The latest version of House Bill 933 would free more small businesses and nonprofit groups from health insurance restrictions tied to the Affordable Care Act. The Senate took an initial 37-10 vote Wednesday to approve the measure. A final Senate vote would send the measure back to the House, which approved an earlier version of the legislation.
The initial House version on H.B. 933 would direct the State Board of Education to grant a license to practice as a school psychologist to any individual who holds the Nationally Certified School Psychologist credential. In other words, it removes an unnecessary state burden that blocks schools from filling open psychologist positions. There is no agreement in place now to allow for out-of-state psychologists to practice in North Carolina without going through a cumbersome education process and licensing procedure.
Senators added three substantial pieces to the bill.
- It would incorporate elements of Senate Bill 748: PSYPACT (Psychology Interjurisdictional Compact)
- It would allow for more small businesses to self-insure and purchase stop-loss health insurance coverage. A law that applies now to businesses with at least 26 full-time-equivalent employees would now apply to businesses with at least 16 full-time-equivalent workers.
- It would allow for nonprofit organizations that have been in existence for at least 10 years to create their own association health plan (AHPs).
During committee discussion, an Aetna representative told senators that small businesses with staffs of 10-20 FTEs are eager to self-insure. Small-group plans under the Affordable Care Act are too expensive to offer to employees.
The N.C. Farm Bureau is among the most vocal supporters of the AHP provision. The Farm Bureau’s Larry Wooten told senators that self-employed farmers are struggling to afford health insurance from the ACA individual marketplace. He gave examples of one member who saw a 54 percent premium increase in 2014 and another who saw premiums jump 94 percent in 2017.
Some farmers’ spouses, who would rather work on the farm, take other jobs just to find access to health insurance. This creates a job-lock problem.
AHPs comprise multiple small businesses that band together to form a self-funded risk pool. These nonprofits would offer health benefits to members. Benefits are not regulated under the state Insurance Department or federal ERISA law. They would not have to comply with state government’s 57 health insurance mandates.
Nonprofits would have the freedom to come up with plans that best meet the needs of their employees. They would not be stuck with a one-size-fits-all plan cooked up by bureaucrats in Washington, D.C.