Self-Insurance Protection Act

Mr. Speaker, by direction of the Committee on Rules, I call up House Resolution 241 and ask for its immediate consideration.

Mr. Speaker, for the purpose of debate only, I yield the customary 30 minutes to the gentleman from Florida (Mr. Hastings), pending which I yield myself such time as I may consume. During consideration of this resolution, all time yielded is for the purpose of debate only.

General Leave

Mr. Speaker, I ask unanimous consent that all Members have 5 legislative days to revise and extend their remarks.

Mr. Speaker, in 2010, then-President Obama said: ``If you like your health insurance plan, you can keep it.''

Unfortunately, at least 4.7 million Americans now know that was simply not true. ObamaCare was a takeover of the American healthcare system. The law's mandates have been burdensome, destroying 300,000 small-business jobs and forcing an estimated 10,000 small businesses to close. Premiums are skyrocketing, and choices are dwindling.

House Resolution 241 provides for the consideration of H.R. 1304, the Self-Insurance Protection Act, an important part of the Republican effort to repair the damage ObamaCare has done to insurance markets. More than 150 million Americans--62 percent of workers--receive their health insurance from their employer. In fact, almost all firms with at least 200 or more employees offer health benefits, and just over half of smaller firms with 3 to 199 employees offer health insurance.

Overwhelmingly, Americans and their employers like this system of employer-sponsored health care; and for many years, employer health plans have been successfully regulated by the Employee Retirement Income Security Act, or ERISA.

Typically, small and large employers offer healthcare coverage to employees either in self-funded arrangements or purchase fully insured plans from an insurer.

Under self-insurance plans, employers cover the costs of their employees' medical expenses. Employers can either process claims in- house or work with a third-party administrator to oversee and implement the plans.

ERISA regulates both fully insured and self-insured plans, but only self-insured plans are exempt from the patchwork of mandates imposed under State insurance law. Furthermore, employer-sponsored self-insured plans are not subject to the same requirements under ObamaCare, as are fully insured plans.

Thus, self-insurance plans are desirable and successful because they are free from many government restrictions and regulations and allow employers to tailor their plans to meet the unique needs of their employees and to innovate.

For example, these plans do not require employees to purchase government-mandated coverage options that their employees do not want or need. This helps lower costs for working families while ensuring access to high-quality health care.

In hearings before the Education and the Workforce Committee, on which I sit, we heard testimony that today self-insurance is often the only way employers can afford coverage, thanks to the burdens of ObamaCare.

Mr. Speaker, in Alabama, we like to say: if it ain't broke, don't fix it. Prior to ObamaCare, there were problems in our Nation's healthcare system, but the successful model of employer self-insurance wasn't one of them. Today, self-insurance remains perhaps the best way for employers to provide health care to their workers.

Unfortunately, the prior administration seemed intent on disrupting this successful healthcare model. Rather than leave self-insurance plans alone, they repeatedly explored ways to impose new regulations that would negatively impact self-insurance. Specifically, the Obama administration wanted to disrupt the model by regulating stop-loss insurance and treating it as if it were health insurance.

Employers who self-insure often purchase stop-loss insurance to cover large medical claims and to protect against the financial risks such claims can pose. Despite decades of Federal regulation on employer health plans under ERISA, stop-loss insurance has never been regulated by the Federal Government. That is because stop-loss insurance is actually a financial risk management tool designed to protect employers from catastrophic claim expenses. Remarkably, in a regulatory grab, the Obama administration tried to reclassify it as ``group health insurance.''

Mr. Speaker, if the last 7 years have taught us anything, it is that more Federal control over health insurance does not make health care more affordable for the American people. Stop-loss insurance is not health insurance, and it should not be regulated like it is.

The Self-Insurance Protection Act simply updates the law to make clear that Federal bureaucrats cannot redefine stop-loss insurance as group health insurance. This is about reaffirming longstanding policies and ensuring workers continue to have access to a health insurance model that is proven to lower costs and provide flexibility to consumers.

This bill will provide workers and employers alike with the regulatory certainty that they have desperately wanted and needed. They shouldn't have to worry about unelected Federal bureaucrats stepping in and destroying their healthcare system.

