[Congressional Record Volume 151, Number 103 (Tuesday, July 26, 2005)]
[House]
[Pages H6466-H6472]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
PROVIDING FOR CONSIDERATION OF H.R. 525, SMALL BUSINESS HEALTH FAIRNESS
ACT OF 2005
Mr. BISHOP of Utah. Mr. Speaker, by direction of the Committee on
Rules, I call up House Resolution 379 and ask for its immediate
consideration.
The Clerk read the resolution, as follows:
H. Res. 379
Resolved, That upon the adoption of this resolution it
shall be in order without intervention of any point of order
to consider in the House the bill (H.R. 525) to amend title I
of the Employee Retirement Income Security Act of 1974 to
improve access and choice for entrepreneurs with small
businesses with respect to medical care for their employees.
The bill shall be considered as read. The previous question
shall be considered as ordered on the bill and on any
amendment thereto to final passage without intervening motion
except: (1) one hour of debate on the bill equally divided
and controlled by the chairman and ranking minority member of
the Committee on Education and the Workforce; (2) the
amendment in the nature of a substitute printed in the report
of the Committee on Rules accompanying this resolution, if
offered by Representative Kind of Wisconsin or his designee,
which shall be in order without intervention of any point of
order, shall be
[[Page H6467]]
considered as read, and shall be separately debatable for one
hour equally divided and controlled by the proponent and an
opponent; and (3) one motion to recommit with or without
instructions.
The SPEAKER pro tempore. The gentleman from Utah (Mr. Bishop) is
recognized for 1 hour.
Mr. BISHOP of Utah. Mr. Speaker, for the purpose of debate only, I
yield the customary 30 minutes to the gentlewoman from California (Ms.
Matsui), pending which I yield myself such time as I may consume.
During consideration of this resolution, all time yielded is for the
purpose of debate only.
This resolution provides for a structured rule and provides for 1
hour of debate equally divided between the chairman and ranking
minority member of Committee on Education and the Workforce, waives all
points of order against consideration of the bill, and makes in order
an amendment in the nature of a substitute offered by the minority.
This is a good and a fair rule. It allows the House to focus the debate
and the vote upon two different approaches aimed at helping America's
small businesses to offer health coverage to its employees, and to
debate and examine the proper role of the Federal Government in the
health care arena.
Amendments not made in order were offered and discussed by the
committee, so it is appropriate, I think, not to duplicate that
committee action here on the floor.
H.R. 525 is the Small Business Health Fairness Act of 2005, sponsored
by the distinguished gentleman from Texas (Mr. Sam Johnson), and is
virtually identical to legislation passed in the 108th Congress, then
H.R. 660, which passed this House by a 90-vote margin of 252 to 162. So
I commend the subcommittee chairman, the gentleman from Texas (Mr. Sam
Johnson); the chairman of the full committee, the gentleman from Ohio
(Mr. Boehner), for once again moving this bill through the committee
process.
Mr. Speaker, H.R. 525 is a modest bill. It does not seek to address
every aspect of health care in America. It does not seek to mandate
Federal control into every aspect of medical treatments. To the chagrin
of some of my friends on both sides of the aisle, it does not move our
country in the direction of government control and taxpayer-funded
universal health care.
What it does do, and this is really the bottom line, is make health
insurance more affordable to small business and thereby increase the
total number of Americans and families that are insured.
H.R. 525, if enacted, will result in more Americans and more American
families being covered by private health insurance, and that is a
worthy goal that we should all be working to achieve.
Mr. Speaker, I would like to point out that large corporations and
unions already enjoy, many through ERISA, the same insurance-risk
pooling features and already enjoy the cost efficiencies built into
this health coverage package for their workers and their members. This
bill, therefore, is about achieving a measure of fairness towards small
business, an effort for the mom and pop businesses and industries to be
treated the same way as giant corporations and union organizations.
The small guy will have nothing the large guy does not already have,
with specific regulations placed in the bill to ensure against unfair
pooling practices. It has bipartisan support from a wide range of
groups, from the U.S. Chamber of Commerce, the National Federation of
American Business, the American Farming Bureau, Associated Builders and
Contractors, the Latino Coalition, the National Black Chamber of
Commerce, the National Association of Women Business Owners and the
National Restaurant Association, as well as many others.
In the course of this debate, Mr. Speaker, there will be many who
will be giving facts and figures. I do not wish to go into those right
now. But I wish to make sure that this is part of a larger picture.
As politicians, we oftentimes talk about the Nation or issues being
at a crossroads. We do that a lot because it is a very dramatic phrase,
and it makes us seem more important because we are in the middle of it.
