12/22/2005
Hopes for curing America's chronic health-care woes were raised this year as Congress again considered Small-Business Health Plans, and small-business owners nationwide are in for the long fight.
More than half of the 45 million Americans without health insurance are small-business owners, their families or their employees. With high deductibles, rising premiums and limited plans from which to choose, small businesses face a mounting challenge in finding and paying for quality health care.
Small-Business Health Plans would allow employers across the country to join together through trade and professional associations to purchase health benefits at a better bargaining rate. The House has passed SBHP legislation eight times, including once this summer, but the Senate has only recently shown signs of stirring.
NFIB: Making a difference
NFIB worked hard this year to push SBHP legislation forward, lobbying lawmakers in the House and the Senate, tracking votes and urging members to share their health-care dilemmas with lawmakers through testimony at committee hearings, letters, faxes and e-mails. Thanks to NFIB members and other small-business owners across the country, more than 7,000 letters were sent to Capitol Hill in 2005, showing the dramatic impact of the health-care crisis for small business.
“There’s considerably more momentum now to fix health insurance costs than we’ve seen in quite a while,” NFIB President Jack Faris said. “We’ve been telling lawmakers for years that small businesses are desperate for a cure. The message finally seems to be getting through to some senators—but we can’t declare victory just yet.”
Climate for change
Signs that the climate for reform had improved began early this year when President George W. Bush again voiced his support for SBHPs—also known as association health plans—and called for their passage in his State of the Union address. In February, a bipartisan group of representatives introduced the Small Business Health Fairness Act of 2005 (H.R. 525), and a companion bill (S.406), sponsored by Sen. Olympia Snowe (Maine), soon followed.
The legislation, endorsed by NFIB, promised to give small businesses access to the same types of discounts offered to labor unions and Fortune 500 companies by allowing them to band together across state lines to purchase health insurance—saving employers a projected $450 to $1,250 per employee. To help lower administrative costs, the bills also allowed for uniform federal regulation of the plans, instead of the hodge-podge of state regulations that create skyrocketing costs today.
Battle heats up
Insurance companies dominating the small-business market came out swinging, holding press conferences slamming the merits of the plans, but their attacks failed to stifle support for the legislation. H.R. 525 passed quickly through committees to the House floor, while its counterpart, S. 406, stalled, despite calls urging senators to act from NFIB and others in the AHP coalition, a group comprised of more than 200 organizations supporting the passage of Small-Business Health Plans.
In July, lawmakers took a positive step toward alleviating the suffering for small business when the Small Business Health Fairness Act passed the House 263-165. Representatives also committed to making health care more available and affordable through a 230-194 passage of The Help Efficient, Accessible, Low-Cost, Timely Healthcare Act of 2005 (H.R. 5), legislation capping noneconomic damages for medical malpractice suits at $250,000 and ensuring liability only in direct proportion to percentage of responsibility.
The fight ahead
Thanks to pressure from NFIB and its members, more senators joined the fight to make Small-Business Health Plans a reality this fall, with S. 406's cosponsor list growing to 16 in the fall when three more senators signed on. (See if your senators are on the list.) Still, the deadlock persisted in the Senate. Sen. Mike Enzi (Wyo.), who chairs the key Senate committee on health-care legislation, broke the impasse by introducing the Health Insurance Marketplace Modernization and Affordability Act of 2005 (S. 1955), a compromise bill blending a modified version of S. 406 with initiatives to streamline varying state benefit mandates and rating rules. The bill, which calls for states to regulate SBHPs, requires associations to offer benefits mandated in 45 states or more and doesn’t allow them to self-insure their plans. NFIB gave qualified support to the introduction of Sen. Enzi’s bill and has vowed to work with him to address our concerns about the legislation. While we do feel S. 1955 provides some relief for small-business owners struggling with health-care costs, we still believe S. 406 would be the better bill for small business.
What you can do now
- Check your e-mail preferences on NFIB.com by registering as a member (click "Sign In" or "Join" in the black bar above this article, or "My Account" to check your preferences if you're already a member) to ensure you are signed up for "Legislative E-Watch." When you are, you'll receive action alerts on pending legislation like SBHPs—you'll know exactly when to contact your lawmakers.
