House continues push for passage of Association Health Plan legislation

The second week of May saw positive, although incremental, progress in the movement to achieve federal legislation enabling small businesses to lower their costs of health care. On May 13, the House of Representatives approved the Small Business Health Fairness Act of 2004 (H.R. 4281) by a strong, bipartisan vote of 252-162. This vote corresponds to that for an identical bill, H.R. 660, which passed in June 2003.

This legislation would greatly expand opportunities for small employers to provide affordable health insurance benefits to their employees by allowing trade and professional associations to sponsor health plans similar to those operated by large corporations and unions.

Under the current system, each state has jurisdiction over its own insurance regulations. The disparity in governing rules from state to state places unfair restrictions on associations seeking to offer policies to members and their employees.

At present, the AVMA Group Health and Life Insurance Trust faces constraints that preclude AVMA members in seven states from purchasing policies. In addition, AVMA members cannot provide policies to their employees.

Reintroducing and voting on identical legislation in the same Congress is a tactic that enables the House to reemphasize the importance of this measure. Legislation to broaden the scope of Association Health Plans has been introduced and passed by the House in previous Congresses, but has repeatedly failed to get Senate approval. A breakthrough occurred May 13 when Sen. Robert C. Byrd of West Virginia became the first Democrat to add his support to the Senate version of the Small Business Health Fairness Act (S. 545). Senator Byrd's co-sponsorship may encourage other senators from both parties to support the bill. Seven other Senate co-sponsors preceded Sen. Byrd in backing the legislation.

The House is also using some procedural maneuvers to further encourage the Senate to pass this bill. A rule approved by the House combines H.R. 4281 with two other health care-related bills and sends all three as a package to the Senate.

The AVMA has identified the Small Business Health Fairness Act as valuable legislation to which the Association assigns a status of "active pursuit of passage." As a member of the Association Health Plan Coalition, the AVMA has joined with 170 other professional and trade associations to achieve passage of this legislation.