Mr. Speaker, I oppose the underlying bill for many reasons. Fundamentally, it violates the concept of federalism that is embodied in our Constitution, respect for our States, and the ability of our States to be able to regulate public…
Mr. Speaker, I oppose the underlying bill for many reasons. Fundamentally, it violates the concept of federalism that is embodied in our Constitution, respect for our States, and the ability of our States to be able to regulate public safety issues and health issues for the people of our States.
This legislation would preempt the ability of my State and your State to protect the rights of our own citizens through regulation. That is wrong. That is the wrong usurpation of power by the Federal Government.
This underlying legislation would adversely affect the people of Maryland, and let me tell you why. Our legislature has passed small market reform. People who work for companies that are between two and 50 employees have the opportunity to purchase insurance, affordable health insurance in Maryland as a result of our small market reform. The passage of this legislation will mean the end of the small market reform and the opportunity to purchase insurance by small employers in my State. That is wrong.
We are going to be moving in the wrong direction with making affordable health insurance available for the people of this Nation.
Mr. Speaker, I want you to understand the Insurance Commissioner of Maryland is a Republican. The Governor of Maryland, who opposes this bill, is a Republican. This should not be a partisan issue. This should be a matter about the appropriate use of the Federal authority and it is being used wrong here.
I congratulate the gentleman from Wisconsin (Mr. Kind) for his substitute which is sensitive to the rights of our States. I hope Members will support the substitute and reject the underlying bill.
Mr. Speaker, as a member who is dedicated to protecting the rights of Americans who have health insurance and to ensuring that opportunities to secure affordable health insurance can be expanded, I rise in opposition to H.R. 525. Since coming to Congress, I have heard frequently from individuals who work in small business. They have spoken to me about the difficulties that result from a lack of health insurance coverage, skyrocketing premiums, and reductions in benefits. I remain committed to developing solutions that will alleviate the hardships faced by many Maryland families and small businesses.
However, the Association Health Plan (AHP) legislation we are considering on the House floor today is not a viable solution. H.R. 525 would exempt AHPs from State laws and State regulatory oversight. Through this special exemption, AHPs would be able to severely undermine the goal of greater health care access and affordability for Maryland residents. Although some supporters of this legislation claim it will benefit small employers, the reality is that H.R. 525 will only hurt the small business community.
H.R. 525 would leave the Maryland insurance commissioner powerless to protect our citizens. Under this misguided bill, unregulated out-of- state AHPs could operate in Maryland without being required to comply with health care safeguards enacted by our state legislature, such as:
Appropriate access to emergency care. The right to independent appeal of denied claims, Fair insurance premiums for small groups, Consumer marketing protections, Prevention of health plan failures due to insolvency.
Under this legislation, my constituents would not only lose their ability to demand an independent review of denied claims, but they would lose guaranteed access to important benefits such as emergency medical treatment and mammography screenings. Workers who purchase association health plan coverage--believing that they are getting comprehensive insurance--may very well find that they would still have to shoulder the costs of these essential services.
Not only would this bill be harmful to potential subscribers, it would destroy the small group market reforms already in place in Maryland. Twelve years ago, my home state of Maryland took a major step toward helping small businesses afford health insurance for their workers. Our reforms guarantee the availability of reasonably priced, comprehensive health insurance for all small employers. Specifically, Maryland requires all health insurers to sell a comprehensive standard benefit package designed by an independent commission to all employers with between 2 and 50 employees. The plan must have benefits that are actuarially equivalent to those required to be offered by federally qualified HMOs, and the average cost cannot exceed 12 percent of Maryland's average annual wage. Insurers have the option of offering additional benefits, but they must be priced separately. Insurers must use adjusted community rating to price their plans, and they cannot impose pre-existing condition limitations. The Maryland plan not only guarantees the availability of reasonably priced insurance, it also makes it easier for small employers to make ``apples to apples'' comparisons of health costs throughout the state.
Due to these reforms, more Maryland small businesses offer health care coverage to their employees than in any surrounding states or in the nation as a whole. Maryland's system is one in which healthy subscribers subsidize those who are less healthy. These reforms work because insurers are not allowed to ``cherry pick'' the businesses that have the healthiest workers. Association health plans have been outlawed in our state. The association health plan legislation before us would undermine our system by using the lure of lower premiums to attract firms whose workers have fewer health problems, firms whose employees might be willing to forgo some of the consumer protections offered under Maryland law. Businesses with older, sicker employees would remain in the state system, driving up premiums. H.R. 525 would, in effect, lead to the collapse of Maryland's system. I want to emphasize that this is not a partisan issue--AHS's are opposed by my own governor, our former colleague Robert Ehrlich, and by the National Governors' Association, and the National Association of Insurance Commissioners. I will submit for the Record an April 19 letter from Alfred Redmer, Maryland's Insurance Commissioner, expressing his opposition to H.R. 525.
This bill would be devastating on a national level, as well. The non- partisan Congressional Budget Office found that premiums would increase for 20 million employees and their dependents who are covered through small firms, and that 100,000 of the sickest workers would lose coverage altogether if this AHP legislation were enacted.
Passage of this legislation would be a disservice to every worker, every family, and every small business in Maryland. H.R. 525 fails to provide meaningful help for the uninsured, denies access to affordable health care for older, less healthy groups, and undermines the crucial consumer protections that our General Assembly has enacted. For these reasons, I urge my colleagues to vote against this bill.
Mr. Speaker, the following is a letter from our insurance commissioner who is opposed to H.R. 525:
Maryland Insurance Administration,
Baltimore, MD, April 19, 2005.
Hon. Benjamin L. Cardin,
House of Representatives,
Washington, DC.
Dear Congressman Cardin: As Commissioner of the Maryland
Insurance Administration I am writing to express my strong
opposition to federal legislation that would create
Association Health Plans, AHPs. I understand such
legislation, H.R. 525, has been passed, again, by the House
Education and the Workforce Committee and may soon come to
the floor of the House for a vote. H.R. 525 would allow AHPs
to form and operate in Maryland outside the authority of my
office and beyond the reach of proven State consumer
safeguards and solvency laws. If enacted into law, this could
do irreparable harm to our small group market and strip our
citizens of critical protections.
Altough I share the sponsor's concern for the growing
number of small business employees who cannot afford adequate
coverage, the fact is this legislation would do little, if
anything to address this problem. H.R. 525 ignores the root
cause of the current crisis--skyrocketing healthcare
spending. Unless spending is brought under control no
attempts to increase competition or enhance options for small
business will truly make insurance affordable and, thus,
promote coverage.
Even more troubling is the harm the legislation would do to
consumers, H.R. 525 would: (1) permit risk selection thereby
creating opportunities for ``cherry-picking'' among healthier
groups; (2) allow inadequate capital standards and solvency
requirements, both of which are inferior to existing State
standards; (3) eliminate proven State consumer protection
laws, including those designed to allow consumer appeals of
adverse plan decisions and those aimed at preventing and
fighting fraud; and (4) allow AHPs to ignore State benefit
requirements. To add insult to injury, while longstanding
State oversight and consumer protections would be eliminated,
H.R. 525 provides no additional resources to the Department
of Labor to regulate AHPs or help consumers.
I remain committed to improving access to affordable
insurance for small business owners and workers in Maryland.
Together, we can find solutions that will be effective and
not lead to greater problems in the future. H.R. 515 is
clearly not the answer and I urge you to oppose it.
Sincerely,
Al Redmer, Jr.,
Insurance Commissioner.