The Alabama Farmers Federation’s proposal to offer health plans to its members won House approval on Thursday in an overwhelming vote, but not before extensive debate about removing an oversight amendment added in committee earlier in the week.
House Bill 477 from Rep. David Faulkner, R-Mountain Brook, has been amended multiple times in the last week to add more required coverage and consumer protections, including not being able to drop customers if they get seriously ill, in an effort to win support.
The plans are needed, Faulkner and Alfa argue, because farmers struggle with health insurance costs. They’re usually self-employed without employer-provided insurance but make too much money to qualify for subsidies under the Affordable Care Act.
“The rising cost of health care is a significant burden for our farmers,” Faulkner said on the House floor.
The bill was approved 98-1.
“We are encouraged by the strong bipartisan support House members showed today for Alabama farmers,” Brian Hardin, Alfa’s director of external affairs, told ADN. “We appreciate Speaker (Nathaniel) Ledbetter and House leadership for bringing this important legislation to the floor and Rep. Faulkner for addressing concerns while preserving its effectiveness.”
Ten other states offer what Faulkner is proposing. Based on their plans, Faulkner said farmers in Alabama could save 30% to 60% on health care costs.
“This is not a plan for everyone,”he said. “This is a plan that is offered to the members of the Farmers Federation.”
Faulkner said multiple times Thursday that this proposal has more restrictions and oversight than any other state’s. Recent additions to the bill include requirements that ill people can’t be dropped, specific care must be covered, including emergency services and mental health and substance abuse, and a complaint process.
Opponents of the bill have argued the plans look like insurance, but can’t be called insurance because they won’t have to follow all the state and federal laws insurers do. Blue Cross and Blue Shield of Alabama and the American Cancer Society, have opposed Alfa’s ability to deny coverage based on pre-existing conditions. Federation officials say Alfa’s reputation and close ties with members are a natural deterrent to denying any coverage and honoring members’ contracts.
Rep. Paul Lee, R-Dothan, also amended the bill on the House floor. Though the Alfa plans will have no annual spending caps, Faulkner said, the state hospital association requested the amendment that said there won’t be an annual limit “of less than $2 million per year” per covered individual.
Oversight amendment
Despite the overwhelming support for the bill, there were nearly three hours of discussion about it on the floor Thursday. Much of it over a House Health Committee amendment added earlier in the week mandating that the Alabama Department of Insurance can enforce provisions in the law.
Faulkner opposed the amendment in committee and moved to remove it from the bill Thursday morning. He said the DOI doesn’t regulate self-funded plans, which is what Alfa is proposing.
“This would be singling out Alfa if we left it in,” he said.
He said the required oversight “could take away options and raise costs.”
Some House members this week found themselves at odds with Alfa over the oversight amendment while largely supporting the health plan proposal.
“… These are our constituents,” Rep. Frances Folk-Jones, R-Foley, said on the House floor about protecting consumers. She’s a State Farm agent with more than 40 years of experience and brought the insurance department oversight amendment, among others, in the committee.
“Insurance is more than just saying, give me the money and I promise to take care of you,” she said.
“… I was actually told yesterday, payback is hell,” Holk-Jones said on the House floor. “That might be true. But is it wrong to do the right thing?”
Holk-Jones later declined to expand on her comments. A few GOP members who voted for the oversight amendment in committee changed their vote to remove it on the floor Thursday.
Several Democrats spoke and voted in favor of keeping the Department of Insurance amendment, saying it would bring peace of mind for constituents who could pay the Alfa membership dues to qualify for the plan.
Faulkner said people could sue if they have issues with their contracts with Alfa.
The amendment to remove the insurance department oversight passed 74-15.
Rep. Mark Shirey, R-Mobile, said he’s heard from more farmers than lobbyists about the bill.
“These people are begging for this plan and we’re standing in the way,” he said in a dialog with Faulkner. “They want this bill passed with a whole lot less restrictions than we have on it now.”
A lot of farmers are going without insurance now, Shirey said. If they don’t like the Alfa plans, they can get out and be no worse off.
The bill now moves to the Senate where Sen. Arthur Orr, R-Decatur, has sponsored previous versions.
“We are eager to continue sharing their stories with senators and showing how the many changes to HB 477 make it the strongest Farm Bureau health plan legislation in the country,” Hardin said.