In a bid to improve the health insurance purchasing clout of small businesses, Republicans in the U.S. House of Representatives dusted off a piece of controversial legislation more than a decade old and passed it this week as part of their effort to remake the market after they throw out the Affordable Care Act.
The bill, the Small Business Health Fairness Act of 2017, had the support of 232 Republicans and 4 Democrats. It now heads to the Senate, where its fate is uncertain, experts say.
The earlier bill, which passed the House in 2003 but didn’t advance, was widely panned by groups representing consumers, providers, the health insurance industry and state officials. At the time, they argued that it would do little to enhance the coverage options or control costs of many small businesses, especially those that employ older, sicker workers. Also, the critics said, the proposal would weaken consumer protections against plan insolvency and fraud.
Health policy analysts say there’s no reason to change that assessment now.
“It was a bad idea in 2003 and it’s a worse idea today,” says Timothy Jost, an emeritus professor at Washington and Lee University School of Law in Virginia, and author of widely used text books on health law.
Republicans have long advocated for small businesses to be able to band together and buy coverage across state lines, and this legislation does that.
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