But I do believe in the issue of health care and insurance we are as a
Nation in the crossroads. We can take one direction which would be to
have greater government control, especially on the Federal level which
ultimately would lead to a single-payer Federal program where
decisions, right or wrong, would be made here.
Indeed, I think the substitute that will be ordered is illustrative
not in topic but in spirit of this, where there is greater government
control, greater regulations being put in there so that one wonders if
the issue is really health insurance or if the issue is control.
The other approach that we are in the crossroads of and could take
would be an approach to try and add market forces into the system to
try and move some type of reforms along the way. This bill is not a
panacea for all of our health care issues; but it is a step for certain
groups who are currently excluded, often by well-intended decisions of
the government.
I clearly understand both sides of these particular issues. I was a
State legislator who did both while I was down there. There were
requirements in health care which I thought were good at the time,
which I also knew were costly at the time; and I also realize in
hindsight, in helping one group of very vulnerable people, we actually
hurt a different group of very vulnerable people.
For example, in my State, family health care is covered for everyone
until the age of 25. When I joined this august body, all of the sudden
the limitation was now at age 22, not 25; and I immediately realized I
had three sons who had no health insurance whatsoever. I still have two
sons who are out there in that risky group with no health insurance
whatsoever.
I clearly realized from personal experience that all the mandates of
coverage of health care systems are useless to those who cannot get or
cannot afford insurance in the first place.
My oldest son finally got a job with a large corporation. I was very
relieved that now he has insurance until a couple of weeks ago when he
came and talked to me about joining a friend in an entrepreneurial
enterprise, in which case they would start their own business. I should
have been excited about his attitude; but the first question out of my
mouth was, Well, what about your insurance?
We make decisions here that have far-reaching effects in creating a
society of limitations instead of visions as they should be. With all
sorts of good intentions, government also has helped create people
whose options are shut to them when all they want really is hope and
the freedom to choose some kind of options. Sometimes it is a matter of
control of those options, which is frightening for any government level
to try and give up.
This bill does not try to create mandatory efforts. It tries to
create options. It tries to create options from which people can
choose. People who are not now covered have a chance to be covered in
some way with insurance. Regardless of how one votes on this issue in
the past or in the future, this is a fair rule. With that, I urge my
colleagues to support this rule.
Mr. Speaker, I reserve the balance of my time.
Ms. MATSUI. Mr. Speaker, I thank the gentleman from Utah (Mr. Bishop)
for yielding me this time, and I yield myself such time as I may
consume.
(Ms. MATSUI asked and was given permission to revise and extend her
remarks.)
{time} 1400
Ms. MATSUI. Mr. Speaker, today I rise in opposition to this rule and
the underlying measure of H.R. 525. This country leads in medicine and
technology. When combined with increased education and awareness, we
have made diseases more preventable and treatable. We have made huge
strides, for example, diagnosing and treating breast cancer. Women are
now going in for annual mammograms. In and of itself, mammograms do not
prevent breast cancer, but they can save lives by finding breast cancer
as early as possible.
For example, mammograms have been shown to lower the chance of dying
from breast cancer by 35 percent in women over the age of 50. And
studies suggest for women between 40 and 50, they may lower the chance
of dying of breast cancer by 25 to 35 percent.
[[Page H6468]]
Having worked on educational campaigns for over a decade, I know that
it has not been easy to convince women that they should be asking their
doctor for a mammogram, nor, I might add, has it been easy to ensure
that health insurance companies cover the cost of these mammograms. But
through the tireless efforts of doctors, survivors, and advocates, the
insurance companies relented.
Today we are increasingly catching and treating breast cancer in the
early stages, yet the legislation we are debating here on the floor
today would effectively roll back these advances, and, even worse,
doctors would now have to tell the 28-year-old woman who thinks she has
found a lump in her breast that her health care insurance does not
cover a mammogram to better see the abnormality; that her health care
coverage is no longer subject to minimum standards established by her
State because she is covered by an associated health plan, an AHP,
which is located in a different State with far more relaxed laws on
health care coverage.
Too many Americans are already without sufficient health care
coverage. They are being forced to accept health care that does not
provide what they need when they fall ill, whether it is breast cancer
exams, diabetes medication, or childhood vaccinations. Why would we
increase the number of these individuals without adequate health care
coverage?
Some may claim that these standards for health care treatments, like
those that require insurance companies to cover mammograms, are nothing
but burdensome regulations, but these safeguards go to the heart of
what responsible health care is all about: providing necessary care to
those in need. And AHPs would not even reduce the cost of the premiums.
