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Committee advances bill to clarify stop‑loss insurance for self‑insured employers
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Summary
The committee approved H.R. 25,71, the Self Insurance Protection Act, to clarify that certain stop‑loss insurance is not health insurance and to protect employers' access to stop‑loss coverage. Democrats warned the change could shield abusive arrangements and limit state regulators' authority; the committee reported the bill, 21–15.
Representative Onder offered H.R. 25,71 to exclude certain medical stop‑loss insurance from the definition of health insurance under ERISA, reaffirming employer access to stop‑loss coverage when self‑insuring group health plans.
Supporters said stop‑loss is a financial backstop used by self‑insured employers to manage catastrophic claims and that small employers should not be prohibited from purchasing it. Representative Onder said some states have effectively barred small employers from buying stop‑loss and the bill restores the ability of small employers to self‑insure like larger firms.
Opponents including Ranking Member Scott and Representative Bonamici warned that stop‑loss arrangements have been used in level‑funded or other structures to mimic health insurance while evading consumer protections. Scott argued the bill could limit state authority to regulate stop‑loss when it functions as de‑facto health insurance and that insolvency risks and adverse selection could harm consumers and markets.
The amendment in the nature of a substitute was adopted and the committee ordered H.R. 25,71 reported to the House, 21–15.
