Letter from health care advocates to Alabama lawmakers

Originally sent February 17, 2025

Dear Alabama Lawmakers,

The undersigned organizations write today to express our unequivocal opposition to SB 84 and HB 477, legislation allowing for the sale of substandard health plans, known as Farm Bureau plans. If enacted, this proposal risks access to health care and the financial security of Alabamians, particularly those battling chronic or life-threatening illnesses.

Patients and consumers deserve health insurance they can afford to use when illness strikes. It should include all the essential health benefits to protect people when they become sick and should be available regardless of one’s medical history. Good coverage should also be properly regulated and overseen to ensure that customers’ financial and medical interests are protected.

We oppose SB 84 and HB 477 for the following reasons:

These products are marketed as a solution for farmers, yet nearly 2 in 3 farmers have pre-existing conditions, and these products would not be required to accept people with pre-existing conditions. If people with pre-existing conditions are accepted, they could be charged a higher premium and not have coverage for care related to their pre-existing conditions.

These new products would not have to limit annual and lifetime out-of-pocket costs and could put caps on key benefits. This could leave patients with massive medical bills or force them to forgo needed treatment.

Consumers would also face the risk of rescission, the practice of retroactively canceling coverage or payment for services based on a person’s medical history.

These products are an inadequate option for closing the coverage gap. For example, Kansas Farm Bureau officials estimated in 2019 that more than 42,000 people would purchase their coverage, and suggested it could supplant the need for any form of Medicaid expansion. However, a mere 16,000 people were covered by these plans in late 2023. Both figures pale in comparison to the 150,000 Kansans who live in the coverage gap.

These products would have no oversight from the state Department of Insurance, leaving consumers in the lurch if they have any problems with their coverage.

These plans create a false sense of security for consumers, who may only discover the gaps in coverage when they face a serious illness. This lack of comprehensive coverage not only undermines the health of Alabamians but could shift costs to the broader health care system as patients are forced to delay or forgo necessary care. These plans are a step backward, returning us to a time when insurers could discriminate against the sick and deny coverage to those who need it most.

We support innovative efforts to improve health coverage affordability and access, but not if these efforts compromise patients’ ability to receive the care they need. We ask you to partner with us to champion policies that strengthen access to comprehensive, affordable health care for all Alabamians.

For further information, please contact Jane Adams with the American Cancer Society Cancer Action Network at jane.adams@cancer.org and Jada Shaffer with the American Heart Association at jada.shaffer@heart.org .

Sincerely,

Abilities Unlimited LLC DBA Accessible Alabama

AIDS Alabama

Alabama Arise

Alabama Coalition for Immigrant Justice

Alabama Institute for Social Justice

Alabama Poor People's Campaign

Alabama Rare

American Cancer Society Cancer Action Network

American Heart Association

American Lung Association

Beloved Community Church, UCC