mr. speaker , i rise today in strong opposition to h.r. 525 , the regurgitated association health plan , ahp , bill . 
this is the fourth vote on this exact same legislation in as many years . 
so , if my statement sounds familiar , that 's because it has all been said before . 
while they 've titled the bill the small business health fairness act , its impact would be the opposite . 
this bill would have the perverse effect of increasing the cost of health insurance for many people and increase the number of people without health insurance altogether . 
this bill would allow new entities , called association health plans , ahps , to bypass state regulation and offer bare-bones health insurance policies . 
small businesses that do n't choose to offer these inadequate policies would see their premiums increase by 23 percent on average . 
this premium hike would occur because ahps , which would offer only bare-bones coverage , would attract the healthiest individuals , leaving traditional health insurance plans with the sickest and most expensive patients . 
this shift would penalize businesses with sicker employees , and make health insurance for those who need it the most even more unaffordable . 
further , this legislation would swell the ranks of the uninsured by over 1 million more individuals . 
as traditional health insurance becomes increasingly expensive , more and more businesses would have no choice but to drop health insurance for their employees , leaving these individuals with little or no opportunity to purchase health coverage . 
contrary to what proponents of this bill claim , ahps would not truly help small businesses purchase health insurance for their employees . 
although proponents claim that ahps would give small employers bargaining power to purchase affordable health insurance , most states already have laws in place that allow for group purchasing arrangements . 
this bill would only harm existing laws while usurping the traditional role of states to regulate insurance . 
in fact , this bill would override key state laws and regulations that protect millions of americans . 
for example , many states regulate insurance premiums to prevent insurers from discriminating against the ill . 
but under this bill those laws would n't apply . 
ahps would be allowed to offer extremely low , `` teaser '' rates , and then rapidly increase the premium if the enrollee becomes sick . 
furthermore , nearly all states have enacted external review laws that guaranteed patients an independent doctor review if a health plan denies them coverage for a particular service . 
patients who join ahps would lose this vitally important consumer protection . 
this bill also exempts ahps from state laws that require health insurance to cover particular benefits . 
these laws have helped to ensure that millions of americans get access to the healthcare that they need -- such as mammography screenings , maternity care , well-child care , and prompt payment rules . 
in my state of california , employees who join ahps could well lose access to these services as well as certain emergency services , direct access to ob/gyns , mental health parity , and other important benefits . 
moreover , this law would allow health plans to `` gag '' doctors , the currently illegal practice of health insurers preventing doctors from discussing treatment options that the plan does not cover , even if some of those options are in the patient 's best medical interest . 
the problems go on . 
ahps are likely to create new fraud and abuse problems in health care as well . 
these plans are very similar to multiple employer welfare plans , mewas , that congress created in the 1970s . 
mewas were also exempt from state insurance regulation . 
the department of labor found that many of these plans were frauds and left their enrollees holding the bag for more than $ 123 million in unpaid health expenses . 
congress had to come back and clean up the law to end this blatant abuse . 
we should learn from that mistake , not repeat it . 
this bill is bad for patients , bad for small business , and bad for states . 
it is opposed by more than 1 , 300 organizations , including the national governors association , the national association of insurance commissioners , the american academy of actuaries , local chambers of commerce , small business associations , physician organizations , labor unions , and healthcare coalitions . 
the senate has no intention of taking up this legislation . 
it 's bad policy , and our colleagues on the other side of the capitol know it . 
taking yet another vote on ahps is an enormous waste of time and taxpayer resources , and has nothing to do with providing affordable healthcare options to our citizens . 
health care reform should n't raise premiums , increase the number of uninsured , lead to massive fraud , and remove key state patient protections . 
i urge my colleagues to reject this legislation once and for all . 
