Rep. Sam Johnson, R-Texas, is continuing the fight to get a multi-state association health plan bill signed into law.

Johnson’s latest AHP bill, H.R. 1101, the Small Business Health Fairness Act of 2017 bill, would let a business group operate either a fully insured or self-insured AHP.

The insurance regulators in an AHP’s home state would be in charge of regulating the AHP and overseeing its solvency. Any state could oversee an AHP’s solvency and prompt payment of claims, and any state could impose premium assessments that were comparable to the assessments imposed on other group plans. But a state could not block a health insurer from offering coverage to an AHP.

Related: Self-insurance group asks Congress for stop-loss help

Johnson introduced the bill Feb. 16. At this point, the bill has 23 Republican cosponsors and no Democratic cosponsors.

Johnson and other colleagues have been introducing similar AHP bills since at least 2001.

In 2004, when George W. Bush was the president, and Republicans held 51 of 100 seats in the Senate, and 222 of 435 seats in the House, members of the House voted 252-162 for a health benefits bill that included an earlier version of the AHP legislation.

The U.S. Chamber of Commerce and other business groups outside of the health insurance sector say multi-state AHPs would increase small and midsize employers’ ability to squeeze good rates out of health insurers, benefit plan administrators and stop-loss providers.

Insurers and insurance groups, including America’s Health Insurance Plans, have argued that managers of other types of multi-employer health plans have a hard time keeping them solvent. Insurers also say that any new, poorly designed efforts to divide the group health market could destabilize the market, by pushing healthier employers to move into one part of the market, and jacking up the ratio of claims to premium revenue in the other part.

State insurance regulators and insurance groups have argued that a multi-state AHP system could weaken state insurance regulators’ ability to look after consumers’, employers’ and health care providers’ interests.

Jon Hurst, president of the Boston-based Retailers Association of Massachusetts, testified in favor of H.R. 1101 Wednesday, in Washington, at a hearing organized by the House Education and the Workforce Committee.

Hurst, who was speaking for the Washington-based National Retail Federation, said that a fully insured, single-state AHP program that’s already available in Massachusetts has worked well.

The AHP “has experienced consistent overall year-to-year growth,” Hurst said at the hearing, which was streamed live on the web.

Claims have been below expectations, in part because of strong wellness and wellness incentive programs, Hurst said.

A copy of the hearing video is available on the House committee’s website.

Related:

Widespread tax, regulatory easing on horizon under Trump

Lawmakers criticize “fair share” bills

We’re on Facebook, are you?