Bill shields stop-loss insurance from state oversight, shifting health costs to workers

What it does

This bill exempts stop-loss insurance purchased by self-insured employers from federal health insurance regulation under ERISA, and preempts state laws that restrict such insurance. Stop-loss insurance protects employers' own assets against catastrophic employee health claims; the bill treats it as a financial risk tool rather than health coverage, removing it from federal oversight and allowing employers to buy it without state-level restrictions.

Why we flagged it

The bill's operative mechanism is a narrow exemption from federal and state oversight of stop-loss insurance. It redefines what counts as 'health insurance coverage' under ERISA to exclude stop-loss policies, and preempts state regulation of those policies—a classic deregulatory carve-out benefiting self-insured plan sponsors.

What the text implies

• Stop-loss insurance thresholds can be set high enough that employees bear most routine and moderate claims; the bill removes state-level guardrails that might otherwise prevent this cost-shifting to workers.
• Preemption of state law (Section 514 amendment) eliminates state consumer protections and solvency requirements for stop-loss carriers, potentially leaving employers and employees exposed if an insurer fails.
• The exemption from federal health insurance definition may allow stop-loss policies to operate outside transparency and disclosure rules that apply to other health coverage, obscuring true employee cost exposure.
• Small employers may face higher stop-loss premiums or reduced availability if state regulation is eliminated, contrary to the bill's stated finding that states should 'reasonably regulate' to assure availability to both large and small employers.

Section numbers refer to the bill text the analysis read — linked under Primary records below.

Who it affects

The bill reduces regulatory oversight of stop-loss insurance, which employers use to limit their exposure to employee health claims. By preempting state regulation and excluding stop-loss from federal health insurance rules, the bill weakens protections that might otherwise ensure stop-loss policies do not undermine employee access to health benefits or shift catastrophic costs back to workers when claims exceed the stop-loss threshold.

Who stands to gain

• self-insured employers (large and small)
• stop-loss insurance carriers and underwriters
• insurance brokers and consultants specializing in stop-loss

Named in the bill

Employee Retirement Income Security Act of 1974 (ERISA), Section 733 of ERISA, Section 514 of ERISA, self-insured group health plans, plan sponsors, stop-loss insurance carriers, state insurance regulators

Where it stands

2 cosponsors: 2 Republicans.

• Apr 1, 2025 — Introduced · Congress.gov: “Introduced in House”
• Apr 1, 2025 — Referred to House Committee on Education and Workforce · Congress.gov: “Referred to the House Committee on Education and Workforce”
• Jun 25, 2025 — Markup held in committee · Congress.gov: “Committee Consideration and Mark-up Session Held”
• Jun 25, 2025 — Reported out of committee · Congress.gov: “Ordered to be Reported (Amended) by the Yeas and Nays: 21 - 15”

Dates and quoted wording are Congress.gov's action record; the timeline shows status changes, not every procedural step.

Money around this bill

6 lobbying clients named this bill on 8 disclosure filings across 2 quarters, Dec 2025 to Jun 2026. Those filings disclosed $8,730,000 in lobbying spend. A filing names 34 bills on average, so that figure is what each filing reported, not a share belonging to this bill.

More lobbying clients named this bill than 82% of bills with at least one filing.

Robert Onder, the sponsor, reported $438,000 in PAC receipts in the 2026 cycle.

• American Cancer Society Cancer Action Network Inc — $3,620,000 on 2 filings
• America's Health Insurance Plans Inc (ahip) — $3,010,000 on 1 filing
• National Association of Wholesaler-distributors — $880,000 on 2 filings
• Nationwide Mutual Insurance Company — $670,000 on 1 filing
• American Heart Association — $400,000 on 1 filing

Lobbying Disclosure Act filings through Jul 20, 2026. A filing shows who paid to lobby on a bill it names, not what changed.