SB 861 – VOTE NO!
A business with more women can be charged more
Two women who start a business can be charged more than 2 men who are the same in every other way. There is no cap on how much more they can be charged.
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A business in certain zip codes can be charged more
Firms based in zip codes with poorer health outcomes could face higher premiums than those in healthier zip codes. Zip codes with poor health outcomes tend to be predominately low income and have more racial minorities.
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A business with an older workforce can be charged more
This bill does not cap how much premiums can be increased for a business with older employees.
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Coverage can be limited and there will be little to no consumer recourse
An individual in an ACA compliant small group plan can file a complaint with the Bureau of Insurance if they disagree with a claim denial. There is no such process for these plans. Additionally, these plans do not have to meet any network adequacy standards and can design there benefits to deter sicker, more costly, enrollees.
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Premiums can fluctuate greatly from one year to the next based on one employee’s health
The impact of one sick employee can have an outsized impact on the rates of a small group.
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To avoid higher premiums, a business might consider discriminating in their hiring practices to limit the number of older, sicker, or female employees.
Allowing rates to vary greatly based on age, gender or health status puts employers in a position of knowing that hiring certain individuals will increase health insurance rates for them and all their employees.
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These plans have a history of mismanagement
Other states have reported a myriad of problems with similar plans, including examples of self-dealing, high administrative fees, and failure to set rates properly.
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The plans will target and draw tens of thousands of younger and healthier people out of ACA compliant plans, driving up rates up for older and sicker consumers and small businesses who require comprehensive coverage.
Instead of allowing unregulated and risky health plans that will fragment the market, the legislature should support a state reinsurance program. That approach protects the ACA marketplace, which currently serves almost 300,000 Virginians, and it will reduce health insurance premiums for even more Virginians.
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