The Health Insurance Marketplace Modernization Act (S. 1955) was recently pulled from the Senate calendar after a vote to limit debate on the bill failed 55 to 43. Although ASHA believes that Congress should enact legislation that makes health insurance more affordable for small business owners and their employees, it opposed two provisions of the bill that would be detrimental to individuals receiving speech-language pathology and audiology services ─ preemption of state mandates and differentiation in premiums.
 
The legislation would have created new health insurance plans that would not be required to provide state mandated coverage of speech-language pathology or audiology services, such as screening and early intervention for newborn hearing loss, hearing aids, and autism-related services. After years of fighting to enact these health care safeguards on a state level, S. 1955 could have preempted these state mandated covered services.

 
The bill would have also created significant differences in the costs of premiums. Under current law, association health plans are regulated by the states. Forty-nine states have adopted some rating rules in the small group market to stabilize the insurance rates. Generally, state legislatures have adopted a principle that a single rate applies to all small groups in the market, such as small businesses with very limited adjustments allowed for specified “case characteristics” (e.g. age, gender or health status). Under S. 1955, insurance companies would be permitted to vary their premium rates, allowing them to charge more for older or chronically ill individuals.
 
Senator Michael B. Enzi (R-WY), lead sponsor of this legislation, tried to compromise on these issues. Negotiations included leaving in place state mandates adopted by more than 26 states. However, even with this compromise, the bill would have undermined the hearing aid assistance in the eight states and autism-related services in the 15 states that currently mandate coverage.  The compromise provisions did not garner the support needed to go forward with debate in the Senate and the legislation was pulled from the Senate calendar. The bill is not expected to be voted on this year. For more information, please contact Deborah Darcy, ASHA’s Director of Grassroots Advocacy, at ddarcy@asha.org or by phone at 800-498-2071, ext. 4427.