To put it simply, this bill is necessary in order to prevent future bureaucratic overreach that would destroy the self-insurance model that has been so successful for so many working families.

I also think this bill is an area where we should have some bipartisan cooperation. It passed out of the Education and the Workforce Committee earlier this year on a voice vote, and I hope it earns bipartisan support here in the full House.

As we continue our efforts to increase choices, lower costs, and provide better healthcare options for working families, let us not forget to shore up and protect the health insurance programs that are actually working and getting the job done.

Mr. Speaker, I urge my colleagues to support House Resolution 241 and the underlying bill.

Mr. Speaker, I reserve the balance of my time.

Mr. Speaker, I yield myself such time as I may consume.

Mr. Speaker, my colleague from Florida said that the Moon is not the Sun. Well, stop-loss insurance is not health insurance, but the Obama administration tried to make it so. Because they tried to make it so, we need to put into statutory law what I think we all agree on both sides of the aisle not only is the law but should be the law so that there is no question about it in the future. It is unfortunate we have to do that, but, because of some of the actions of the prior administration, it is necessary.

He talked about the strong foundation of the ACA, ObamaCare. That foundation is crumbling beneath the program. We now have more insurers jumping out of exchanges. My home State of Alabama is down to one carrier on the exchange. Soon enough, we may find that, in Alabama, like some other States, there are no carriers. This isn't a foundation. It is a foundation made of sand--and the sand is leaking out. Something has to be done.

Today's bill is a step--not the only step--in that direction. I know my colleagues on the other side of the aisle agree with what we are doing here in substance, and I wish we would just come together and get this bill done so that we can assure that the self-insured smaller employers and larger employers have the protection that they need for the working families that participate in their programs.

Mr. Speaker, I reserve the balance of my time.

Mr. Speaker, I reserve the balance of my time to close.

I yield myself the balance of my time.

Mr. Speaker, I thank my colleague from Florida for his remarks. I completely agree with him. Both parties should be working together to make sure that we provide what we can reasonably for the health care of the people of America, and we should be collaborating, not just in this House across the aisle but in the Senate as well. I think it is a good place to start right here with this bill because we really don't have a substantive disagreement about this bill.

Both sides understand that stop-loss insurance is not health insurance. It is just the Obama administration tried to turn it into that. This bill would stop that and bring the certainty we need back to these self-insured plans that mainly small employers have and make sure that we have in place for working families across America a system that is working for them and maintain that.

I hope that my colleagues on the other side of the aisle will join with us, will collaborate with us, and that our colleagues in the other House, in the Senate, will do as well and pass this legislation because it truly is bipartisan in substance and, I hope today, in the vote.

Mr. Speaker, I again urge my colleagues to support House Resolution 241 and the underlying bill.

Mr. Speaker, I yield back the balance of my time, and I move the previous question on the resolution.

Mr. Speaker, I yield myself such time as I may consume.

Mr. Speaker, H.R. 1304, the Self-Insurance Protection Act, purports to protect stop-loss insurers from being regulated at the Federal level. It appears that we are considering a bill that is a solution in search of a problem.

I am not opposed to stop-loss insurance or the purpose of stop-loss insurance. It can be helpful in shielding employers from unforeseen risks in many instances when they choose to self-insure and want to protect themselves from unexpected and unusually high expenses.

Now, while many self-funded plans, in conjunction with the purchased stop-loss, look like a traditional fully insured plan, stop-loss coverage itself is not regulated at the Federal level. There is no indication or suggestion that the administration would seek to regulate stop-loss insurance, so the bill prohibits Federal regulation of stop- loss insurance.

The Federal Government does not regulate stop-loss insurance today, and doesn't look like it is going to seek to regulate self-insurance in the foreseeable future, so it is difficult to ascertain exactly what the purpose of the bill is.

But employers, particularly small ones, do face risks when self- insuring. I think it is important that we ensure that employers are aware of the risks and protect them and their employees when appropriate. They can incur tremendous losses if the employee incurs a serious injury or illness.

Employees are also at risk of receiving fewer benefits because many consumer protections do not apply to self-funded plans.

