Congress Ponders Health-Care Deregulation Bill

April 17, 2006 ( - Congress is considering a far-reaching reform that would give insurers a new right to scale back benefits by pre-empting state-mandated offerings.

The Health Insurance Marketplace Modernization and Affordability Act, sponsored by Senator Mike Enzi, (R-Wyoming), and co-sponsored by Senator Ben Nelson, (D-Nebraska) and Senator Conrad Burns, (R-Montana), would allow private insurers to bypass state regulations requiring coverage of things such as preventive cancer screenings, diabetes supplies and routine women’s health care, MarketWatch reported.

The bill is pitting lobbyists for advocacy groups such as the American Diabetes Association and AARP against powerful small-business lobbies such as the National Association of Realtors and the National Federation of Independent Business, according to the report.

Insurers also would have to offer an “enhanced” plan that’s at least as comprehensive as the state employee plan in one of the five most populous states, though the bill sets up no enforcement mechanism, Mila Kofman, associate research professor at Georgetown University Health Policy Institute, told MarketWatch.

“This bill is the most fundamental reform effort we’ve seen in probably two decades out of Congress,” Kofman said, noting it may increase the number of medical-bill-related personal bankruptcies.

With insurers free to pursue the most profitable options without regard to state oversight, the bill “will lead to people who are either underinsured – they just don’t have enough coverage – or completely uninsured for certain conditions,” she said. “It’s great for Wall Street, but it’s not what businesses and workers need.”

However,   Craig Orfield, communications director for the Senate Health, Education, Labor and Pensions committee, bristled at the suggestion the bill would gut health care as Americans know it. “We think this is going to result in more people being able to afford insurance, as opposed to gutting insurance,” Orfield said.

According to the news report, the bill is expected to come up for a Senate vote in early May. About 45.5 million Americans, or 15.7%, lack health insurance, according to census data.