Relating to small and large employer health group cooperatives.
Impact
The bill is expected to create a more inclusive health insurance market by enabling single-employee entities to join health group cooperatives. This could lead to better insurance options and lower premiums for these smaller businesses, which often struggle to find affordable health coverage. Additionally, the legislation stipulates that health group cooperatives must adhere to regulations regarding the treatment of employers enrolled within them, ensuring fairness in premium rates and coverage options across different business sizes.
Summary
SB972 seeks to amend the Insurance Code of Texas to facilitate the formation and functioning of health group cooperatives that include small employers, large employers, and eligible single-employee businesses. This legislation introduces the term 'eligible single-employee business' for businesses with fewer than two employees, allowing them to participate in cooperative health plans that were previously limited to larger entities. By expanding the membership eligibility, the bill aims to enhance accessibility to health coverage for small and solo businesses, potentially reducing the financial burden associated with securing such benefits independently.
Contention
Notably, the legislation may raise concerns regarding the financial viability of health cooperatives as they take on a broader range of members. Critics might argue that including single-employee businesses could lead to adverse selection issues, where healthier groups opt out, leaving riskier groups—which could include businesses with higher health care needs—to dominate the pool. Additionally, questions about the administrative capabilities of cooperatives to adequately cover a more diverse range of participants could be a source of contention among legislators and health policy experts alike.
Relating to the nonsubstantive revision of the health and human services laws governing the Health and Human Services Commission, Medicaid, and other social services.