- The Washington Times - Wednesday, February 5, 2003

Federal lawmakers, energized by President Bush's call for health care reform, plan to reintroduce a bill that lets national organizations offer health coverage to small businesses in an effort to reduce escalating premium costs.
Congress has tried twice before to include association health plans with the Patients Bill of Rights but failed to get Senate support.
Advocates for the bill say that small-business workers have better access to affordable health care if they can go through a national organization.
But opponents say the legislation waives state-mandated coverage requirements, like covering mammography screenings in Virginia or in-vitro fertilization in Maryland, and would only pool the youngest and healthiest small-business workers.
If passed, the Small Business Health Fairness Act would allow national trade organizations the chance to offer health care coverage to members nationwide. It would also throw out state regulations and operate under the federal statute known as ERISA, the Employee Retirement Income Security Act.
The bill comes as the Senate today holds a hearing on potential solutions to the problem of rising health care costs for small businesses nationwide.
About 41 million people in the nation are uninsured, with 60 percent, or 24 million, small-business employees and their families, according to a study by the Kaiser Family Foundation, a nonprofit organization monitoring health care issues.
Many small business have dropped coverage or reduced it in the past three years because of rising rates, which went up 13 percent last year, the study said.
Local, state and national organizations and chambers of commerce provide association health plans, but they work on an in-state basis, following individual consumer-protection laws, coverage, and financial-solvency requirements.
"We want to provide affordable health care to small businesses," said Rep. Ernie Fletcher, Kentucky Republican and leading co-sponsor of the bill.
Critics fear these health plans put older workers at a disadvantage and allow for "cherry picking," a practice of insurance carriers picking younger, healthier workers for low rates and coverage.
"Because older, sicker workers will be penalized, it ends up raising premiums even more for small businesses," said Todd McCracken, president of the National Small Business United, a Washington advocacy organization for 650,000 small businesses.
Alissa Fox, executive director of policy for the Blue Cross Blue Shield Association, an insurance organization covering 47.2 million Americans, also said the legislationwould not cover expensive or special treatments included in state laws, putting the cost on small-business owners.
Trade associations vying to offer insurance include the U.S. Chamber of Commerce, the National Restaurants Association, the National Federation of Independent Business, American Farm Bureau and the National Association of Wholesaler-Distributors.
"These plans are about giving small businesses a choice in their health care that they don't have today," said Rep. Nydia M. Velazquez, New York Democrat and co-sponsor of the bill.
Mr. Fletcher said association health plans would increase competition in the health care industry, drive down premium costs by 20 percent to 35 percent for small businesses and offer coverage to about 8.5 million uninsured workers.
Dan Blankenburg, lobbyist with the National Federation of Independent Business, added that the bill calls for stronger insurance-solvency requirements and a "must-carry policy" that mandates that associations cannot discriminate against older workers or ones with illnesses and disabilities.

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