Healthcare Legislative Activity: The Next Steps for Reform

Date: October 02, 2015

Just because we have a new healthcare law, doesn’t mean the fight is over and it doesn’t mean there isn’t additional healthcare legislation we can and will be working on. There are still opportunities to right this wrong, and there are always new and different legislative approaches to be pursued.
Our Legislative Priorities

NFIB's 10 Principles of Healthcare Reform
- our current system of health insurance and healthcare is financially unsustainable and threatens the health and financial security of the American people. Small business owners and their employees are especially vulnerable to the weaknesses of our current system. NFIB supports policy reforms to balance the competing goals of access to quality care, affordability, predictability and consumer choice. Read NFIB's Principles.

Repeal the "Small Business Health Insurance Tax"- the new healthcare law includes an $87 billion health insurance tax (HIT) that will fall hard on small businesses. The HIT, which is levied on health insurance companies, will almost entirely be passed onto consumers in the fully insured marketplace, where nearly all small businesses and the self-employed purchase their coverage. This new tax on small businesses will raise insurance costs for already struggling small businesses and is contrary to the goals of healthcare reform. Learn more on how the "HIT" might impact your business and insurance costs.

Repeal the Employer Mandate Provision - The Patient Protection and Affordable Care Act will impose large financial penalties on certain employers who do not provide health insurance coverage and, in some cases, on employers who do provide coverage.

VICTORY! Preventing Unnecessary Premium Increases - NFIB led the charge to repeal the mandatory federal expansion of the small business insurance definition in PPACA.  The “small group market” definition was scheduled to automatically increase from businesses with fewer than 50 employees to businesses with fewer than 100 employees in 2016.  Midsized businesses (50-100 employees) would have seen increased costs due to new insurance restrictions and requirements, and would have lost the health insurance plans they currently enjoyed.  Current small group market businesses (1-50 employees) would have also seen increased premiums and more midsized businesses opted to self-insure, and only businesses with less healthy risk pools joined the new small group market.  If the small group market expansion would lower premiums for small businesses, the decision to expand is left to individual states.NFIB supports H.R. 1624, the Protecting Affordable Coverage for Employees Act (PACE).

VICTORY! Maintaining Flexibility for Businesses to Control Increasing Costs - NFIB lead the charge to repeal arbitrary limits on deductibles that exclusively applied to small businesses.  The $2,000 limit for employee-only policies and $4,000 limit for family plans were included in the PPACA, and were scheduled to begin in 2014, and would have necessarily increased premiums and decreased benefit design flexibility for small businesses.  These limits would have threatened small businesses’ ability to access high deductible health insurance plans in the future.  NFIB supports Section 213 of H.R. 4302, the Protecting Access to Medicare Act of 2014.

Healthcare Exchanges - the creation and implementation of the new healthcare exchanges will be of huge importance to small business owners and their employees. We remain committed to ensuring these exchanges provide the most opportunities they can for small business owners – in order to try to encourage competition as much as possible.

 - NFIB pursued and supported a proposal called vouchers and, while it didn’t make it into the new healthcare law, we will continue to work to gather support for future introduction of this legislation in Congress. Vouchers would provide a new, voluntary way to give small employers and their employees more options to purchase health insurance.

Liability Reform - due to skyrocketing medical liability insurance rates, small business owners are finding it difficult to afford health insurance for themselves and their workers, and to locate specialty medical care from OB/GYNs, surgeons and emergency room doctors. We support legislation that would cap non-economic damages in medical liability suits at fair rates and abolish joint liability so that liability is commensurate with responsibility. NFIB also supports capping attorney fees to ensure that patients harmed from negligent care are allowed to keep a higher percentage of the award.

VICTORY! 1099 Reporting Requirement Repealed from PPACA - in a win for small businesses, in early 2011 the president signed off on a bill to repeal the onerous IRS Form 1099 reporting requirement, which was included as part of the Patient Protection and Affordable Care Act. NFIB led the repeal effort on behalf of over 350,000 member businesses. Some previous 1099 mandates for small business are still in effect.

Coalition Activity
NFIB is an active participant in the Small Business Coalition for Affordable Healthcare. The Small Business Coalition for Affordable Healthcare is a group of more than 150 organizations dedicated to increasing access and affordability of private health insurance for small business owners, the self-employed, employees and their dependents.

NFIB is the lead organizer of The Stop the HIT Coalition which represents the nation’s small business owners, their employees and the self-employed who are actively working to repeal the Health Insurance Tax (HIT) provision in the Patient Protection and Affordable Care Act. The Stop the Health Insurance Tax Coalition (Stop the HIT Coalition) is working to repeal the costly, unfair and hidden health insurance tax on small businesses that begins in 2014.


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