The House of Representatives approved a bill July 26 that would give trade associations, such as Plumbing-Heating-Cooling Contractors -National Association, the power to pool their members nationwide and offer healthcare plans to their members.
“Affordable healthcare is of the utmost importance to our membership,” said Tim Williford, PHCC government relations chairman. “In a recent PHCC survey, 94 percent of those responding stated the uncontrolled growth of health insurance costs was their biggest concern.”
The House passed the so-called “Association Health Plans” legislation, 263-165, the highest tally of support for such legislation thus far. Similar AHP bills have passed the House several times in recent years, but have always faced opposition in the Senate.
Lake Coulson, PHCC vice president of government relations, said the idea has gained some support in the Senate in the last year or so, but probably not enough to win approval in its current form.
Disagreement over AHP legislation has always centered on who would regulate the plans. Since AHPs would cross state lines, federal laws would regulate them, in much the same way unions and large corporations purchase health insurance. As a result, however, opponents say AHPs would be exempt from state regulations covering consumer protection requirements and mandated medical services.
The bill's fate now lays with Sen. Mike Enzi (R-Wy.), the chairman of the Senate's Health, Education, Labor and Pension Committee, which oversees healthcare legislation.
Based on what Enzi has stated in the past, Coulson indicated the senator endorses letting associations offer health plans - just as long as they are regulated by the states.
“Preempting the states and providing federal oversight is a key component of the legislation, so it is unclear how both of Enzi's goals can be attained,” Coulson said.
The senator is primarily concerned that the AHP legislation may go too far by allowing some association plans to play by a different set of rules than those governing the rest of the small group insurance market.
“Associations deserve a real seat at the coverage table,” Enzi said June 30 in a Senate speech, “but that table should not have a substantial tilt one way or the other.”
Enzi has outlined several principles that will guide his approach to reaching a possible compromise. While the senator certainly believes in leaving regulatory matters up to the states, he also believes that “the current hodgepodge of varying state health insurance regulations should be streamlined.”
In addition, he favors at least allowing small businesses the ability to purchase low-cost plans exempt from expensive and complicated state coverage mandates.
“Not everyone needs or wants the same degree of coverage, and, where possible, our insurance laws should accommodate this reality,” Enzi said.
Coulson expects the Senate to take further action on AHPs sometime this fall.