Employers are legally prohibited from discriminating on the basis of health status, but stop-loss insurers are not. Many policies have provisions that will trigger immediate, even retroactive, increased premiums when the stop-loss insurer receives greater-than-expected claims.

To date, many States have taken action to regulate stop-loss insurance in order to protect both businesses and workers. Some have required a minimum, what is called attachment point. That is when the stop-loss insurance kicks in. Others have restricted the selling of stop-loss insurance with certain small group markets.

New York prohibits the sale of stop-loss insurance to small employers, and prohibits employers from serving as their own third- party administrators. North Carolina has chosen to regulate stop-loss insurance as if it were normal health insurance, holding stop-loss insurance to the same standards of others in the market.

Now, if States want to ban stop-loss insurance altogether, that should be a State prerogative. States have taken these steps because, frankly, self-insuring and stop-loss insurance come with greater risks to both employers and employees. Stop-loss plans place annual limits on services. Some place annual limits on services or exclude coverage for certain benefits, such as prescription drugs.

Furthermore, the renewal of stop-loss insurance is not guaranteed, so if an employer suddenly has high medical costs, the stop-loss insurer can refuse to renew or charge so much that it is no longer affordable.

In the committee markup, the gentlewoman from Oregon (Ms. Bonamici) offered a clarifying amendment to ensure that this legislation would not be construed to restrict the ability of States to regulate stop- loss insurance.

Chairwoman Foxx agreed to include such clarifying language in the committee report, agreeing with the intent of that amendment. Based on that understanding, that amendment was withdrawn.

The clarifying language is in the report, and that clarification is vital to ensure that there is nothing in the bill that incorrectly can be interpreted as to preempt or restrict a State's ability to regulate stop-loss insurance as they see fit, or otherwise restrict effective oversight and regulation of these policies at the State level. I appreciate the majority's willingness to work with us on the inclusion of that clarifying language.

Mr. Speaker, while I don't intend to oppose the legislation, I would note that it seems to be a distraction from the Republicans' recent failed attempt to repeal the Affordable Care Act. After 7 years of complaints, the Republicans offered an alternative which was demonstrably worse than the Affordable Care Act on every measure; more people uninsured, higher prices, and the policy you end up getting is worse.

Democrats will continue to resist any attempts to move this country backwards by making health insurance less accessible and less affordable to American families.

Mr. Speaker, I reserve the balance of my time.

Mr. Speaker, I yield myself such time as I may consume.

Mr. Speaker, we are continuing to hear complaints about the Affordable Care Act. Whatever someone thinks about the Affordable Care Act, I think it is important to look at the replacement that was offered just over a week ago which actually would have made

things worse. It would have increased the number of uninsured, it would have increased the price, it would have reduced the quality of the product, and it would have made it less likely that insurance companies would come in and offer anything at all.

If we are going to amend the Affordable Care Act, we ought to improve it. We ought to make things better. We should first do no harm with the Affordable Care Act, and we should not allow this administration to sabotage the Affordable Care Act. When they said it might implode, we have to be careful that they are not doing the implosion. There are things that this administration can do to undermine the Affordable Care Act and sabotage it, and we would hope that we would join in a bipartisan effort to make sure that that does not happen.

Mr. Speaker, I reserve the balance of my time.

Mr. Speaker, I yield myself the balance of my time.

Mr. Speaker, this bill prohibits Federal regulation of stop-loss insurance. The Federal Government does not regulate stop-loss insurance. It does not affect the States' ability to regulate the insurance, and that is where it should be done. So the bill does no harm. I would hope that, after this bill, we will refocus our efforts into addressing some of the challenges with the Affordable Care Act by first doing no harm, not going backwards like the bill did several days ago where the costs went up, the number of insurers went down, and the quality of the insurance was worse. We can improve healthcare coverage in this country, but we can't do it if the first step is a backward step.

Mr. Speaker, I yield back the balance of my time.

Mr. Speaker, I yield myself such time as I may consume, and I thank the gentleman for yielding me the customary 30 minutes for debate.

Mr. Speaker, I rise today to debate a rule for a piece of legislation that many on this side of the aisle do not necessarily have a serious issue with. The attempt here today is to ensure that a thing that is already happening continues to happen.

