The Blue Cross and Blue Shield Association has published a report promoting the value of state health insurance coverage mandates.[@@]

The Blues often fight what they believe to be ill-considered mandates, but the group has put out the report to fight a proposal by the Bush administration to create a system of federally regulated association health plans.

The association plans might be exempt from most state health insurance mandates.

Supporters of the association plan proposal say it would simply give small employers the same flexibility that large employers now enjoy when they create self-funded health plans that are exempt from the Employee Retirement Income Security Act.

The Blues’ association and 1,300 other groups, including the National Association of Insurance Commissioners, Kansas City, Mo., are arguing that a national association plan system would siphon healthy employers away from traditional, state-regulated insurers; hurt employers with sick employees by shutting them out of the association plans and increasing the cost of traditional coverage; and increase the incentive for employers to discriminate against workers with health problems.

The new, anti-association plan report points out that 49 states now protect consumers by regulating health carriers’ ability to raise an employer’s rates when an employee gets sick; 44 states give employees access to independent, external review systems when carriers deny medical claims; and 50 states have laws and regulations that require carriers to pay providers promptly.

Going to an association-plan program could gut those state-imposed consumer protection mandates, the Blues and their allies argue.