H.R. 1624, a bill that would change a small-group definition provision in the Patient Protection and Affordable Care Act (PPACA), sailed through the Senate Thursday.
Members of the Senate approved the Protecting Affordable Coverage for Employees (PACE) Act bill by a voice vote. The House approved the bill by a voice vote Monday.
Rep. Brett Guthrie, R-Ky., the lawmaker who introduced the bill, attracted 48 Democratic cosponsors for the bill in the House.
The White House has not yet said whether President Obama will sign the law. A strong PPACA supporter, Rep. Frank Pallone, D-N.J., inserted a statement into the Congressional Record after the House vote indicating that he agrees on the need for group definition fix but would prefer to see lawmakers come up with a temporary fix, rather than a permanent change in PPACA.
Some states have traditionally set the small-group cut-off at 50 employees, and some at 100.
Drafters of PPACA included a provision requiring all states to set the cut-off at 100 employees, in an effort to have PPACA small-group rules, including minimum benefits requirements and rate review requirements, apply to groups with 50 to 100 employees as well as to smaller employees.
Defenders of the provision, including Mike Kreidler, the Washington state insurance commissioner, say the employees in the big small groups ought to have the kinds of protections that provide for employees in smaller groups.
Opponents, including the National Association of Insurance Commissioners (NAIC) and the National Association of Health Underwriters (NAHU), say requiring states to change their definitions could cause chaos in the small group market in some states.