I suppose that, the next time we meet, we will take up a bill that declares that the Moon is not the Sun. Doing so is a complete waste of time, but that does not seem to necessarily be dispositive when deciding whether we should legislate on an issue these days.

Look, I get it. My friends across the aisle took one on the chin the other week when their Affordable Care Act repeal bill--a bill they spent 17 days working on, even though they had 7 long years to prepare for it--went down in flames in a most public and spectacular fashion, and now they need some time to dust themselves off and become reoriented.

The problem is, while they are doing that, while they are recovering from the miserable failure that was their attempt to strip 24 million Americans of their health care, they are burning valuable time--time that should be used to tackle more pressing issues like addressing the debt ceiling and fixing our crumbling infrastructure.

Let me also take this opportunity to remind my Republican colleagues that, while we spend our time here today debating these filler bills, there are only 7 legislative days, including today, remaining before the government runs out of funding. But are we tackling any of these importance issues or ensuring the government remains open? No.

Instead, we have before us a bill that addresses an issue that is not an issue. On top of that, this legislation was actually supposed to be the third bucket of their three-bucket strategy to end health care for millions of Americans.

We saw how sturdy the first bucket was a couple of weeks ago. In fact, the bucket we are talking about today was actually referred to as the ``sucker's bucket'' by Senator Cruz. That is not exactly a glowing endorsement.

Indeed, some, like Senator Cotton, have referred to all this bucket talk as simply a bunch of political spin. Whatever it is, it is certainly a bucket that has a hole in it.

In all of the uncertainty facing my Republican friends, one thing becomes crystal clear: they have no plan whatsoever to help working Americans achieve the American Dream. They are adrift, in general, and most particularly when it comes to health care.

What do they really want? At first, it was repeal, then it was repeal and replace, then it was repeal and delay, followed finally by access to coverage, and would you believe another one: patient-centered.

That is repeal, repeal and replace, repeal and delay, access to coverage, and patient-centered. We still don't have a plan. Then it turned toward a three-bucket strategy that makes little to any sense, let alone to the American people but even to powerful elected leaders in the Republican Party.

At the end of the day, Mr. Speaker, do you know what all this talk was?

Exactly what Senator Cotton said: nothing but political spin.

My fear is that it will all come down to whatever it takes to win in the eyes of the other side of the aisle, regardless of the consequences to the American people.

While we were told there was no plan B, we now hear there is a plan B. Donald John Trump ``doesn't lose,'' and doesn't like to lose. So I guess they are going to pass something, even if it is just this bill that does absolutely nothing, just so our Republican friends can say they did something. I am sure Donald John Trump will tweet about this great victory.

Mr. Speaker, Republicans must end their secretive plan B option and embrace the opportunity to do what is right, which is to pursue a path that strengthens and builds upon the strong foundation that has been set by the Affordable Care Act.

Democrats stand ready to work with my friends in the Republican Party on this task to continue to provide affordable coverage to millions of American citizens.

Mr. Speaker, I reserve the balance of my time.

Mr. Speaker, I yield myself such time as I may consume.

Mr. Speaker, yesterday, Donald John Trump signed into law a measure that eliminates Americans' internet privacy. With Trump's signature, internet service providers will now be able to sell your personal information to the highest bidder.

Mr. Speaker, we stand here ready to fight for the privacy of the American people.

If we defeat the previous question, I am going to offer an amendment to the rule to bring up legislation which would reinstate the Federal Communications Commission's internet privacy rule.

Mr. Speaker, I ask unanimous consent to insert the text of my amendment in the Record, along with extraneous material, immediately prior to the vote on the previous question.

Mr. Speaker, I yield 5 minutes to the gentlewoman from Nevada (Ms. Rosen), a member of the Armed Services and Science, Space, and Technology Committees to discuss our proposal.

Mr. Speaker, I yield myself the balance of my time.

It is time for my friends on the other side of the aisle to end their self-proclaimed political spin designed to bewilder and confuse average Americans, making them believe that their Republican representatives are fighting for the future of their health care and the health care of their families, when what they are really doing is fighting for powerful corporate interests.

Now is the time for us to face facts and accept truths.

