National Conference of State Legislatures
The Forum for America's Ideas
May 9, 2006
The Honorable William H. Frist
Majority Leader
United States Senate
Washington, D.C. 20510
|
The Honorable Harry Reid
Minority Leader
United States Senate
Washington, D.C. 20510
|
Steven Rauschenberger
Assistant Senate Republican Leader
Illinois
President, NCSL
Susan Clarke Schaar
Clerk of the Senate
Virginia
Staff Chair, NCSL
William T. Pound
Executive Director |
Dear Majority Leader Frist and Minority Leader Reid:
Expanding access to affordable, quality, comprehensive health coverage to small employers, the backbone to our economy, is very important to the National Conference of State Legislatures (NCSL). It is equally important that states continue to maintain the integrity of the small group market by regulating these products and protecting their constituents who use these products. The legislation before you today, the Health Insurance Marketplace Modernization and Affordability Act of 2006 (S. 1955), makes an effort to accommodate our concerns, but unfortunately falls short. This bill preempts state laws regulating insurance in all markets, while the House-passed bill is limited to small group association plans. The sweeping preemption of state regulation of insurance, particularly state mandated benefits and state rating rules is troubling, particularly in light of the limited experience of federal lawmakers in establishing and enforcing insurance policy.
NCSL is concerned about the broad preemption of state mandated benefits. In health care we should always strive to do no harm. Under the provisions of this bill, some will lose coverage for critical health care services because this bill provides no real floor for coverage. While the provision in the bill regarding mandated benefits is anchored in state offerings for their state employees, the mechanism for determining benefit offerings is not likely to reflect the range of coverage states offer their employees. Small employers will be limited to selecting from the coverage insurance companies opt to provide. We are concerned that with no reasonable floor provided for in the bill, there is no incentive for the insurance companies to offer comprehensive coverage.
NCSL is also concerned about the preemption of state rating laws. The rating rules proposed in this bill will wreak havoc in states that have moved aggressively towards community rating. While it is unclear that uniform rating rules is necessary to promote the availability of affordable, quality health insurance for small businesses, there is no doubt that under the provisions of this bill, rates will increase for some of our most vulnerable citizens and the states in which they reside will be unable to intercede on their behalf. Finally this legislation will permit insurance companies to sue states in federal court. This unnecessary and potentially costly provision cannot be supported by NCSL.
We sincerely believe that there is a way to make affordable, high quality and comprehensive insurance coverage available to small businesses and their employees without undoing the significant and substantial work of state lawmakers and regulators over the years to ensure that insurance products offered and administered in the states meet the requirements established by the people in the states. We hope to have an opportunity to work with you toward the development legislation that would achieve this important goal.
Sincerely,
Carl Tubbesing
Deputy Executive Director
cc: Members, U.S. Senate
|
