Health insurance pools near OK

ASSOCIATED PRESS

Employers could get a cheaper alternative when it comes to health insurance for their workers, under provisions of legislation that advanced yesterday in the Senate.

Senators voted 96-2 to limit debate on the measure, which would allow businesses to band together to offer their workers limited health insurance based on their membership in a professional trade association.

The legislation, sponsored by Sen. Michael B. Enzi, Wyoming Republican, pits business groups and insurers against health organizations and consumer groups.

Republicans and business groups say the ranks of the uninsured would be reduced because the legislation would allow businesses to offer insurance at a lower cost.

But Democrats and consumer groups who oppose the bill point out that in exchange for the lower costs, insurers would be freed from state requirements that they cover mammograms, childhood physicals and diabetes, as well as other health services.

Sen. Jim Talent, Missouri Republican, said that insurance policies for large employers already are exempt from state coverage requirements. He said it’s time to do the same for small-group coverage.

“The small-business people are paying more to get the same benefits because they have higher administrative costs and higher overhead costs,” Mr. Talent said.

But Sen. Christopher J. Dodd, Connecticut Democrat, said he fears that the insurance industry would offer plans that exclude childhood immunizations and other important services. They would also be allowed to increase premiums beyond what individuals states now allow.

“What we’re doing here is shrinking the amount of benefits offered to people,” Mr. Dodd said.

In recent decades, it has become common for states to require that insurance companies offer coverage for certain types of cancer screenings, such as mammograms, 49 states; colorectal examinations, 22 states; and cervical cancer screenings, 29 states.

But how many state mandates are too many when insurers are also required to cover acupuncture, speech therapy, or the treatment and evaluation of Lyme disease? That’s the question the Senate had before it in connection with the bill that would let insurers bypass coverage requirements mandated by states.

Insurers say the state mandates are driving up the cost of policies — and the ranks of the uninsured. States have approved more than 1,800 coverage requirements, says the Council for Affordable Health Insurance.

“Although one mandate may only increase the cost of a policy by 1 percent, 40 such mandates will price many people out of the market,” the council said in a recent report.

Opponents say the bill would result in health insurance policies that don’t protect workers when they get ill.

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