May 9, 2006

United States Senate
Washington, DC 20510

Dear Senator:

The undersigned organizations are writing in opposition to the Health Insurance Marketplace Modernization and Affordability Act, S. 1955. This controversial legislation would preempt state insurance laws, not just in the small group market (as is done by Association Health Plan legislation), but also in the individual and large group markets. S. 1955 would eliminate all the progress states have made to ensure that consumers have adequate health coverage.

S. 1955 would take away the states' power to regulate health insurance. The bill preempts benefit, service and provider laws that states have enacted to ensure that consumers have adequate health coverage. Coverage for cancer screenings and treatment, diabetes supplies and education, mental health, preventive care, rehabilitation, well-child care and immunizations, maternity care, and other important health care needs would be lost. S. 1955 also exempts Small Business Health Plans (SBHPs, also known as AHPs) from state benefit, service and provider access laws.

Insurance companies, instead of state-elected legislators, would now decide the benefits that consumers should have when they purchase health care. States would have no recourse to protect their own residents and they would lose any incentive to enact protective health insurance laws in the future and be laboratories for healthcare innovation.

An insurer would only need to meet one requirement in order to bypass a state’s protections: offer a second plan that resembles a plan offered to state employees in one of the five most populous states. There are no limits on the cost-sharing an insurer can charge, nor is there a requirement that the plan be comprehensive. In fact, an insurer could choose a high deductible/HSA plan, an option now available to employees in at least one of the five most populous states. Again, a state has no recourse if this so-called enhanced option does not meet the needs of its residents.

S. 1955 also would preempt stronger state laws that limit the ability of insurers to vary premiums based on health status, age, gender and geography. For many older, sicker Americans and those with complex health needs and disabilities, this would price them out of the health insurance market, undermining the stated purpose of the legislation. The bill imposes on all the states an outdated model law created by the National Association of Insurance Commissioners (NAIC), rather than using the NAIC’s current model standard that is more protective.

While the sponsors of S. 1955 have attempted to address the shortcomings of the AHP legislation, their solution makes things worse by endangering the quality of health care for the 68 million Americans in state-regulated group health plans and 16.5 million Americans with individual coverage. A bill that preempts over 1,000 state laws, raises premiums for those who need coverage the most, and leaves people uninsured for certain diseases, basic preventive care and events such as pregnancy, should be rejected.

We urge your opposition to this legislation.

