ALBANY, N.Y., April 12 – Health care advocates,labor officials, and heads of nonprofit health plans insuring over six million New Yorkers joined the Senate and Assembly Insurance Committee Chairmen in urging the United States Senate to reject a federal bill that would undermine New Yorks health care consumer protection laws.

The strong opposition centered on the Health Insurance Marketplace Modernization and Affordability Act (S.1955)sponsored by Senator Mike Enzi (R-Wyoming) and reported out of the Senate Health, Education, Labor and Pension committee for consideration by the full Senate.The legislation authorizes business groups and associations to form Small Business Health bPlans (SBHP)and offer health insurance coverage through insurers to small and large businesses.It exempts SBHPs from state laws in three key areas: how rates are calculated for coverage; the benefits that policies must contain; and the rights and protections provided for health care consumers.

N.Y. Legislature Objections

Senator James L. Seward (R/C/I- Chenango), Chairman of the Senate Insurance Committee, expressed grave concern that if enacted this proposal could seriously impact the insurance market in New York State in a very negative way.The Enzi proposal would essentially allow businesses participating in the new small business health plans to completely bypass state insurance regulations.The proposal allows the federal government to infringe on our states rights.A state should not be forced to give up regulatory control authorityin the business of insurance, health, or any type.State regulation of insurance has been in place for very sound reasons.

He declared one size does not fit all.This one size fits all approach of the Enzi proposal would create one set of national rules while completely disregarding traditional state authority and oversight.Such an approach cannot accurately determine how risk would be spread in the marketplace.Each state has its own particular characteristicsand needs.What is appropriate for one state is not appropriate for another.

The proposed legislation would eviscerate New Yorks strong consumer protection laws and change the entire climate for healthcare delivery, according to Assemblyman Alexander B. Grannis (D/L-New York), Chairman of the Assembly Insurance Committee. New Yorks landmark Community Rating/Open Enrollment Law prohibits insurers from discriminating against consumers based on their age, sex, medical condition or occupation, he said. Senator Enzis bill would return our health insurance market to the Dark Ages by allowing unlimited rate increases based on the age and sex of workers, and 25 percent increases based on health status.Each year, rates for individual businesses could also increase based on the amount of health care workers or their dependents received.This bill would cause havoc in our health insurance market and expose businesses to dramatic shifts in costs from year to year.

New Yorks insurance laws require a full complement of benefits, from preventive screenings to coverage by providers needed for the effective delivery of health care, Grannis continued.Enzis bill would disregard these laws and instead allow insurers to determine benefit packages.Thousands of New Yorkers would be at risk of losing coverage for a host of needed benefits.

Association Opposition

The National Conference of Insurance Legislators (NCOIL) expressedserious concerns with inadvertent consequencesof the legislation.NCOIL opposes preemption of tried and true state ratingsystems, which are a result of many years of delicate regulatory balancing.NCOIL agrees with the National Asso-ciation of Insurance Commissioners (NAIC) that a one size fits all policy cannot determine how risk will be spread in the marketplace. Each state is best suited to establishappropriate rates for its unique health insurance market.

L. Hunter Limbaugh, chairman of the American Diabetes Associations National Advocacy Committee, expressed concern that the Enzi bill would enable health insurers to bypass existing state health insurance regulations.Passage of S.1955 will result in the loss of critical health coverage guarantees for millions of people with diabetes.Forty-six states and the District of Columbia require insurers to provide coverage for diabetes supplies, medication, equipment and education, but S.1955 would undermine those basic protections.

New York has along standing commitment to providing protections for our most vulnerable populations, from women facing breast cancer to providing a standard by which to appeal denials of benefits, Bill Cromie, M.D.,CDPHP CEO, said.These protections have been the model for other states and the federal government to follow.The Enzi bill would subvert these protections.

Frank Branchini, CEO of a Man-hattan-based GHI, added that vulnerable New Yorkers would experience huge increases in the cost of health coverage, which would in turn lead to an increase in the number of uninsured New Yorkers, and additional burdens for the hospital system in the state.Instead, he said, we needto increase access to coverage by preserving and building upon the system of community rating in New York.