New Congress, Old Debate: Affordable Health Insurance for Small Businesses

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It may be a new year and a new Congress, but providing small businesses access to affordable health care remains a key issue for Capitol Hill lawmakers. Already this year, House Republicans made an unsuccessful attempt to bring Small Business Health Plans (SBHP) legislation to a vote; Sen. Ted Kennedy (D-MA), the chairman of the Health, Education, Labor, and Pensions (HELP) Committee, convened a committee on health care policies; and Sen. Michael Enzi (R-WY) has holding discussions with Senate Democrats in an effort to finally get SBHP legislation passed.

Meanwhile organizations representing small and independent businesses are continuing their push for passage of legislation that would allow business and trade associations to offer their members group health coverage on a national or regional basis.

In January, the American Booksellers Association wrote to Sen. John Kerry (D-Mass.) and Rep. Nydia M. Velazquez (D-N.Y.), the chairs of the Senate Committee on Small Business & Entrepreneurship and the House Small Business Committee, respectively, requesting a meeting in the near future to discuss relevant small business issues, including the need for adequate health insurance options for its members.

Craig Orfield, a spokesperson for Sen. Enzi, the ranking member of the HELP Committee, told BTW that the senator was continuing to hold discussions with prominent Democrats, including Sen. Richard Durbin (D-IL), in an effort to reach a compromise on his SBHP legislation. "I don't think there is any questions that [Enzi's SBHP] legislation will be introduced this year," Orfield said.

Last spring, Enzi's attempt to push for a quick vote on his legislation, The Health Insurance Marketplace Modernization and Affordability Act, S. 1955, was blocked when the Senate voted 55 - 43 against cloture. Similar legislation crafted by Durbin based on the successful Federal Employees Health Benefits Program, which provides extensive benefit choices at affordable prices to members of Congress and federal employees, was proposed last spring as well.

"There weren't enough Democrats to support [Enzi's] bill," Orfield said of last year's vote on S. 1955. "Since that time, Sen. Enzi has had additional Democrats approach him, and they say they remain interested and could support it. We need to negotiate a few points here and there."

Last year's opposition to the Enzi bill came from many Democrats, as well as groups such as the American Cancer Society and the American Diabetes Association, who were concerned that the legislation would lead to the creation of low-end insurance plans excluding benefits currently mandated in many states, including cancer screenings, mammography, pap smears, and colonoscopies. However, Orfield noted, under the Employee Retirement Income Security Act of 1974 (ERISA), large unions are not bound by state mandates.

This year, Enzi hopes that working with Senate Democrats will increase the chances his revised SBHP legislation will pass. Orfield was quick to note, however, that although Enzi has had discussions with Durbin, the Illinois senator had made no commitment to support Enzi's legislation.

On a second front, on January 10, Sen. Kennedy convened a hearing on "Health Care Coverage and Access: Challenges and Opportunities." Todd Stottlemyer, president and CEO of the National Federation of Independent Business (NFIB), which had representatives at the hearing, said in a statement, "Small business is the country's leading job creator and represents 99 percent of employers, so a reasonable health care solution demands the attention of our federal lawmakers. It will take both sides of the aisle to broker an agreement and find common ground. We are confident that an open, honest debate on this critical issue can take place, and we encourage the leadership to set a timeline."

Meanwhile, in the House, on January 5, Democrats voted against Republicans efforts to tack Rep. Samuel Johnson's (R-TX) Small Business Health Fairness Act onto a minimum wage bill. According to Stephanie Cathart of NFIB, Democrats rejected the effort because it was non-germane to the minimum wage legislation. --David Grogan