[Congressional Record Volume 149, Number 41 (Thursday, March 13, 2003)]
[Senate]
[Pages S3667-S3668]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                        COVER THE UNINSURED WEEK

  Mr. TALENT. Mr. President, this is ``Cover the Uninsured Week'' and 
there have been press events--and I guess you can call them rallies--
around the country designed to inform America about the problem of the 
uninsured. I guess I am glad that is happening. It seems as though it 
happens a lot. We have been talking about the uninsured for a long 
time.
  I think it is time we do something about the uninsured instead of 
just telling everybody that we have. And we can do that. I would 
suggest we are on the brink of doing it. We in the Senate just have to 
choose between the employees of the small businesses around the 
country, who are most of the uninsured, and the big insurance companies 
that have them under their thumb currently.
  There are about 41 million uninsured people in the country at any 
given time. About 60 percent of those uninsured people are either 
owners of small businesses or employees of small businesses, or 
dependents of somebody who owns or works for a small business. Most of 
the people who are uninsured are working people. The reason they are 
uninsured and the reason they are not getting health insurance through 
their small business is that the small businesspeople are caught. They 
are stuck on a dysfunctional market. They are caught because all they 
bring to that market is a unit of 4 or 5 people, or maybe 20 or 30, or 
maybe 60 or 70. And they have very few choices. They consistently pay 
higher costs for health insurance premiums, and they get lower quality 
insurance than people who work for big businesses or people who work 
for the Federal Government, as we do.
  I have seen this all over the State of Missouri and, indeed, all over 
the country. I chaired the Small Business Committee for two terms in 
the House. In that capacity and since then, I have visited personally 
with hundreds and hundreds of small businesspeople and with thousands 
of their employees. This is their No. 1 issue. It is not fair for them 
to be laboring under impediments that the rest of us do not have.
  I was in Farmington, MO, over the weekend. I stopped by an 
optometrist's office run by a couple of optometrists, and a couple of 
their employees were there. They gathered around and told me a very 
familiar story. In 1999--I think it was--they said, we just felt we had 
to start providing health insurance to our people, as expensive as it 
was and as difficult as it was.
  They had to spend hours and hours soliciting bids, maneuvering, and 
trying to get insurance for their people. So they started it.
  They said: When we started, it was a little over $200 a month per 
employee. Now, 4 years later, it is over $500 a month per employee.
  They are not able to give wage increases to their people because 
health insurance costs are increasing so fast.
  Everywhere I go, small business health insurance costs are going up 
20 or 25 percent a year.
  There is a further human side to this story. One of their employees--
a really neat lady--I talked with for a while. She is a single mom and 
a cancer survivor. She is trapped, and the small business is trapped 
with her, because if they drop the insurance, she will never get 
reinsured anyplace else. They feel a moral obligation to continue that 
insurance for her. The other employees are doing without wage increases 
and dealing with substandard insurance in order to help their fellow 
employee.
  I have seen this story over and over again. And it is not necessary. 
We can do something about it, and we need to.
  Here is what we can do.
  The House passed several times in the 1990s--and the President now 
supports the plan--a plan that would simply allow small businesses to 
pool through their national trade associations or their professional 
associations and get health insurance on the same terms and under the 
same regulatory apparatus as the big businesses, the unions, and the 
Government currently do.
  That is all we need to do, just empower the small businesspeople. It 
will not cost the taxpayers a dime because it is not a Government 
program. It is just allowing people to do what is already happening all 
over the United States.
  So here is how it would work: Let's say the National Restaurant 
Association would sponsor national health insurance plans. They would 
start an employee benefit side, just like the big companies do. They 
would contract with national insurance companies. They would have a 
self-insured side. And then, if you are a restaurant employee, by 
joining the restaurant association, you would automatically be entitled 
to get this insurance. They would have to offer it to you. They could 
not tell you you could not have it. And you would be part of a pool of 
20,000 or 30,000 people instead of in a unit by yourself with two or 
three or five or ten people, like my brother's situation. He has a 
little tavern kind of restaurant in St. Louis. Actually, it may be more 
of a saloon. But, in any event, he could join the National Restaurant 
Association to get coverage. It is just him and my sister-in-law who 
run this place. Apart from the money, which is impossible for him, he 
does not have the time and does not want to incur the risk of going out 
two or three times a year and soliciting bids.
  And then, all of a sudden, what often happens to small businesspeople 
is they get called up because somebody actually filed a claim. The big 
insurance company tells them their rates went up astronomically. They 
have no power in this market. They are caught with few choices, with 
small groups, with high administrative costs. It is not necessary, and 
it does not even cost anything for us to fix it.
  I was talking about this at a dinner the other day with six or seven 
people who were there to talk about how we could serve the underserved 
better with health care. This is part of the answer to it. We had a 
real good dialog with these folks. Many of them are operating a 
charitable enterprise where they are helping people get health care.
  I laid this out for them, and one of the men said to me: Well, who 
wouldn't support that? Indeed, who wouldn't support it? I will tell you 
who doesn't support it: the big insurance companies, who control this 
small group market now. They are operating like monopolists. 
Monopolists ratchet down their output and raise their prices. That is 
what is happening. Fewer and fewer people are covered, and prices are 
going higher and higher. They are making money, and people around this 
country do not have health insurance. It is wrong, and it ought to 
stop.
  One argument I hear about this is: Look, if we do this, the 
association health plans will engage in cherrypicking. What that means 
is, the healthy small business groups will go into the big plans, the 
sicker small business groups will prefer to stay out there in the small 
business market. This is actually an argument that the big insurance 
companies are raising. It is the exact opposite of the truth.
  Common sense tells you if you have a history of illness, if you have 
cancer or had cancer or diabetes or kidney problems, or something 
similar to that, and somebody says to you, look, you can be

[[Page S3668]]

in a small group market, you can work for a small business and be part 
of a group of 4 or 5 people or 40 or 50 people, or you can work for a 
big business and be part of a group of 10,000 people, which would you 
choose?
  I have asked that question in small business groups around the 
country. I have not had a single person say: If I were sick, I would 
rather be part of the small group. Of course you would rather be part 
of the bigger group.

  This is a haven for small business people who want to help themselves 
and their employees, and particularly the ones who are sick and need 
the insurance, such as that lady in the optometrist shop in Farmington. 
It is a haven for them. And it will cut the cost of their health 
insurance, on average, 10 to 20 percent and make insurance available to 
millions of people who currently do not have it. It does not cost the 
taxpayers anything. It is just like a big co-op.
  We have a lot of support in the Senate. I am very pleased about our 
progress. The chairman of the Small Business Committee, the senior 
Senator from Maine, Ms. Snowe, is a strong supporter and is leading the 
fight. Senator Bond is supportive. The Senator who is presiding over 
the Senate today is supportive. Senator McCain is supportive. I have 
been talking with a number of my friends and colleagues on the other 
side of the aisle. I am hoping to get support there.
  In the House, it passed on a strong bipartisan basis. I believe we 
can do the same. It is just a question of the choices we want to make. 
We can choose these small businesspeople and their employees who have 
been telling us, year after year after year: We are working full time; 
We care about our jobs; We care about our fellow employees; Let us help 
ourselves, or we can choose the big insurance companies that have a 
monopoly on this market and are charging higher and higher prices and 
providing fewer and fewer policies of insurance for people who need it.
  I think the choice is clear. I urge the Senate to look at this bill, 
the association health plans. We can get it passed. We can make a 
difference, and we can do it now.
  I yield back the remainder of my time.
  Mr. REID. I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The legislative clerk proceeded to call the roll.
  Mr. REID. Mr. President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.

                          ____________________