[Congressional Record Volume 165, Number 63 (Thursday, April 11, 2019)]
[Senate]
[Pages S2437-S2439]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
STATEMENTS ON INTRODUCED BILLS AND JOINT RESOLUTIONS
By Mr. INHOFE (for himself and Mr. Reed) (by request):
S. 1215. A bill to authorize appropriations for fiscal year 2020 for
military activities of the Department of Defense and for military
construction, to prescribe military personnel strengths for such fiscal
year, and for other purposes; to the Committee on Armed Services.
Mr. INHOFE. Mr. President, Senator Reed and I are today introducing,
by request, the Administration's proposed National Defense
Authorization Act for Fiscal Year 2020. As is the case with any bill
that is introduced by request, we introduce this bill for the purpose
of placing the Administration's proposals before Congress and the
public without expressing our own views on the substance of these
proposals. As Chairman and Ranking Member of the Armed Services
Committee, we look forward
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to giving the Administration's requested legislation our most careful
review and thoughtful consideration.
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By Mr. ENZI (for himself, Mr. Alexander, Mr. Barrasso, Mr.
Cornyn, Mr. Isakson, Mr. Braun, Mr. Blunt, Mrs. Capito, Mr.
Inhofe, Ms. McSally, Mr. Thune, Mr. Sasse, Mr. Romney, Mrs.
Hyde-Smith, Mr. Grassley, Mr. Cramer, Mr. Kennedy, Mr. Scott,
of South Carolina, Ms. Ernst, Mr. Perdue, Mr. Wicker, Ms.
Murkowski, Mr. Daines, Mr. Lankford, and Mr. Graham):
S. 1170. A bill to amend the Employee Retirement Income Security Act
of 1974 to establish additional criteria for determining when employers
may join together in a group or association of employers that will be
treated as an employer under section 3(5) of such Act for purposes of
sponsoring a group health plan, and for other purposes; to the
Committee on Health, Education, Labor, and Pensions.
Mr. ENZI. Mr. President, I rise to introduce the Association Health
Plans Act of 2019. I have been championing association health plans,
which I sometimes call small business health plans, for more than 15
years. As a small business owner, I understand firsthand the
difficulties these employers face trying to provide health insurance
for their employees. Small business owners want to provide
comprehensive health insurance to their employees, but it can be a real
struggle to afford those plans. In part due to these pressures, the
number of small businesses offering coverage has dropped substantially
over the years, from 47 percent in 2000 to 30 percent in 2017.
Few families are shielded from the rising costs of healthcare and, by
extension, the rising cost of health insurance, but among the hardest
hit are American small businesses.
Small businesses have limited ability to pool risk and lack coverage
in the market, so they often end up paying more for health insurance
than large employers who have more buying power. According to the
National Conference of State Legislatures, small businesses pay about 8
to 18 percent more on average than large businesses for the same health
insurance policy.
To put it another way, one family shoe store probably can't get an
insurance company to play ball, but 1,000 family shoe stores probably
could. This is the premise of the association health plans. Let's let
small businesses band together and leverage their shared power in
numbers to obtain comprehensive and affordable health insurance as
though they were a single large employer.
This does not mean they are allowed to cut corners. The coverage
offered to association members is subject to the consumer protection
requirements that apply to large employers. That includes important
consumer protections established on a bipartisan basis under the
Employee Retirement Income Security Act, ERISA, the Health Insurance
Portability and Accountability Act, HIPAA, and the Consolidated Omnibus
Budget Reconciliation Act, COBRA. Association health plans also comply
with the Affordable Care Act requirements for large-employer health
plans.
Association health plans are not a new concept. They have long been
permitted under Federal law. For example, the Wyoming Chambers Health
Benefit Plan has served Wyoming's Chambers of Commerce since 2007. It
currently offers comprehensive and affordable coverage to 11 local
Chambers of Commerce, 52 employers, and 255 employees.
