Capitol Hill

Thanks to the November 2004 election results, the outlook for association health plan (AHP) legislation never has been better. President Bush's re-election ensured there would be a champion for AHPs in the White House, and he specifically urged Congress to pass AHP legislation during his State of the Union address Feb. 2.

And on Feb. 28 in a speech to the National Governors Association, which opposes AHPs, the president said: "I believe in association health plans that will allow small businesses to aggregate together, to pool risk and to be able to buy insurance—to pool risk across jurisdictional boundaries. Now, I understand that there are some issues. There are some people in your respective states, people who might have got a pretty good lock on selling insurance, that don't like this idea. But the objective is affordable insurance. And so I want to work with Congress to allow association health plans to expand."

Senate prospects

The 2004 elections improved the outlook for AHP legislation in the U.S. Senate substantially. The election of five senators who supported AHP legislation during their tenures in the House of Representatives provides a stronger foundation for building majority support for the bill in the Senate. These new senators are Richard Burr (R-N.C.), Jim DeMint (R-S.C.), Johnny Isakson (R-Ga.), John Thune (R-S.D.) and David Vitter (R-La.). Given their previous support for the AHP bill in the House, these senators have signaled they will continue to be supportive in the Senate. Therefore, this represents an increase of five votes in the Senate in favor of AHPs.

On Feb. 17, Sen. Olympia Snowe (R-Maine), chairman of the Senate Committee on Small Business, led a bipartisan group of senators introducing the Small Business Health Fairness Act of 2005 (S 406) to facilitate AHP formation. Another new senator, Mel Martinez (R-Fla.), was one of 11 original co-sponsors.

Three other developments bode well for the prospects that AHP legislation will have a plausible chance to make it out of the Senate. Sen. Judd Gregg (R-N.H.), who opposes AHPs, no longer chairs the Health, Education, Labor and Pensions Committee, which has jurisdiction over AHP legislation, and the new chairman, Sen. Mike Enzi (R-Wyo.), is more receptive to AHPs. Also, the Senate's most ardent foe of AHPs, Don Nickles (R-Okla.), retired at the end of the previous Congress. And in the past two months, Senate Majority Leader Bill Frist (R-Tenn.), a heart surgeon, has been speaking publicly of his support for AHP legislation.

House action

On Feb. 2, the House's AHP bill, the Small Business Health Fairness Act of 2005, HR 525, was introduced by House Committee on Education and the Workforce Chairman John Boehner (R-Ohio) and Reps. Sam Johnson (R-Texas), Nydia Velázquez (D-N.Y.) and Albert Wynn (D-Md.). The House passed the bill in 2004, making it the sixth time in 10 years the House has passed AHP legislation.

On March 16, the House Committee on Education and the Workforce considered amendments to HR 525 and reported it favorably by a vote of 25-22.

A letter of support signed by 14 Democrats was submitted to the committee, and the bill is expected to be scheduled for a House vote in early spring.

Developments

NRCA is a member of The Association Healthcare Coalition (TAHC). TAHC belongs to a larger lobbying effort called The Coalition Supporting Access & Choice through Association Health Plans, and NRCA is part of its steering committee. For more information about the coalition, access www.ahpsnow.com.

Hundreds of associations, including the National Federation of Independent Business and U.S. Chamber of Commerce, belong to this coalition, which saw its clout enhanced when, before the 109th Congress, the National Association of Realtors made AHPs its No. 1 issue. And in another positive development, on Feb. 22, Kentucky Gov. Ernie Fletcher (R) sent the coalition a letter supporting AHPs; the letter was circulated on Capitol Hill.

Being optimistic

AHP legislation has its best chance ever of becoming law. Once again, the key is getting it through the Senate. It will take a strong lobbying campaign to overcome resistance from opponents such as the insurance industry to get AHP legislation out of the Senate and sent to the president's desk.

If and when AHP legislation is signed into law, NRCA will be able to offer quality, affordable health insurance to its members in all 50 states. NRCA is preparing such a program in anticipation of AHPs becoming law.

Craig S. Brightup is NRCA's vice president of government relations.