Although we had a short floor calendar on May 1, we had some rousing debates. The highlight was a two-hour debate on SB1085, association health plans. (Watch the action here, beginning at 19:32 min.)
The Republicans have had three bills this year to lower healthcare insurance costs by encouraging people to leave the healthcare marketplace. I agree that the Affordable Care Act is too expensive, particularly for sole proprietors (like my husband who was offered a silver ACA plan for more than $1000 per month just for him.) This is why I voted for direct care contracts. I believe those are a better deal for sole proprietors than association health plans.)
I get that costs are too high, but the association health plans are not the way to go. They could, indeed, lower costs for business owners, but they could be risky due to limited coverage. There are reasons why these plans will likely be cheaper. Remember the old adage “you get what you pay for”. If sole proprietor business owners want to take a risk with their own insurance and their own health, I have a mind to let them take their own risk. (Just don’t ask me to help you later with a Go Fund Me Request if it turns out I was right on limited coverage under cheap junk insurance plans.)
Where I object is when businesses are making these risky insurance decisions for their employees— just to save money.
Under this bill, businesses can band together as an “association” and come up with a customized health insurance plan. The problem is that these association health plans don’t have to cover the 10 essential benefits in the ACA (like drug coverage, maternity care, mental health coverage, price parity for men and women, and more). According to Rep. Nancy Barto, association health plans do cover pre-existing conditions and allow parents to cover adult children up to a certain age– two very popular parts of the ACA. The businesses in the association could come up with whatever benefits they want to cover … or not. I’m not sure if Barto is saying that the plans can be designed to include these two items, or if they are required to; I’ve heard this both ways. The Republican talking points were right out of Democracy in Chains.” Barto said that association health plans would be better for employees and business because business owners would be designing the insurance plans– not insurance companies. (I don’t think that statement would be reassuring to most employees at all!)
These plans do allow businesses to discriminate based on pricing. Women will remember that before the ACA, we had to pay significantly higher premiums than men. The ACA leveled the playing field on price between men and women. Look at all of the attacks on women’s health since the ACA expanded benefits and equalized pricing. We can expect more attacks as businesses are allowed to customize to reduce costs. You— the employee— will he left to pay the bills.
In public health, we say that if the mother is healthy, the family is healthy because women make healthcare decisions and day-to-day retail decisions. They are usually the ones who take their children to the doctor and get their husbands to seek care when they need it. Given the current crisis in maternal and child health in Arizona, the last thing we should do is to put price barriers up in front of women’s access to healthcare. Limiting women’s access to care is bad for women, bad for their families, and bad for the overall health of our state.
Even with the ACA, our country’s healthcare non-system is just too expensive. We have the most expensive healthcare in the world, and our health outcomes are middling to horrible. Medical bankruptcy has been a long-term problem in the US. Too many Americans are one diagnosis or car accident away from bankruptcy or homelessness. The ACA expanded coverage to more Americans but didn’t significantly reduce medical bankruptcy. Underinsurance is widespread. People buy the insurance they can afford— not insurance they need. With association health plans, business groups can tweak the benefits to reduce costs, but that puts people at risk for inadequate care, high out-of-pocket costs, and bankruptcy.
For example, more than 100 million Americans have diabetes or prediabetes. If a person with diabetes works for a business that decides not to cover drugs in their association health plan, that person will be stuck paying $540 a month for insulin. Insulin costs have skyrocketed. Insulin has been around since 1920, but like the EpiPen, Big Pharma has dramatically raised the price because demand is high. It’s all about profit. It doesn’t have anything to do with good healthcare for Americans.
Lastly, because of the allure of a cheap deal, association health plans will entice people to leave the healthcare marketplace, thus weakening it by pulling healthy people out.
A cadre of Democrats— including Reps. Butler, Friese, Blanc, Epstein, Rodriguez, Cano and I— fought hard against association plans. Unfortunately, it passed with a handful of Democrats in both the House and the Senate voting with the GOP. BTW, all of the major healthcare groups were against SB1085. Check out AZLeg.gov video for May 1 (here) if you want to see and hear the debate, beginning at 19:32 min.