BY ROBERT P. MADER
OF CONTRACTOR'S STAFF
WASHINGTON — Unsuccessful last year in attempts to get association health plans passed through the U.S. Senate, members of Plumbing-Heating-Cooling Contractors — National Association, again called on their representatives and senators. The contractors urged the legislators (or, typically, their staffs) to pass legislation allowing trade associations to provide group health insurance to their members. The contractors were in Washington in mid-April for the PHCC-NA Legislative Conference.
Association health plans have widespread support, including the support of President Bush who has urged Congress to pass such legislation. AHP bills currently before Congress are H.R.525 and S.406.
Lake Coulson, PHCC vice president/government relations, told contractors that the No. 1 opponent of AHPs is the insurance industry, especially the Blue Cross affiliates that fear losing business. Another opposition group is state insurance commissioners, who don't want to lose control over insurance regulation.
At a breakfast before the contractors fanned out across Capitol Hill, Sen. Russ Feingold, D-Wis., told the group he would oppose AHPs because the bill would undo all the insurance protections that he and other legislators had spent years crafting in the Wisconsin legislature.
" Straight talk from Wisconsin," Feingold said.
Feingold also spoke about unfair utility competition, a subject on which he and the contractors were on the same page.
The contractors also heard Sen. Jon Kyl, R-Ariz., speak on repeal of the death tax and Rep. Randy Neugebauer, R-Texas, on tort reform.
Following the breakfast, the contractors visited congressional office buildings, meeting with staffers through appointments made by PHCC staff. PHCC staff made more than 1,000 phone calls to House and Senate offices to nail down the appointments.
Before they hit the streets, the contractors-were told to focus only on AHPs, lest they confuse congressional staffers.
The contractors lobbied some actual legislators, although most of the contractors spoke to staffers who had little or no understanding of AHPs.
Members of the Connecticut delegation spoke with a "legislative fellow" on the staff of Sen. Joseph Lieberman, DConn., who clearly had no idea what the contractors were talking about.
The Small Business Health Fairness Act of 2005 would allow small business owners to band together through their associations across state lines to purchase group health insurance. In effect, it would allow members of an association to create the same type of group health plan as a Fortune 500 corporation or a labor union.
The AHP law would give contractors more choices. A contractor might belong to more than one association, such as PHCC and the National Federation of Independent Business, and have a choice of more than one plan.
The bill would require that associations offering plans to have been in existence for at least three years for some other substantial business purpose other than offering health insurance.
Such a health plan could either be fully insured or self-insured. If an association self-insures, the plan would be required to maintain surplus reserves of $500,000 to $2 million, depending upon the level of stop-loss coverage.
An association plan would have to have at least 1,000 participants and it would be required to take every member of the association — opponents incorrectly claim that associations could cherry-pick participants. The legislation also prohibits associations from charging any member higher premiums based on health status or prior claims experience.
AHP proponents say that contractors will save money through reduced premiums. The Congressional Budget Office has estimated that small businesses would see their premiums decline by 13% to 25%, PHCC reported, with the largest savings experienced by the smallest firms. A January 2003 Small Business Administration study showed that administrative expenses for insurers of small health plans made up 33% to 37% of claims, compared with 5% to 11% of claims for large company selfinsurance plans.
PHCC has cited independent research that says as many as 8.5 million workers who do not have health insurance would receive coverage.