Sincerely,

National Partnership for Women & Families
Action Alliance of Senior Citizens of Greater Philadelphia
Alabama Psychological Association
Alliance for Advancing Nonprofit Health Care
Alliance for Justice
Alliance for the Status of Missouri Women
American Academy of Child & Adolescent Psychiatry
American Academy of HIV Medicine
American Academy of Pediatrics
American Academy of Pediatrics – Nebraska Chapter
American Academy of Physician Assistants
American Association for Geriatric Psychiatry
American Association for Marriage and Family Therapy
American Association of People with Disabilities
American Chiropractic Association
American College of Nurse-Midwives
American Counseling Association
American Diabetes Association
American Federation of State, County and Municipal Employees
American Federation of Teachers
American Nurses Association
American Optometric Association
American Pediatric Society
American Podiatric Medical Association
American Psychological Association
American Speech-Language-Hearing Association
Arizona Action Network
Arizona Business and Professional Women
Asociacion de Psicologia de Puerto Rico
Assistive Technology Law Center
Association of Medical School Pediatric Department Chairs
Association of Women’s Health, Obstetric and Neonatal Nurses
B'nai B'rith International
Bazelon Center for Mental Health Law
C3: Colorectal Cancer Coalition
California Coalition for PKU and Allied Disorders
California Black Health Network
California Psychological Association
Campaign for Better Health Care - Illinois
Capital District Physician's Health Plan, Inc.
Catholics for a Free Choice
Center for Civil Justice
Center for Justice and Democracy
Center for Women Policy Studies
Children’s Alliance
Citizen Action/Illinois
Citizen Action of New York
Clinical Social Work Guild 49, OPEIU
Colorado Center on Law and Policy
Colorado Children’s Campaign
Colorado Progressive Action
Colorado Psychological Association
Communications Workers of America
Connecticut Citizen Action Group
Consumers for Affordable Health Care
Delaware Psychological Association
Department for Professional Employees, AFL-CIO
Disability Rights Wisconsin
District of Columbia Psychological Association
Empire Justice Center
Excellus Blue Cross Blue Shield
Families USA
Families with PKU
Family Planning Advocates of New York State
Florida Consumer Action Network
Georgia Rural Urban Summit
Guttmacher Institute
HIP Health Plan of New York
Hawaii Psychological Association
Health and Disability Advocates
Hemophilia Federation of America
Idaho Psychological Association
Illinois Alliance for Retired Americans
Illinois Psychological Association
Indiana Psychological Association
Institute for Reproductive Health Access
International Association of Machinists & Aerospace Workers
International Brotherhood of Electrical Workers
International Longshore & Warehouse Union
Iowa Citizen Action Network
Iowa Psychological Association
Kansas Psychological Association
Kentucky Task Force on Hunger
League of Women Voters
Maine Children’s Alliance
Maine Dirigo Alliance
Maine People’s Alliance
Maine Psychological Association
Maine Women’s Lobby
Maternal and Child Health Access
Mental Health Association in Michigan
Mental Health Legal Advisors Committee (Commonwealth of Massachusetts)
Michigan Association for Children with Emotional Disorders
Michigan Campaign for Quality Care
Michigan Citizen Action
Minnesota COACT
Minnesota Psychological Association
Missouri Association of Social Welfare
Missouri Progressive Vote Coalition
Montana Senior Citizens Association, Inc.
National Association for Children's Behavioral Health
National Association of Social Workers
National Association of Social Workers, Arizona Chapter
National Association of County Behavioral Health and Developmental Disability Directors
National Consumers League
National Council of Jewish Women
National Council on Independent Living
National Disability Rights Network
National Family Planning and Reproductive Health Association
National Health Care for the Homeless Council
National Health Law Program
National Mental Health Association
National Multiple Sclerosis Society
National Organization for Women
National Research Center for Women & Families
National Urea Cycle Disorders Foundation
National Women’s Health Network
National Women's Law Center
Nebraska Psychological Association
New Hampshire Citizens Alliance
New Jersey Citizen Action
New Jersey Psychological Association
New Mexico PACE
New Mexico Psychological Association
New York Civil Liberties Union Reproductive Rights Project
New York State Health Care Campaign
New York State Psychological Association
North Carolina Justice Center's Health Access Coalition
North Carolina Psychological Association
North Dakota PKU Organization
North Dakota Progressive Coalition
North Dakota Psychological Association
Northwest Health Law Advocates
Northwest Women's Law Center
Ohio Psychological Association
Oregon Action
Oregon Advocacy Center
Oregon Psychological Association
Organic Acidemia Association
Patient Services, Inc.
Pediatrix Medical Group
Pennsylvania Council of Churches
Pennsylvania Psychological Association
Philadelphia Citizens for Children and Youth
Philadelphia Coalition of Labor Union Women
Planned Parenthood Federation of America
Planned Parenthood of New York City
Progressive Maryland
Public Citizen
RESULTS
Religious Coalition for Reproductive Choice
Rhode Island Ocean State Action
Rhode Island Psychological Association
Sargent Shriver National Center on Poverty Law
Save Babies Through Screening Foundation
Senior Citizens' Law Office
Small Business Majority
Society for Pediatric Research
South Dakota Psychological Association
Summit Health Institute for Research and Education, Inc.
Tennessee Citizen Action
Tennessee Psychological Association
Texas Psychological Association
The Arc of the United States
The Black Children’s Institute of Tennessee
The Disability Coalition of New Mexico
The Institute for Reproductive Health Access
The Senior Citizens’ Law Office
The Virginia Academy of Clinical Psychologists
Triumph Treatment Services
USAction
USAction Education Fund
Union for Reform Judaism
United Association of Journeymen and Apprentices in the Plumbing and Pipe Fitting Industry
United Cerebral Palsy
United Food and Commercial Workers
United Senior Action of Indiana
United Steelworkers International Union
United Vision for Idaho
Univera Healthcare
Universal Health Care Action Network
Utah Health Policy Project
Vermont Coalition for Disability Rights
Vermont Office of Health Care Ombudsman
Voices for America’s Children
Voices for Virginia’s Children
Washington Citizen Action
Washington State Coalition on Women’s Substance Abuse Issues
Washington State Psychological Association
West Virginia Citizen Action Group
West Virginia Psychological Association
Wisconsin Citizen Action
Wisconsin Psychological Association
World Institute on Disability
Wyoming Psychological Association