I emailed Santorum about the Enzi bill and got the following response. Naturally he brushes aside all concerns about the bill.
I'm not an expert on any of this stuff (this bill, health insurance, etc.). I'd like others' opinions on what he says.
Relevant passages below, all emphasis added:
May 5, 2006
Dear ____:
Thank you for contacting me regarding health insurance for small businesses, with specific reference to the Health Insurance Marketplace Modernization and Affordability Act of 2005 (S. 1955). I appreciate hearing from you and having the benefit of your views.
Please be assured that S. 1955 would preserve the states' traditional role in overseeing health insurance. In fact, contrary to what you may have heard, under S. 1955 small business health plans (SBHPs) would have to be fully insured and marketed by state licensed insurance companies--entities that must comply with the consumer protection laws and the capital and solvency requirements in each state they operate.
[snip]
Under S. 1955, SBHPs would be group health plans sponsored by trade, industry, professional, chamber of commerce, or similar business associations that meet the Employee Retirement Income Security Act of 1974 (ERISA) certification requirements that currently cover large employers and unions. The establishment of SBHPs would allow small business owners to come together to leverage the bargaining power that larger employers have in negotiating contracts with insurers, reducing the challenges small employers continue to face in seeking out, contracting with, and administering health benefits. Similar to the health insurance that government employees, unions, and large corporations enjoy, SBHPs would provide small business employees with a number of options to best meet their healthcare needs, with stronger patient protections than other ERISA plans have today.
As you likely know, the complexity of structuring a plan that complies with the more than 1,800 different state mandates has made it impossible to offer health benefit packages on a regional or national basis. Under S. 1955, SBHPs would be allowed to offer a basic benefit plan as long as the SBHP also offers an enhanced benefit option to participating employers. For example, federal employees currently have the choice of different plans, with different levels of benefits. S. 1955 would require that the enhanced benefit option include those covered benefits, services, and categories of providers as are covered by a state employee health benefit plan in one of the five most populous states: California, Texas, New York, Florida, and Illinois.
In other words, employers could offer a cheap plan that skips a lot of benefits (and which would save them tons of money) as long as they also offered the option of a fancy plan that has all the good benefits. And would employers be able to shift to the employees the extra cost of the fancy plan?
I understand that some individuals have expressed concern that under S. 1955 employees would have a limited choice in their health plan options, and that the plan would be structured such that benefits currently offered by many health plans today would not be covered. As you may know, the vast majority of health plans cover many services and supplies regardless of whether or not the plans are subject to state mandated coverage. Like any employer plan, SBHPs would have a strong incentive to offer the best policy possible for their members--otherwise they risk losing employees to employers that offer better coverage. SBHPs would have a vested interest in structuring their benefit design such that their members have access to healthcare services that improve their overall health, helping to reduce healthcare expenditures. Moreover, when comparing SBHPs, small business owners would be weighing their loved ones' healthcare needs since these plans would cover themselves and their families. Just as small businessmen and women would not accept inadequate coverage for their employees, they would not stand to jeopardize the health of their family.
So in other words, hope for the best! Employees' healthcare would be subject to the whims of their employers. I always get suspicious when people start saying things like "there would be a strong incentive..."
Over half of the estimated 46 million uninsured Americans work for, or are family members of employees who work for, small employers--a formidable constituency that could leverage significant competition and choice within the health insurance market, and would demand high-quality coverage. As the full Senate considers S. 1955, or other legislation related to helping to make health insurance more affordable for America's small businessmen and women, I will be sure to keep your concerns in mind.
There is no universal remedy for the rising costs of health care and the uninsured; however, I will continue to support legislative proposals that expand access to quality and affordable health care for Pennsylvanians. If I can be of further assistance to you with this or any other matter, please do not hesitate to call on me again.
Sincerely,
Rick Santorum
United States Senate
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So tell me what you think, people. If there are any experts on this bill, I'd love your opinions on Santorum's letter.
More information on the Enzi bill can be found at the Families USA site.