Members of the House today voted 400-16 for the Self-Insurance Protection Act bill.
The bill, H.R. 1304, would block federal efforts to regulate small stop-loss plans as health insurance by excluding the plans from the federal definition of “health insurance coverage.”
All 230 of the Republicans who voted supported passage.
Just 16 of the 186 Democrats who participated opposed passage; the other 170 joined with Republicans to support passage.
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(Related on ThinkAdvisor: Self-insurance group asks Congress for stop-loss help)
Employers self-insure their health plans to get more control over the plans, and to take advantage of federal rules that preempt state efforts to regulate employee benefits. States can regulate the insurance that insurers provide for group health plans, but states cannot regulate the benefit plans themselves.
Sponsors of self-insured plans often use stop-loss, or insurance for insurance plans, to protect themselves against catastrophic losses.
Some consumer groups, regulators, insurers and others have suggested that very small employers may be making more use of self-insurance to avoid Affordable Care Act benefits requirements, consumer protection requirements and other requirements. Observers have said that those may be using stop-loss insurance arrangements with attachment points, or deductibles, of $50,000 or less as if the arrangements were high-deductible major medical coverage, without understanding that stop-loss carriers operate outside the rules that apply to major medical coverage.
Some states have tried to discourage small employers from self-insuring by imposing small-group major medical rules on small stop-loss arrangements.