The Independent Insurance Agents & Brokers of America and the Council of Insurance Agents & Brokers expressed “disappointment” and “concern” over the sweeping health care reform bill passed by the U.S. House of Representatives on Sunday.

The reform package, estimated to cost $940 billion over 10 years, will, among other things, extend health care coverage to 32 million uninsured U.S. residents, chiefly by expanding Medicaid and establishing federal health insurance premium subsidies to those with moderate incomes. State-based health insurance exchanges will be created for the uninsured to compare and shop for plans.

The legislation is packed with provisions that will affect employer-sponsored health care plans.

On Sunday, the Big I said it was “disappointed” with the bill's passage, saying it does “little to stem the skyrocketing cost of health care” and that it will be financed “on the backs of small business during one of the most delicate financial periods in American history.”

In particular, the IIABA said it is concerned with the .9% Medicare surtax and new 3.9% tax on nonwage income that will be imposed on some individuals and small businesses that file as individuals to finance the government-run health insurance plan.

“A tax increase, especially during today's tough economic climate, will put many small businesses in the untenable position of deciding between job cuts, employee pay cuts, or shutting their doors,” said Charles Symington, IIABA's senior vp of government affairs, in the statement.

The IIABA also said it is disappointed that the bill contains no “meaningful attempt” at medical malpractice reform, which it contends will help bring health care costs down.

Joel Kopperud, director of government relations for the Washington-based CIAB said the association is “concerned” about the impact the reform bill will have on the employer-provided marketplace.

“We worry the mandates are ineffective and may not truly cover the cost of market reforms, possibly resulting in higher premiums,” Mr. Kipperud said in an e-mail this morning. “That said, we are relieved that premium regulation remains at the state level with solvency regulations, and that brokers may be able to represent their clients through state exchanges,” he said.