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The Quality Care for the Uninsured Act, (H.R. 2990), November 1999

The issue

What steps can be made to increase access to quality health care while controlling the rising costs of health insurance for small-business employees and their families?

Why it's important

According to the Employee Benefit Research Institute, 60 percent of the 43 million uninsured Americans are either self-employed or work for small businesses. This is because rising costs and increased regulation have made it much more difficult for small businesses (unlike large companies that can self-insure) to offer health insurance to employees.

The Quality Care for the Uninsured Act, sponsored by Representatives Jim Talent (R-MO) and John Shadegg (R-AZ), would amend the Employee Retirement Income Security Act (ERISA) to allow small companies to form insurance pools across state lines under the management of franchise networks, collectively bargained plans, and business and professional associations. These Association Health Plans (AHPs) would be subject to strict sponsor-eligibility requirements, including financial and other reporting criteria, for the protection of consumers. In addition, AHPs could not discriminate against an employer member based on the health status of employees, previous claims or the risk associated with the employer's business.

Key provisions of H.R. 2990:

• Small businesses would be able to negotiate better and more affordable agreements with insurance providers, which larger companies currently enjoy.
  
  
• Small businesses would have the flexibility to choose the coverage they want, including uniform benefits across state lines.
  
  
• Costly state-mandated benefits would be superceded, thus enabling small businesses to save an estimated 30 percent in overhead costs.

NRCA's position

NRCA supports the Talent/Shadegg Quality Care for the Uninsured Act, H.R. 2990, which passed the House on October 6, 1999, because it would give small businesses access to affordable health insurance for millions of their uninsured workers and families. [On October 7, 1999, the House passed the Dingell/Norwood "Patients' Bill of Rights" to facilitate lawsuits against HMOs and employers, merged it with H.R. 2990, and sent the entire package to the Senate. NRCA opposes the Dingell/Norwood bill and would like it stripped from the House package.]

The other side

Opponents of the legislation state that because the plans would not be regulated by the individual states, it would be difficult to hold AHPs accountable to enrollees.

(November 1999)

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