Mr. Speaker, I rise in opposition to H.R. 525, the Small Business Health Fairness Act. I am deeply concerned that this legislation will jeopardize valuable patient protections for all Americans. While pooling insurance risks may allow employers to strengthen their bargaining power with insurance carriers and share administrative functions, the methods outlined in this bill would threaten the quality of health plans available to small business employees, and the stability of the market for small businesses without access to trade associations.

This legislation establishes association health plans by removing them from state oversight - including the application of state patient protections and solvency standards. For example, my home state of Rhode Island is one of 15 states to mandate health insurance coverage of a colorectal cancer screening test. My constituents value this protection. But under this legislation, my constituents could find themselves enrolled in association health plans that are not required to follow that and other state laws designed to increase access to preventative care and screenings.

In addition, this bill permits association health plans to offer coverage to specific types of employers, allowing plans to seek memberships with better risks and less costly populations. This “cherry picking” - skimming off the healthiest consumers and leaving the sickest patients uninsured – will force premiums even higher for the majority of the market. A recent Congressional Budget Office study estimated that costs would decline for the 20 percent of businesses that join AHPs, but would therefore go up for the remaining 80 percent.

Alternatively, the Democratic substitute would provide small business and their employees access to small employer health pools, without the negative features of H.R. 525, by including a number of protections for businesses and their employees. The substitute amendment provides that participating health insurance companies will remain subject to the requirements of state health insurance laws and stipulates that all participating insurers offer benefits equivalent to or greater than the options offered to federal employees. There are ways to accomplish the goal of increased access to health insurance that do not threaten that patient protections and state laws that Americans have come to rely on.

Small business employers and their workers do need better access to affordable health care coverage, but this misguided bill is not the way to accomplish that important goal. As we look for innovative ways to provide health care to all, we must not sell small business owners and employees short. We must address the health care crisis, and we must do it in a way that does not exacerbate the existing problems. I urge my colleagues to vote against H.R. 525.