The Health Insurance Marketplace Modernization Act (HIMMA, S. 1955), sponsored by the Senate HELP Committee Chairman Michael Enzi (R-WY) and approved by the committee on March 15, continues to loom as a threat to consumers of health insurance in every state. The bill may come up on the floor of the Senate as early as Tuesday, May 9. The stated purpose of HIMMA is to create a national market for health insurance in which policies can be marketed and sold across state lines, but the legislation goes much farther than that.
One problem cited by advocates is that HIMMA would invalidate state laws that restrict the differences in premiums charged to customers based on factors such as sex and health status. State regulations concerning premiums would be replaced with a weak standard that could result in some small companies with younger healthier employees paying lower premiums while companies with older or less healthy employees — the very people who need health insurance — could be charged more. The Center on Budget and Policy Priorities found that this is exactly what happened when a similar policy was put in place in New Hampshire.

Another problem cited by advocates is that state laws requiring plans to cover certain treatments and certain types of providers would be nullified. The bill’s current language would exempt health insurers from state mandates regarding treatments and providers so long as they sell one policy that includes the same coverage received by state employees in one of the five most populous states: California, Texas, New York, Florida or Illinois. Advocates fear that insurers will then offer one plan that generously matches a state employee plan but is very expensive, while providing barebones plans as their only affordable options.

Senator Olympia Snowe (R-ME) announced this week that she may introduce an amendment on the floor that would deal with this problem by requiring insurers to cover any treatments that are mandated by two- thirds of the states. Snowe also has her own similar bill, S. 406, that would also allow health insurance policies to bypass state mandates, but that has been opposed by a broad array of advocates, insurance companies and others.

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