Under the legislation we debate today, AHPs could skim off a small
minority of small businesses, those with younger and healthier
workforces. As a direct result, 80 percent of small businesses would
see an increase in their health care premiums.
Mr. Speaker, I truly question what we are doing today. Why would we
create a situation that increases the already skyrocketing health care
costs for four out of five small businesses? Sadly, this is what we are
doing. We are putting our small businesses in the awkward position of
not being able to offer health care coverage to that young woman facing
the possibility of breast cancer, or offering access to a health care
plan that will not cover her diagnosis and certainly not a treatment.
We could do better by that young woman and our Nation's small
business owners. Congress could pass the Democratic substitute offered
by the gentleman from Wisconsin (Mr. Kind) and the gentleman from New
Jersey (Mr. Andrews), which would allow small business employees to
access the same quality health care coverage which Federal employees
enjoy. The substitute's Federal partnership would allow this plan to be
offered at an affordable price. This alternative would truly have a
positive impact, ensuring that Americans have access to affordable and
quality health care. I urge my colleagues to support it.
Unfortunately, the legislation we debate on the floor, H.R. 525,
which would create AHPs will most likely worsen health care situations.
Mr. Speaker, if we, Members of Congress, would not accept a health plan
that does not include minimum coverage, why then should the American
people?
We have an opportunity today. We can support the Democratic
alternative and pass legislation that actually addresses the critical
health care problems facing small business owners, or we can pass the
legislation in front of us that does the opposite. It should not be a
difficult decision. Mr. Speaker, I urge all Members to votes against
the rule and the underlying bill.
Mr. Speaker, I reserve the balance of my time.
Mr. BISHOP of Utah. Mr. Speaker, I yield 2 minutes to the gentlewoman
from West Virginia (Mrs. Capito).
Mrs. CAPITO. Mr. Speaker, I thank my friend and colleague on the
Committee on Rules, the gentleman from Utah (Mr. Bishop), for yielding
me this time; and I rise today in support of the rule and the
underlying legislation, the Small Business Health Fairness Act.
Mr. Speaker, a trip to the doctor should not bust the family budget.
Too many of America's small business employees go without health
insurance or pay a big chunk of their paycheck for health care. This
House has acted on four separate occasions in a bipartisan way to pass
reforms that will allow small business owners to provide their
employees with affordable health insurance options, yet our efforts to
help reduce the ranks of the uninsured has not gone forward.
This crucial legislation allows small business owners to have similar
purchasing power for health insurance as large corporations. The
creation of association health plans will permit small business owners
to band together through a trade association or other method to
purchase health insurance for them and their employees. The ability to
provide health insurance is critical for our small businesses to remain
competitive.
Mr. Speaker, workers are frustrated with paying the high cost of
health care. Congress needs to finish this job and pass association
health plans into law. I urge my colleagues to support the rule and the
underlying legislation.
Ms. MATSUI. Mr. Speaker, I yield 2\1/2\ minutes to the gentlewoman
from California (Ms. Lee).
Ms. LEE. Mr. Speaker, I want to thank the gentlewoman for yielding me
this time and for her leadership and consistent work on behalf of the
American people regardless of what issue and what bills we are dealing
with today. I want to say that I join her today in opposition to this
rule and to the underlying bill. It is fundamentally flawed not only
for what it does, but for what it fails to do.
Mr. Speaker, if this bill were made law, we would still have well
over 44 million people in our country uninsured. Something is wrong.
Something is fundamentally wrong where in the wealthiest Nation in the
world we have 44 million uninsured. Where, quite frankly, is the
morality in that? Under this bill, of the 45 million uninsured
Americans in this country, only 600,000 people would move into
coverage, while 10,000 workers with coverage would be pushed off of
their current plans.
Not only does this bill fail to provide any significant coverage for
the uninsured, it also puts women and girls at risk by preempting very
strong State laws. Specifically, the bill overrides contraceptive
protections in 21 States that currently ensure access to contraceptives
and treatments for sexually transmitted diseases. Clearly, Mr. Speaker,
this bill puts women and girls at risk and makes empty promises to
millions of uninsured Americans in desperate need of health care.
Instead of considering this bill, we should be debating the real
question: How do we begin to put people before profits in our own
health care system? Millions of Americans are calling on Congress to
address this question by debating and voting on meaningful proposals,
like universal health care, reimportation of prescription drugs, and
allowing HHS to negotiate drug prices for Medicare recipients. It is
time for Congress to wake up and take a hard look at our broken health
care system. It is time for us to make a real effort at reform.
