Alfa health plans bill goes to governor

MONTGOMERY — The Alabama Legislature on Thursday gave final approval for Alabama Farmers Federation to sell health care plans to its members, a first-of-its-kind proposal in the state.

House Bill 477, one of the biggest issues of the session, pitted Alfa against some of the state's health care establishment, including Blue Cross and Blue Shield of Alabama and the American Cancer Society.

Proponents said the plans would be a financial benefit to struggling ranchers and crop producers; opponents said the unregulated plans look like health insurance, without the same protections as traditional plans.

"For me, this is a freedom of contract issue," Sen. Arthur Orr, R-Decatur, said on the Senate floor Thursday afternoon prior to that chamber's vote that sent the bill to Gov. Kay Ivey.

Orr sponsored a similar bill last year and Alfa and supporters have worked, and made changes, to round-up support for the health plans that have been approved in about a dozen other states.

Alfa President Jimmy Parnell called Thursday a big day for farm families.

"With farmers facing the worst economic challenges in 40 years, passage of Alfa health plans legislation provides hope for the survival and sustainability of these family businesses," Parnell said. "The engagement of Alabama Farmers Federation members — from phone calls and emails to multiple trips to the State House — demonstrates the importance of this issue. This bill will have a positive impact on Alabama agriculture and small businesses for generations to come."

The bill passed 32-2-2.

Alfa has said because farmers don't have employer-provided insurance and earn too much for significant subsidies under the Affordable Care Act, insurance premiums are driving them out of business and keeping young people from entering the profession.

Sen. Jack Williams, R-Wilmer, said his grandson pays $2,400 a month for a policy that covers him, his wife and baby.

"It's hard to make it," Williams said. "If we don't do something to help our young farmers out, we're not going to have any because they've got to go somewhere else to work for insurance."

Amendments to the bill this session included:

Agreeing to pay a 1.3% tax on premiums paid by members.

Stipulating that people who have access to employer-sponsored health insurance can't participate in the Alfa plans unless the employer insurance is more than 9% of his or her household income.

Added prescription drug and mental health and substance abuse treatment to covered services. Others are ambulatory, laboratory and emergency services and hospitalizations.

Putting into the legislation that customers won't have their health benefits contract canceled or see their premiums increased because of a "medical event."

One of the biggest opponents of the legislation was Blue Cross and Blue Shield of Alabama.

"We appreciate the many changes the Legislature made to the bill that was originally proposed in an effort to provide some protections for consumers, but we still believe allowing a single company to sell an unregulated health plan administered entirely outside of the state of Alabama is a mistake," BCBS spokeswoman Sophie Martin told ADN Thursday evening.

Like they have previously, bill supporters were able to fight off Thursday proposed amendments to require that people with pre-existing conditions have access to the plans and to give the Alabama Department of Insurance the authority to enforce provisions of the law.

"If an emergency claim is denied, who do the farmers go to?" Sen. Linda Coleman-Madison, D-Birmingham, said on the Senate floor.

Orr on the Senate floor said Alfa will have a vested interest in treating their customers right. Customers could sue over a breach of contract, and going to court would cause Alfa to lose credibility and customers, he said.