The federal debate largely centers on proposals to allow employers or individuals to purchase insurance through association health plans (AHP). The federal proposals for AHPs would allow creation of both inter- and intra-state plans, which would not be subject to the many state insurance requirements, including minimum benefit packages, prompt payment to providers, and access to state-required appeals processes (by extending ERISA preemption to AHPs). Proponents for AHPs suggest that small businesses and individuals would gain bargaining power in the markets; however, opponents view dropping benefits currently mandated by state legislation as a strategy that would likely appeal to only the healthiest groups and raise costs even more for those less-healthy groups who are not in the AHP.

[The Robert Wood Johnson Foundation - http://statecoverage.net/matrix/grouppurchasing.htm]

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