Last year, the Trump administration issued a new rule that made it
easier for small businesses to band together for the purposes of
offering an association health plan. Specifically, the Department of
Labor created a new ``pathway'' for forming the association so that
small businesses can band together by common industry or common
geography. For example, flower shops across the Nation might band
together to offer an association health plan, or small businesses in
unrelated professions might band together just within my State of
Wyoming.
The final rule also allowed self-employed Americans to receive
coverage through association health plans established under the new
pathway. It did not rescind the old pathway, so association health
plans in existence before the final rule can continue to operate
unchanged, or new ones can use that pathway to form.
The final rule also does not change existing ERISA preemption rules
that authorize broad State insurance regulation of association health
plans either through health insurance issuers or directly in the case
of self-insured association health plans. I will repeat that again. The
final rule does not change existing ERISA preemption rules that
authorize broad State insurance regulation of association health plans
either through health insurance issuers or directly in the case of
self-insured association health plans.
Roughly 30 association health plans have formed under the new pathway
since the Department of Labor finalized the rule. For example, the Las
Vegas Chamber of Commerce formed an association health plan covering
500 small businesses and 100 sole proprietors. The Georgia Chamber of
Commerce began taking steps to launch a new self-insured association
health plan that could eventually enroll 800,000 people. Two Michigan
small business associations joined forces to create an association
health plan that has enrolled nearly 400 small businesses throughout
the State.
There are likely more to come. According to the Congressional Budget
Office, about 4 million people are expected to enroll in association
health plans by 2023, including 400,000 who would otherwise be
uninsured.
All of this is to demonstrate one simple fact: Association health
plans work. They provide coverage to people who would not otherwise
have it, and they provide comprehensive health benefits at an
affordable price.
Unfortunately, a Federal district judge vacated the Labor
Department's final rule, threatening to disrupt coverage for tens of
thousands of enrollees in association health plans formed under the
final rule and threatening to restrict the ability of small businesses,
working families, and self-employed Americans to band together to
obtain affordable and high-quality health insurance in the future.
My bill will simply codify the Labor Department's final rule to
provide certainty for current enrollees and to ensure the pathway
remains available for new association health plans to form. It is not
intended to disrupt the State authority. That is important so we don't
need to build another Washington bureaucracy, and you can be assured of
better help if you need it. Our State insurance commissioners are much
closer to the real problems confronted by insurance consumers and are
better able to deal with those issues at a local level. It is also not
intended to affect association health plans created by other means than
the pathway established in the final rule.
There has been a lot of discussion in the Senate lately about
protections for people with preexisting conditions. I support
protecting people with preexisting conditions. Every Republican Senator
I know does too. It is important to point out that robust coverage
doesn't mean very much if you can't afford to buy it. Unfortunately,
that has been the experience for a lot of small business owners and
self-employed Americans in my State. Association health plans can help
solve this problem for small businesses. The Labor Department's final
rule didn't just expand eligibility for a type of health insurance that
has long been available for some small business owners in the United
States. It made the promise of comprehensive and affordable health
insurance coverage a reality for the same Americans who have identified
the cost of health insurance as the No. 1 problem facing small
businesses for the last 30 years.
This is not to say there is not more that can be done. The final rule
is an important step forward, but it is not a silver bullet. There is
more Congress can do to advance association health plans, and there is
more Congress can do to improve our healthcare system and address the
issues of rising healthcare costs and rising drug prices, all while
ensuring protections for people with preexisting conditions, but one
thing we can do immediately to help people with preexisting conditions
is to pass the bill I am introducing today. The district court judge
struck down the Labor Department's final
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rule and did not issue a stay, so thousands of currently covered
individuals are at risk of losing their health insurance coverage.
Passing this bill will ensure that they do not.
Small businesses ought to have the opportunity to band together and
leverage their combined strength so they can negotiate and provide
their employees with comprehensive and affordable health insurance
coverage. That coverage should be subject to the same consumer
protection requirements that apply to large employers offering similar
coverage. Small businesses and their employees are the bedrock of our
country's economy, and proper health insurance coverage is a key
element of family well-being and peace of mind. This bill will
strengthen those foundations so we can continue to prosper as a
country.
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