Fact: House Republicans made an attempt to replace the Affordable Care Act with a bill that caused such an outcry from their own constituents that they were forced to pull it.

Truth: There are serious issues in health care that need to be addressed for the betterment of all Americans, and it is going to take the effort of both parties in both the House and the Senate working together to strengthen our healthcare system.

No more smokescreens, no more political rhetoric, only collaborative discourse using only the well-being of the American people as our compass. It is this approach that will steer us back onto course for the betterment of this and future generations. Unfortunately, this bill does not further that effort.

Mr. Speaker, I urge a ``no'' vote on the rule and underlying measure, and I yield back the balance of my time.

Mr. Speaker, on that I demand the yeas and nays.

Mr. Speaker, I demand a recorded vote.

Mr. Speaker, pursuant to House Resolution 241, I call up the bill (H.R. 1304) to amend the Employee Retirement Income Security Act of 1974, the Public Health Service Act, and the Internal Revenue Code of 1986 to exclude from the definition of health insurance coverage certain medical stop-loss insurance obtained by certain plan sponsors of group health plans, and ask for its immediate consideration in the House.

Mr. Speaker, I ask unanimous consent that all Members may have 5 legislative days in which to revise and extend their remarks and include extraneous materials on H.R. 1304.

Mr. Speaker, I yield myself such time as I may consume.

I rise today in strong support of H.R. 1304, the Self-Insurance Protection Act.

Mr. Speaker, across the country, hardworking men and women are struggling to afford rising healthcare costs, and their options continue to drop year after year. At the same time, employers, large and small, are finding it harder to provide the type of high-quality, affordable healthcare coverage their employees need.

With over 150 Americans relying on an employer-sponsored health plan, Congress must do everything possible to ensure employers have the tools they need to help control healthcare costs for working families. Preserving access to self insurance is one simple step we can take as part of that effort.

More than 60 percent of employers who offer healthcare coverage choose to self-insure. This means that instead of purchasing a plan from an insurance company, employers pay their employees' healthcare costs directly. As a result, the employers have greater flexibility to structure a healthcare plan to the unique needs of workers and their families.

Although these plans provide important protections, they are free from certain restrictive rules that force workers to purchase one-size- fits-all benefits that they may not want or need. Self-insurance is a popular option that often leads to lower health insurance premiums for workers and their families.

In years with below average medical claims, any remaining healthcare dollars can help offset premiums for workers the following year, or can be used to help create new jobs and higher wages.

It is not just private sector employers who like the flexibility and affordability of self-insured health coverage. It is also embraced by labor organizations, schools, cities, and counties.

Of course, there is some level of risk associated with these plans. That is why employers purchase stop-loss insurance, so that employees can count on their healthcare coverage when they need it. Because it simply serves as a financial backstop to an actual health insurance policy, stop-loss has never been regulated as health insurance by the Federal Government. Never.

But as we all know, the previous administration had a constant urge to regulate practically every aspect of American life, regardless of the consequences. It was only a matter of time before the Obama administration made stop-loss insurance one of its regulatory targets, even though many employers would find it nearly impossible to self- insure as a result.

Limiting a popular free-market healthcare option that millions of Americans rely on was a price they were willing to pay in order to push their government-run healthcare scheme.

Fortunately for working families, the Obama administration was unsuccessful, and we now have a new administration committed to expanding, not limiting, affordable healthcare options. However, all this highlights the need to protect access to self-insurance.

Employers need long-term certainty when it comes to the healthcare benefits they provide, and working families deserve peace of mind that they won't lose the plan they like because of a partisan, unnecessary Federal regulation. The Self-Insurance Protection Act provides that certainty and peace of mind by reaffirming existing law and preventing Federal bureaucrats from regulating stop-loss as health insurance.

There is more we can and should do to promote affordable healthcare coverage for working families. This legislation is one small step we can take to ensure Americans can continue to benefit from flexible healthcare plans that help lower costs.

I urge my colleagues to stand up for affordable healthcare options for workers and employers by voting in favor of H.R. 1304.

Mr. Speaker, I reserve the balance of my time.

Mr. Speaker, I yield 5 minutes to the gentleman from Tennessee (Mr. Roe), the author of the bill, a member of the Education and the Workforce Committee, and chair of the Veterans' Affairs Committee.

