March 2006

DC associations oppose controversial health bill

A controversial healthcare bill is being considered by the Senate. The bill, S. 1955, “Health Insurance Marketplace Modernization and Affordability Act of 2005,” would allow small businesses to join together to purchase health insurance through associations.

The American Chiropractic Association (ACA) has “committed to use all available resources” to defeat this bill, saying that this small business health plan bill could prove “disastrous” to chiropractors and their patients. The World Chiropractic Association (WCA) has also come out against the bill.

Other organizations, including the U.S. Chamber of Congress, are in favor of the bill, saying it would allow small businesses “to leverage the same power as their larger competitors and offer health insurance across state lines.”

ACA’S POSITION

The ACA has expressed strong opposition to the bill. It says that the bill allows insurance companies and small businesses instead of policy makers to decide benefits that consumers should have when they purchase healthcare.

ACA’s arguments include:

• The bill overrides state laws. It would allow insurers to offer plans without the benefits, services, and healthcare providers that individual state legislatures have identified as critical.

• Access to chiropractic provider protections will be lost. S. 1955 wipes out existing protections and prevents state policy makers from making future decisions about protections for the state’s healthcare consumers.

• The bill sets aside discriminatory-pricing laws. The bill would allows insurers to charge small businesses as much as 50 percent more for premiums and would allow unlimited premium increases based on the sex or age of workers.

• It forces consumers to choose between two extremes. Consumers who seek comprehensive coverage that includes chiropractic care will be forced to pay higher premiums.

The WCA concurs with the ACA, saying in a press release, “If enacted into law, S.1955 would preempt all state directed benefits legislation, not just those that are specific to the chiropractic profession. As well, this legislation would allow for highly discriminatory premiums schedules, based on age, sex, and previous health conditions for which basic consumer protections are now provided by many states.”

CHAMBER’S POSITION

The U.S. Chamber’s arguments in favor of the bill include:

• The bill allows pooling of small employers. By joining together, small employers will enjoy greater bargaining power, economies of scale, and administrative efficiencies.

• It provides consistency. S. 1955 provides rate and benefit consistency across state lines and allows for states to continue overseeing fully insured programs.

• It levels the playing field. The bill allows small businesses to provide more affordable health insurance to their employees and families. Small businesses could bargain with providers.

• The bill can reduce the cost of health benefits. The chamber estimates a reduction in cost as much as 15 percent to 30 percent.

Among other organizations involved in the debate over this bill are the National Center for Policy Analysis (NCPA) — a nonprofit, nonpartisan public policy research association, established in 1983 — and America’s Health Insurance Plans (AHIP), an association of 1,300 health insurance companies.

AHIP opposes S. 1955. It says “[association health plans] have the potential to fragment the small group market by siphoning off the young and healthy … Giving AHPs exemption from state solvency and liquidity standards and regulations runs the risk of bringing back the Multiple Employer Welfare Arrangement bankruptcy problems of the late 1980s and early 1990s … Unlike the individual states, the U.S. Department of Labor [overseer of the proposed law] simply does not have the resources to monitor the more than 22,000 national associations … potentially eligible to sponsor AHPs.”

NCPA advocates passage of the bill. It says, “Federally regulated, self-funded AHPs would help expand the small-group market and allow small employers to enjoy many of the advantages that larger employers currently have … They also would help stabilize the market by avoiding the underwriting cycle of premium spikes and dips that plague the fully insured market today.”

NCPA further states, “AHPs would not solve all the problems in the small group and individual markets. Nor would they make healthcare suddenly cheap or abundant. Nor would they substantially reduce the numbers of uninsured. But they would introduce more competition into the market, reduce unnecessary regulation and administrative costs, and make health coverage more affordable for many small employers and their employees. And they would do so without new federal subsidies or expenditures.”

Full text of the bill is available online through the Library of Congress access to legislative action, Thomas. Go to http://thomas.loc.gov/ and type in S. 1955 in the search area.

Sources: S. 1955, http://Thomas.loc.gov; American Chiropractic Association, www.acatoday.com; U.S. Chamber of Commerce, www.uschamber.com; National Center for Policy Analysis, www.ncpa.org; America’s Health Insurance Plans, www.ahip.org; World Chiropractic Association, www.worldchiropracticalliance.org.

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