Members of the House today voted 400-16 forthe Self-Insurance Protection Act bill.

Related: Commitee backs stop-loss, AHP and wellnessbills

The bill, H.R. 1304, would block federal efforts toregulate small stop-loss plans as health insurance by excluding theplans from the federal definition of "health insurancecoverage."

All 230 of the Republicans who voted supported passage.

Just 16 of the 186 Democrats who participated opposed passage;the other 170 joined with Republicans to supportpassage. Self-Insurance Institute of America President MikeFerguson says one concern has been catastrophic claims.

Employers self-insure their health plans to get more controlover the plans, and to take advantage of federal rules that preemptstate efforts to regulate employee benefits. States can regulatethe insurance that insurers provide for group health plans, butstates cannot regulate the benefit plans themselves.

Related: Medical stop-loss insurance is trendingup

Sponsors of self-insured plans often use stop-loss, or insurancefor insurance plans, to protect themselves against catastrophiclosses.

Some consumer groups, regulators, insurers and others havesuggested that very small employers may be making more use ofself-insurance to avoid Affordable Care Act benefits requirements,consumer protection requirements and other requirements.

Observers have said that those may be using stop-loss insurancearrangements with attachment points, or deductibles, of $50,000 orless as if the arrangements were high-deductible major medicalcoverage, without understanding that stop-loss carriers operateoutside the rules that apply to major medical coverage.

Some states have tried to discourage small employers fromself-insuring by imposing small-group major medical rules on smallstop-loss arrangements.

Related: The case for self-funding at small and mid-sizedbusinesses

Rep. David Roe, R-Tenn., the lead sponsor of H.R. 1304, hasargued that self-insurance and stop-loss are popular optionsthat help many large employers offer solid coverage at a reasonablecost.

Rep. Virginia Foxx, R-N.C., said Wednesday on the floor of theHouse that self-insured plans and stop-loss insurance are popularwith labor unions as well as with schools,cities, counties and other nonprofit employers, in partbecause the sponsors of the plans can do a better job than sponsorsof fully insured plans of tailoring the benefits to fit theenrollees' needs.

"Stop-loss has never been regulated as health insurance by thefederal government, ever," Foxx said during floor debate, whichwas streamed live on the web.

Obama administration officials started to make efforts tocontrol stop-loss insurance to consolidate their grip on the healthinsurance market, Foxx said.

Rep. Bobby Scott, D-Va., who voted for H.R. 1304, criticized thebill, and the idea of small employers self-insuring, on the Housefloor.

"Employees are at risk of receiving fewer benefits," Scottsaid.

Scott said, however, that a clarifying note added toa bill report at the committee levelsuggests that H.R. 1304 should not actually affect the ability ofthe states to regulate stop-loss insurance. Because the federalgovernment is not currently regulating stop-loss insurance, thebill should not have any affect on current stop-loss marketregulation, he said.