Alfa health plan bill gets overwhelming House support

MONTGOMERY — The Alabama Farmers Federation's proposal to offer health plans to its members won House approval on Thursday in an overwhelming vote, but not before extensive debate about removing an oversight amendment added in committee earlier in the week.

House Bill 477 from Rep. David Faulkner, R-Mountain Brook, has been amended multiple times in the last week to add more required coverage and consumer protections, including not being able to drop customers if they get seriously ill, in an effort to win support.

The plans are needed, Faulkner and Alfa argue, because farmers struggle with health insurance costs. They're usually self-employed without employer-provided insurance but make too much money to qualify for subsidies under the Affordable Care Act.

"The rising cost of health care is a significant burden for our farmers," Faulkner said on the House floor.

The bill was approved 98-1.

"We are encouraged by the strong bipartisan support House members showed today for Alabama farmers," Brian Hardin, Alfa's director of external affairs, told ADN. "We appreciate Speaker (Nathaniel) Ledbetter and House leadership for bringing this important legislation to the floor and Rep. Faulkner for addressing concerns while preserving its effectiveness."

Ten other states offer what Faulkner is proposing. Based on their plans, Faulkner said farmers in Alabama could save 30% to 60% on health care costs.

"This is not a plan for everyone," he said. "This is a plan that is offered to the members of the Farmers Federation."

Faulkner said multiple times Thursday that this proposal has more restrictions and oversight than any other state's. Recent additions to the bill include requirements that ill people can't be dropped, specific care must be covered, including emergency services and mental health and substance abuse, and a complaint process.

Opponents of the bill have argued the plans look like insurance but can't be called insurance because they won't have to follow all the state and federal laws insurers do. Blue Cross and Blue Shield of Alabama and the American Cancer Society have opposed Alfa's ability to deny coverage based on pre-existing conditions. Federation officials say Alfa's reputation and close ties with members are a natural deterrent to denying any coverage and honoring members' contracts.

Rep. Paul Lee, R-Dothan, also amended the bill on the House floor. Though the Alfa plans will have no annual spending caps, Faulkner said, the state hospital association requested the amendment that said there won't be an annual limit "of less than $2 million per year" per covered individual.

Rep. Mark Shirey, R-Mobile, said he's heard from more farmers than lobbyists about the bill.

"These people are begging for this plan and we're standing in the way," he said in a dialog with Faulkner. "They want this bill passed with a whole lot less restrictions than we have on it now."

A lot of farmers are going without insurance now, Shirey said. If they don't like the Alfa plans, they can get out and be no worse off.

The bill now moves to the Senate where Sen. Arthur Orr, R-Decatur, has sponsored previous versions.