The Quality Care for the Uninsured Act, (H.R. 2990), November 1999
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Costly state-mandated benefits would be superceded, thus enabling small businesses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 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.