as prepared to twist arms for this reform as it was a few years back for the Medicare prescription drug entitlement." It concludes, "A vibrant national health insurance market would be partial absolution for that expensive new burden on taxpayers" (Wall Street Journal, 5/9).
  
  
• Washington Post: "[T]he proposed bill is risky," and its "preemption of state authority might stifle creative experiments in health policy that could help solve the long-term crisis of health costs," a Post editorial states. It says, "The backers of the Senate bill ... ought to concede that viable purchasing pools can already be created within large and medium-size states; the need to recruit people from other states is powerful only in states with small populations." The editorial continues, "They should also concede that, with health policy at the federal level paralyzed, the most promising experiments in containing costs and expanding coverage are taking place at the state level; there's a risk in narrowing states' room to maneuver." The Post concludes, "If the bill's backers concede these two points, their legislation should not pass" (Washington Post, 5/9).
  
  
• Tom Daschle, The Hill: "Small businesses need help to afford health insurance. But [Enzi's bill] goes in the wrong direction," former Senate Majority Leader Daschle (D-S.D.) writes in a Hill opinion piece. He says, "It would raise premiums for those who most rely on the health care system today and make coverage more affordable only for those who need it least." Daschle adds, "It would take away important benefits people depend on today and leave them uninsured for basic care." He concludes, "And, it would prevent states like Massachusetts from making progress on what should be a national priority: providing affordable health coverage for all" (Daschle, The Hill, 5/9).