Mr. Speaker, I yield 3 minutes to the gentleman from Michigan (Mr. Walberg), chairman of the Health, Employment, Labor, and Pensions Subcommittee.

Mr. Speaker, I yield 2 minutes to the distinguished gentleman from Michigan (Mr. Mitchell) who is a member of our committee.

Mr. Speaker, I yield myself the balance of my time.

Mr. Speaker, we all want workers and employers to have access to high-quality, affordable healthcare coverage, and that is exactly what this legislation is about.

Our Nation faces significant healthcare challenges. Costs are soaring, and choices are diminishing. This legislation will in no way address all of these challenges; however, it is one step we can take to protect access to affordable healthcare options for workers and employers.

Let's give workers and employers who rely on self-insured healthcare plans a little bit of certainty and peace of mind today by passing this commonsense legislation.

Mr. Speaker, I urge Members to vote in favor of the Self-Insurance Protection Act, and I yield back the balance of my time.

Mr. Speaker, on that I demand the yeas and nays.

Mr. Speaker, I rise today in support of the Self-Insurance Protection Act, H.R. 1304.

Mr. Speaker, I find it hardly plausible you could make something worse where one-third of the counties in my district have no option to buy any insurance on the exchange, and the third largest county in the State of Tennessee has no option. So I would beg to differ, Mr. Speaker.

We all want to ensure workers have access to high-quality, affordable health coverage. That is exactly what this legislation is all about.

Self-insured plans offer high-quality healthcare coverage at a reasonable cost for workers. This popular option allows employers to pay their employees' healthcare costs directly and, if costs are lower than expected, those savings can be reserved for later years to help cover their workers' future healthcare costs.

One of the benefits to self-insurance is that employers have more flexibility to customize their healthcare plans as they see fit for the unique needs of their employees. These plans are also free from many of the restrictive requirements associated with traditional healthcare plans, requirements that limit choices and force employees to purchase specific benefits they may not want or need.

As healthcare costs have risen, many employers have turned to this cost-effective model. In fact, in 2016, more than 60 percent of all employers offering health insurance coverage were self-insured, of the 160 million or so people in this country that have insurance through their job.

Even the labor unions have embraced this approach. However, employers may also take greater financial risk when providing this popular option to workers. To help mitigate that risk, many employers opt to purchase stop-loss insurance.

Stop-loss insurance is not health insurance, nor has it ever been considered health insurance under Federal law. It does not process medical claims, and it does not perform any other traditional function of health insurance. What it does instead is provide employers choosing to provide self-insurance with a financial backstop, protecting the benefits of workers and their families.

Unfortunately, the former administration threatened to regulate stop- loss insurance as traditional health insurance, a move that would put workers and their families at risk of losing access to the self-insured market. While we now have a new administration that understands the importance of providing more pathways to affordable healthcare coverage, Congress must also act to ensure that no future administration will be able to restrict the self-insurance option. The Self-Insurance Protection Act does just that.

This legislation reaffirms longstanding policies, prevents future bureaucratic overreach, and clarifies once and for all that stop-loss insurance is not health insurance. By supporting H.R. 1304, we will promote more choices and protect access to affordable healthcare coverage options for families.

Let me put this all in English. I was the mayor of Johnson City, Tennessee, where we had a self-insured plan for the teachers and for the workers there at the city. The city provided an opportunity for people to have health insurance for their families. We would accept risks up to $250,000, and then we bought policies to protect the taxpayers and the city from any costs that went above that.

What this plan also allowed us to do is put in incredibly innovative health prevention, things like wellness programs, smoking cessation, weight loss, diabetes screening, lowering cholesterol. We put all those things in that plan, which helped hold--even with insurance premiums going up, we were able to level insurance costs going up and, therefore, save the employees and the teachers money in that community. That is all it is.

Everybody buys insurance in this country to mitigate risk. When you by homeowners insurance, you say: I will have $1,000 deductible. So if I have a roof blow off, I can stand to pay $1,000, but my insurance covers the rest.

That is all this is. It just protects risk.

Mr. Speaker, I urge my colleagues to support H.R. 1304.