skip to main content

H.R. 1304: Self-Insurance Protection Act

This was a vote to pass H.R. 1304 in the House.

H.R. 1304 clarifies that federal regulators cannot redefine “stop-loss” insurance as “health insurance coverage” under federal law. Specifically, the legislation amends the Employee Retirement Income Security Act of 1974 (ERISA), the Public Health Service Act (PHSA), and the Internal Revenue Code (Code) to continue allowing employers to utilize stop-loss insurance coverage, a financial risk-management tool, when offering employees health care coverage through a self-funded plan. The bill does not restrict the regulation of stop-loss insurance at the state level.

An employer who self-funds provides for employees’ medical costs by paying providers directly or reimbursing employees as claims arise. This occurs instead of paying a fixed premium to an insurance company. In these circumstances, a trust is typically set up to fund such claims. Self-insured employers are responsible for employees’ health care expenses, and they have the flexibility to customize the design of their health plans to meet the specific needs of their workforce.

Some employers who self-insure purchase stop-loss insurance as a financial risk management tool to protect against catastrophic claims. Stop-loss coverage reimburses a self-insured sponsor for medical claims that exceed a certain pre-established level of liability, but it does not insure employees or reimburse medical providers for care.

Stop-loss insurance is regulated at the state level, but not the federal level. The previous administration repeatedly signaled interest in regulating stop-loss insurance as health insurance under ERISA, the PHSA, and the Code, potentially forcing many employers to decide between offering self-insured employee benefits and offering a potentially more expensive fully-insured health care plan. H.R. 1304 will ensure the federal government cannot regulate stop-loss insurance, protecting access to flexible and affordable health care coverage.

Source: Republican Policy Committee


Congress
115th Congress
Date
Apr 5, 2017
Chamber
House
Number
#220
Question:
On Passage of the Bill in the House
Result:
Passed

What you can do

Key: R Yea D Yea D Nay
Seat position based on our ideology score.
This is a cartogram. Each hexagon represents one congressional district.
Totals     Republican     Democrat
  Yea 400
 
 
93%
230 170
  Nay 16
 
 
4%
0 16
Not Voting 13
 
 
3%
6 7
Required: Simple Majority source: house.gov

Vote Details

Notes: The Speaker’s Vote? “Aye” or “Yea”?
Download as CSV

Statistically Notable Votes

Statistically notable votes are the votes that are most surprising, or least predictable, given how other members of each voter’s party voted and other factors.

All Votes