Action Alert

April 24 , 2006

NCIL Vigorously Opposes Senate Bill 1955
Legislation would Eviscerate Patient Protections in Health Insurance

Tell Senate to Reject Health Insurance Marketplace Modernization and Affordability Act Which Could Make Health Insurance for Persons with Disabilities Unresponsive to Needs and Cost-Prohibitive

Senate Majority Leader Bill Frist (R-TN) has dubbed the first week of May, "Health Week," and has announced his intention to consider several health care bills during that week, which are supposedly designed to contain spiraling health care costs and make it more affordable to consumers. During "Health Week," Frist intends to press the Senate for a vote on S 1955, the so-called Health Insurance Marketplace Modernization and Affordability Act (HIMMA), a bill introduced by Chairman Enzi (R-WY) and approved by the HELP Committee by a party line vote on March 15, 2006. NCIL STRONGLY OPPOSES THIS BILL since it would make it decidedly harder for persons with disabilities and chronic illnesses to be able to get and afford the health care they require to join/ remain in the workforce. Between now and the first week of May it is VITAL that groups and advocates representing persons with disabilities and chronic health conditions make an all-out effort to stop this potentially devastating bill from being passed by the Senate!!!

Why we Oppose S 1955: Though it claims to help small businesses to combat soaring health care costs and purports to be a vehicle to expand public access to health care, HIMMA actually undermines state safeguards regulating health insurance policies. Title I of S 1955 is bad enough, allowing small businesses to band together to buy health insurance through Small Business Health Plans (SBHPs), or Association Health Plans (AHP)s, which would be exempt from most state health insurance laws and regulations. By itself, this would already create a major loophole for small businesses to avoid state health insurance plan requirements.

Yet Title I pales in comparison with the truly devastating Title II provisions that undercut private health insurance as we know it!!! Title II would preempt States' rights to mandate coverage of benefits, services, or categories of providers for individuals, small groups, or large groups. If adopted, this provision would strip away virtually all state-enacted consumer protections for people buying insurance individually or through their employers. Under S 1955, private plans in 18 states would no longer have to offer home health care services, 33 states would lose mental health parity, 46 states and DC would lose a requirement for diabetic screening and education, 48 states would lose mandatory mammography screenings, 26 states would lose covered prostate screenings, 7 states would lose rehabilitation services requirements & 3 states would lose guaranteed coverage for hearing aids. S 1955 would both deprive workers of the health care they require to remain in the work force and adversely impact health outcomes through de-emphasis on early diagnosis and treatment. Similarly, guaranteed access to categories of providers such as OB/GYNs, optometrists, dentists, podiatrists, psychologists, etc. would also be eliminated.

Premium rating protections, enacted by states to make small group insurance more affordable to older and sicker workers, would also be set aside. This would mean that states would be powerless to protect seniors and persons with disabilities and chronic conditions from being charged many times more for health insurance than their young and able-bodied peers. The bill sets a ceiling on, but no floor under, what states can do to protect insurance consumers. Insurers would be free to sue states that do not comply.

In this new marketplace, individuals would be forced to choose between low-cost, barebones health plans and comprehensive coverage. Those with the most medically involved conditions would be grouped together in the same plans and therefore experience soaring premiums that could become cost-prohibitive!

According to California's Insurance Commissioner, John Garamendi S 1955 "will do nothing to control healthcare costs. Instead it will simply shift them to older and sicker individuals." Wisconsin's Insurance Commissioner, Jorge Gomez adds that HIMMA "will have the effect of increasing rates for small businesses . increasing the fiscal burden on state high-risk pools and Medicaid and other safety nets, and unnecessarily hamstringing effective federal and state market conduct regulation."

NO WONDER THAT S 1955 IS COMING TO BE KNOWN AS THE "LOSE YOUR HEALTH CARE BILL"!!!

Legislative Status: Awaiting consideration by Full Senate, anticipated on the week of May 1, 2006. An Association Health Plan bill HR 525 has already passed the House. So, if S 1955 passes the Senate, these provisions are a threat to become law before the end of this Congress. Supporters describe the bill as bipartisan, but in reality, there is only one Democratic sponsor, Ben Nelson (D-NE).

MESSAGE: OUR MESSAGE IS SIMPLE: Stop S 1955 in its tracks, at all costs!!! It could have a devastating impact on employment for persons with disabilities and chronic illnesses, since removing mandated coverage and testing, as well as premium rating could compel many people to choose between taking care of their health and continuing to work and support themselves. So Senators who support expanding employment opportunities for persons with disabilities or are concerned by the growing strain on entitlements such as Medicaid and Medicare should not be supporting this bill. Furthermore, Senators who believe that government and business should be promoting a culture of respect for the value of life would lose their moral force if they support a bill that is so subversive to the general health and welfare of so many American citizens. Leaders of good will from both parties should take a firm stand against this misguided legislation and see to it that it does not become law. Though we hope a majority of Senators will take a firm stand to stop S 1955 - we join Families USA in supporting a filibuster if necessary to prevent it from becoming law.

>>Take Action:
Call or FAX your Senators in opposition to S 1955
Speak from personal experience if you, your friends, your colleagues or your consumers have benefited from the services, provider access, premium rating or other health insurance safeguards guaranteed at the state level. If affordable insurance that meets your needs is essential to your ability to remain in the work force, make sure to call attention to that fact.

>>Who to Contact: Each and every Senator should be contacted by their
constituents on this bill - because of the potentially breathtaking ramifications that it would have if it became the law of the land. Priority Senators include Gordon Smith (R-OR), Arlen Specter (R-PA), Olympia Snowe (R-ME), Lincoln Chafee (R-RI), Susan Collins (R-ME), Mike DeWine (R-OH), Joe Lieberman (D-CT), Norm Coleman (R-MN), George Voinovich (R-OH), Charles Grassley (R-IA), Pete Domenici (R-NM), Kay Bailey Hutchison (R-TX), Ben Nelson (D-NE), Jim Talent (R-MO), John McCain (R-AZ), Lisa Murkowski (R-AK), Tom Carper (D-DE), Tim Johnson (D-SD), Mark Pryor (D-AR), Blanche Lincoln (D-AR), John Warner (R-VA), Richard Lugar (R-IN), Elizabeth Dole (R-NC), Rick Santorum (R-PA) and Robert Byrd (D-WV)

>>REPORT BACK:
Tell us how your Senator plans to vote or the response from your Senator's office. Is the response favorable? Unfavorable? E-mail Daniel@ncil.org to let us know.

FOR MORE INFORMATION:
>>For a chart detailing which benefit protections would be lost on a
State-by-State basis, see http://www.familiesusa.org/issues/private-insurance/enzi/state-benefit-prote
ctions-lost.html

>>For links to a wide range of additional informational resources see
http://www.familiesusa.org/issues/private-insurance/enzi/

If you have questions, or need additional information, e-mail Daniel Davis at Daniel@ncil.org or call him at (202)-207-0334, ext# 1001.