This bill would clarify that stop-loss insurance policies obtained by a group health plan that self-insures the health risks of plan participants are excluded from the definition of health insurance in relevant federal laws. Stop-loss insurance is commonly purchased by businesses that choose to self-insure and pay for their employees’ medical expenses rather than buying a group health insurance plan. It pays for an employee or family member’s medical bills after the purchaser of the stop-loss insurance has already paid out a predetermined amount of the beneficiary’s medical bills. This protects buyers of stop-loss coverage from having to cover catastrophic claims.
What is House Bill H.R. 1304?
Cost of House Bill H.R. 1304
In-Depth: Sponsoring Rep. Phil Roe (R-TN) also introduced this bill during the 114th Congress, saying at the time that it would help businesses that self-insure continue to provide for their healthcare expenses of their workers:
“I am proud to introduce this commonsense bill that will protect employers that provide health insurance to employees through a self-insured group health plan. Stop-loss insurance is an essential tool for these employers, as it helps manage financial risk while providing employers more flexibility in designing the right plan for their workers. This legislation will simply prevent federal regulators from redefining and regulating this safeguard as traditional health insurance, which it was never intended to be.”
Democrats on the House Education & Workforce Committee mentioned in the bill’s committee report that while they “continue to be concerned about the lack of clarity of the legislation and the possible unintended consequences, Committee Democrats have worked with the Majority to ensure that report language addresses some of these concerns.”
This legislation was introduced during the 114th Congress to counteract an anticipated move by the Obama administration to redefine stop-loss insurance as health insurance and thus subject it to the Affordable Care Act (commonly known as Obamacare).
- House Education & Workforce Committee Press Release
- National Law Review
- U.S. Chamber of Commerce (Previous Version - In Favor)
Summary by Eric Revell(Photo Credit: 401(K) 2012 via Flickr / Creative Commons)
Self-Insurance Protection Act
To amend the Employee Retirement Income Security Act of 1974, the Public Health Service Act, and the Internal Revenue Code of 1986 to exclude from the definition of health insurance coverage certain medical stop-loss insurance obtained by certain plan sponsors of group health plans.
- Not enactedThe President has not signed this bill
- The senate has not voted
Committee on Health, Education, Labor, and Pensions
- senate Committees
- The house Passed April 5th, 2017Roll Call Vote 400 Yea / 16 Nay
Committee on Education and LaborCommittee on Energy and CommerceHealthCommittee on Ways and MeansIntroducedMarch 2nd, 2017
- house Committees