Update on Association Health Plan Legislation

By Marian J. Marshall

Senator Mike Enzi, Chairman of the Senate Committee on Health, Education, Labor and Pensions (HELP), introduced his version of AHP legislation, the Health Insurance Marketplace Modernization and Affordability Act of 2005. While the AHP Coalition (of which MCAA is a member) commends Senator Enzi for his efforts to move the process forward and address the need to improve access to affordable health care benefits for small businesses, the bill is a bit off the mark for benefiting association memberships in a meaningful way. In short, the bill is about "big insurance", namely the Blue Cross Blue Shield companies and not the "little guy." The bill does not address the fact that in most states, the small business market is dominated by a few carriers because it fails to allow for self-funding. Therefore the larger insurers will be allowed to continue to exploit their market power and little will be done to enhance competition?the very thing that we want and need to reduce insurance premiums.

HELP Committee staff is meeting with a small group of representatives of our AHP Coalition this week in an effort to see if any changes could be made to the bill which would help garner our support and that of a few key Senators. However, my view is that if Senator Enzi were as interested in supporting the small business community as he seems to be in favoring the Blues, he and staff might have made a more concerted effort to work closely with our coalition early on. In conversations I've had with a few staff of HELP Committee members -- Senator Isakson of Georgia for one ? Senator Enzi and his staff will likely work through the weekend on the bill in an effort to take it to markup next week. The Chairman will likely have the votes to get the bill out of committee, but floor action is unlikely until next year. Senator Isakson's staff also told me that although her boss would not want to buck the Chairman, because he is a cosponsor of the original AHP bill, he is likely to be hard-pressed to vote for Enzi's bill. Senator Isakson may also be willing to entertain the possibility of offering amendment(s) in committee if there something in particular the AHP Coalition viewed as important enough ? and something we could secure enough votes for passage on.

Should the Enzi bill be reported out of the HELP Committee, with floor consideration anticipated for next year ? at least our AHP Coalition will have time to continue working with Senators Talent and Snowe (and Kerry) on their version and possible floor amendments. One positive aspect in all of this is that we are moving forward and when we do finally get to a conference with the House, we can be assured of much greater support from people like Speaker Hastert to include more of the components of the original AHP bill we favor such as self funding and promoting competition to reduce premium costs.

If you have any questions about this, please let me know. I'll keep you informed as things progress in the HELP Committee.