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WASHINGTON – Today, Education and the Workforce Committee Chairwoman Virginia Foxx (R-NC) spoke on the House Floor in support of H.R. 3799, the CHOICE Arrangement Act, a Republican package that takes the first step towards addressing rising health care costs for small businesses. The package is comprised of several innovative health care solutions. One is the Association Health Plans Act, which allows employers—including self-employed and independent contractors—to band together across state lines to access lower-cost coverage. Another is the Self-Insurance Protection Act, which preserves small businesses’ ability to self-insure and provide lower-cost, high-quality health care to their employees. Both bills passed out of the Committee during a markup earlier this month. 

Chairwoman Foxx’s remarks (as prepared for delivery):

“I rise today to support the House Republican package to alleviate rising health care costs for small businesses. I am proud that my Committee, the Committee on Education and the Workforce, has taken a leading role in this effort.

“Health care cost is the number one issue facing small businesses today. In fact, according to the NFIB, it has been their top issue for over 30 straight years. Through the dot-com bubble, the Great Recession, the COVID-19 pandemic, and record inflation, small businesses have consistently identified health care costs as their greatest concern.

“House Republicans recognize that these small businesses are the engines of the American economy, and this package is the first step towards much needed relief.

“So, I’d like to take a moment to discuss the two pieces of this package from the jurisdiction of my Committee. 

“First, this package incorporates Representative Good’s Self-Insurance Protection Act. 

“We passed the Self-Insurance Protection Act through Committee because small businesses are being squeezed. There is no other way to put it.

“On the one hand, premiums are skyrocketing, and it’s costing small businesses a fortune to cover their employees. Single-coverage premiums cost about 8,000 dollars per year now, and they are drastically outpacing inflation. 

“So, the bottom-up inflationary pressures have inevitably forced small businesses out of the insurance marketplace, and more and more are deciding to self-insure. Experts predicted this when the ACA passed, and it has held true. 

“On the other hand, the government is coming from the top-down and telling small businesses they cannot access stop-loss insurance. 

“Stop-loss insurance is a financial tool that self-insured businesses typically buy to protect themselves from catastrophic costs. But the government overreaches, overregulates, and denies many small businesses this critical tool.

“For example, in New York, insurers are expressly prohibited from selling stop-loss insurance to employers with fewer than 100 employees. The New York State Association of Health Underwriters wrote regarding the law: ‘Some groups have already lost their employer provided health coverage altogether and have had to go into the NY Health Insurance Marketplace Exchange to obtain coverage, only to find that their new coverage has higher co-pays, larger deductibles, greater total out-of-pocket annual limits, narrower in-plan healthcare provider networks, and fewer out-of-network medical specialists.’

“Like in a pincer maneuver, the government is coming from both sides and trapping small businesses in the middle with no options. 

“The Self-Insurance Protection Act is the solution. It provides a lifeline to small businesses and hardworking Americans who are being squeezed by the soaring costs of traditional health insurance.

“It would stop federal and state overregulation of stop-loss insurance, allowing self-insured small businesses a way out of the government’s two-sided trap.

“Next, this package also incorporates Representative Walberg’s Association Health Plans Act, which is perhaps the single best cost saving tool at our disposal. The Association Health Plans Act would offer immediate relief for everyday workers, taxpayers, and job creators.

“I know this because it has been tested. In 2019, before the courts stopped President Trump’s association health plan (AHP) rule, America got a chance to see and feel the impact of deregulation. AHPs produced savings of up to 29 percent on average. At the upper limit, groups saved 50 percent with their newly formed AHPs.

“AHPs achieve these savings by allowing small businesses to band together to increase their bargaining power when purchasing health insurance. Currently, many regulations restrict small businesses and individuals from doing so.

“Enabling smaller economic actors to pool resources is critical to their competitiveness in the market. In health care, big companies enjoy large economies of scale and only more so with each passing year. 

“Countless studies and evidence point towards this worrisome trend of market consolidation. Three pharmacy benefit managers own 80 percent of the market. Physician practices and hospitals are merging at a rapid pace. Thankfully, hospital mergers have slowed during and after the pandemic, but it’s not enough.

“This bill helps mom-and-pop shops and self-employed workers fight back. 

“I should also clarify that this bill does not turn health care into the Wild West like some members claim. Important regulatory guardrails exist to make sure enrollees would not be defrauded under AHPs. For example, every AHP must have a board consisting of at least 75 percent employer membership. This ensures that AHPs are maintained in good faith. They are also required to abide by existing consumer protections, such as prohibitions against discriminating based on an individual’s health status and prohibitions against using preexisting conditions to deny coverage, increase premiums, or impose waiting periods.  

“The benefits of the Association Health Plans Act can be summed up in the words of Trump’s DOL, ‘AHPs are about more choice, more access, and more coverage.’

“I agree. 

“Let’s help small businesses get the relief they need and working Americans the coverage they deserve, and with that, I urge passage of this health care package.”