Associated Health Plans- another BOHICA from Congress

[BBFRN, BSN, PhD]

http://www.protectyourhealthcare.org/ourgoals.html

The goal of ProtectYourHealthcare.org is to protect consumer and employee access to quality healthcare and oppose federal legislation that would allow Association Health Plan (AHP) insurers to take away the few health protections that consumers now have under state law.

Why we oppose AHPs

Proposed legislation exempting AHPs from those consumer safeguards puts your family's healthcare at risk:

Higher Premiums: AHP insurers will raise your rates if you get sick;

Unpaid Medical Bills: AHP insurers will not be required to have cash on hand to make sure your claims can be paid;

Rejected Claims: AHP insurers will not allow you to appeal when they deny a claim;

Limited Benefits: AHP insurers will restrict essential healthcare services for consumers, including OB-GYN choice and mandatory mammogram coverage for women; and

Poor Management: AHP insurers will report, on a limited basis, to the ill equipped U.S. Department of Labor.

As Congress considers a policy solution, the question is not whether AHPs should exist - because they do today in dozens of states. It is whether Washington will protect your healthcare and reaffirm state consumer protection laws or enact a national AHP proposal that takes away the few healthcare protections you have.

Learn from history. Healthcare without protections is healthcare that hurts.

In the '80s and '90s, an epidemic of health insurance fraud swept the country. Health plans called Multiple Employer Welfare Arrangements (MEWAs) were designed to help fill an important small business need for affordable health insurance. Yet in practice, lack of consumer protections exposed too many small businesses and their employees to poorly managed and under funded health plans or outright scams, leaving hundreds of thousands of consumers without healthcare when they most needed it. In 1983, Congress eventually addressed its failed policies with federal legislation that returned regulatory authority for MEWAs to the states.

Safeguard consumers from Association Health Plans that increase insurance costs for all of us - and leave the sickest among us without care. AHPs without protections will hurt all healthcare consumers by increasing premiums and failing to expand healthcare coverage, exposing consumers to fraud and unpaid medical bills. According to the Congressional Budget Office, 20 million employees and dependents would face rate increases, and as many as 100,000 of the sickest people would lose coverage entirely if AHPs are allowed to operate outside of state consumer protection laws.

Know the truth about "affordable" Association Health Plans.

An Association Health Plan is a certified group health plan that is sponsored by a business or professional association. Legislation now in Congress will exempt AHPs and other small group health plans from more than 1,000 state consumer protection laws regarding premiums, benefits, and financial standards. They will have no limits on how much or how often they increase your premiums, or how high they set out-of-pocket costs. In fact, you will have no right to appeal your AHP insurer's decision if they deny your claim.

AHPs would be exempt from state requirements to have adequate cash reserves to pay all medical claims, increasing the risk for fraud and abuse. If your AHP insurer or the organization sponsoring your AHP folds and files for bankruptcy, your claims will likely not be given priority over general creditors. Moreover, you cannot attempt to recover unpaid claims from the organization's assets (Groom Law Group).

Despite claims that AHPs provide low-cost healthcare, the Congressional Budget Office reports that these plans would actually result in higher premiums for 80 percent of small businesses. AHPs would also increase administrative costs for small businesses, according to a study by William M. Mercer, Inc. Read a summary of the study.

An Urban Institute study concluded that AHPs would result in more uninsured Americans. Read a summary of the study.

Over 1,050 national organizations oppose exempting AHPs from state consumer protection laws, from the AFL-CIO to the American Nurses Association to the National Partnership for Women and Families.

Can America really afford healthcare without security and the most basic consumer protections?

Take action now to oppose Association Health Plans, and tell Congress healthcare without consumer protections is healthcare that hurts.