H.R. 2813, Self-Insurance Protection Act

H.R. 2813 would amend the Employee Retirement Income Security Act of 1974 (ERISA) to exclude stop-loss policies from that act’s definition of health insurance coverage. Stop-loss policies insure against excess or unexpected losses and are obtained by self-insured group health plans or plan sponsors of a group health plan that self-insures. Excluding stop-loss policies from the definition of health insurance coverage would exclude those policies from being regulated by ERISA. The bill also would preempt state laws that prohibit group health plans from obtaining stop-loss policies.

CBO and the staff of the Joint Committee on Taxation (JCT) estimate that enacting H.R. 2813 would have insignificant effects on direct spending, revenues, and deficits over the 2023-2033 period. CBO and JCT’s analysis of state laws indicates that few states prohibit the sale of stop-loss coverage; thus, the bill’s preemption of state laws would affect only a small number of people.

H.R. 2813 would impose an intergovernmental mandate as defined by the Unfunded Mandates Reform Act (UMRA) by preempting any state laws that prevent certain group health plans from using stop-loss policies to insure against excess or unexpected claims losses. CBO estimates that the cost of the mandate would not exceed the intergovernmental threshold established by UMRA ($99 million in 2023, adjusted annually for inflation). The bill would not impose any private-sector mandates.