House Passes Cheaper Small Business Insurance
The bill passed Tuesday evening by a wide 263-to-165 margin but still remains controversial in the Senate.
The programs, known as association health plans, are designed to decrease health costs for small employers, who usually pay higher prices than large companies do for workers' coverage.
To cut costs, Tuesday's bill exempts the plans from state coverage mandate laws, often including minimum maternity hospital stays, equal insurance limits for mental health treatments, and other requirements. Forty-nine states have some form of the mandates in place.
"These mandates drive up the cost of premiums," says Rep. Sam Johnson (R-Texas), who leads the House subcommittee on employer-employee relations.
Rep. John A. Boehner (R-Ohio) says that what workers using the plans would lose in guaranteed coverage they would gain in cheaper insurance.
The best patient protection for uninsured working families is access to affordable health care benefits," says Boehner, who leads the House Committee on Education and the Workforce.
Boehner and other supporters marked the bill as a way to cut down on the 45 million Americans without medical coverage. Many of them work full time in small firms but cannot afford to purchase coverage because of high and rapidly rising health insurance costs.
But the actual impact on the ranks of the uninsured remains an open question. A 2003 study performed by the Mercer research group concluded that businesses participating in AHPs would realize a 10% average cut in premiums. At the same time, the plans could raise premiums for companies keeping traditional insurance by as much as 23%.
The report further concluded that while 8 million persons could gain coverage through AHPs, as many as 9 million could lose it as older forms of insurance become more expensive.
What Opponents Say
The exemptions could allow plans to "cherry pick" only the youngest and healthiest workers, leaving sicker and more expensive workers with standard insurance, opponents say.