Mr. Speaker, H.R. 525 does nothing to expand health care to those who
need it the most, and it undermines vital protections for women and
girls. As a former small business owner, I know from years of
experience the difficulties small businesses face due to a lack of
consistent cash flow to afford these payments. Profitability for small
businesses to afford health care contributions should really be
addressed, and that is what we should be talking about today.
What this bill should do is assist small employers or employees in
affording premium payments. I am sure that is why 69 local Chambers of
Commerce, the National Governors Association, 41 attorneys general,
Blue Cross/Blue Shield, and over 1,300 business, labor and community
organizations oppose H.R. 525. This bill is bad for the health of our
country.
Mr. BISHOP of Utah. Mr. Speaker, I am pleased to yield 3 minutes to
the distinguished gentleman from Ohio (Mr. Boehner), the chairman of
the Committee on Education and the Workforce.
Mr. BOEHNER. Mr. Speaker, uninsured working families are looking to
[[Page H6469]]
Congress for answers to help give them access to quality health care,
and before us today is a bipartisan bill that should give them hope.
The economic picture remains bright, and more Americans are finding
work every day. Earlier this month, the Department of Labor reported
that 3.7 million new jobs have been created since May of 2003, marking
25 consecutive months of positive job growth for the U.S. economy.
Unfortunately, there are still millions of working families without
health insurance. They need access to quality health care, and they are
asking for our help. The bill we will consider on the floor later today
responds directly to their needs.
It is simply unacceptable that more than 45 million Americans lack
health insurance today. Studies indicate that 60 percent of these
uninsured Americans either work for a small business or are dependent
upon someone who does. Many of these Americans work for small employers
who cannot afford to purchase quality health insurance benefits for
their workers. That is the crux of the problem. More Americans are
finding new jobs, but many small businesses cannot afford to offer
health insurance because of rising premium costs.
Our primary goal here in Congress, Mr. Speaker, should be creating
affordable options to help the uninsured. With health care costs
continuing to rise sharply across the country, more and more employers
and their employees are sharing the burden of increased premiums.
Employer-based health insurance premiums rose by 11 percent last year,
following a 15 percent increase in 2003. As costs escalate, the ranks
of the uninsured could continue to increase as well.
The Small Business Health Fairness Act before us represents a
bipartisan solution to this problem. By creating association health
plans, the bill gives small businesses the opportunity to band together
through bona fide trade associations and purchase quality health
insurance for their workers at a lower cost. In the last year, we have
seen how large corporations are now starting to band together to
provide health care to their part-time workers. Small businesses and
their workers deserve the same opportunities.
This bipartisan bill would increase small businesses' bargaining
power with health care providers, giving them freedom from costly
State-mandated benefit packages and lowering their overhead costs by as
much as 30 percent, which are benefits many large corporations and
unions already enjoy. By pooling their resources and increasing their
bargaining power, association health plans will reduce the cost of
health insurance for employers and allow more small businesses to
provide health care to their workers.
Last year, the House passed this measure on a bipartisan basis with
the support of 37 of my colleagues on the other side of the aisle.
Unfortunately, the other body has yet to act on this bill. But there
remains hope. Senator Enzi, who chairs the Senate Committee on Health,
Education, Labor, and Pensions, has expressed a strong interest in
working on this proposal, and I am more optimistic than ever that the
Senate will address this problem.
This measure is supported by President Bush, the Labor Department,
Republicans and Democrats, and, moreover, a poll conducted last year
reveals that 93 percent of Americans support AHPs as an option for
providing affordable health care for American workers. Small businesses
deserve the chance to obtain high-quality health insurance at an
affordable price for their workers, and AHPs are a prescription for
helping the uninsured.
Mr. Speaker, I think the rule before us today is a fair rule, and I
urge my colleagues to support it.
Ms. MATSUI. Mr. Speaker, I yield myself such time as I may consume to
comment that only 1 out of every 14 people enrolled in an AHP will be
newly insured. Overwhelmingly, this is a bill that shifts the already
insured into plans with lower coverage.
Mr. Speaker, I yield 4 minutes to the gentlewoman from New York (Mrs.
McCarthy).
Mrs. McCARTHY. Mr. Speaker, I oppose this rule and the underlying
bill because it will result in preempting State laws and in a reduction
in health care. AHPs would be exempt from having to provide certain
critical services, preempting State laws which require coverage.
Mr. Speaker, this Nation spends millions and millions of dollars on
cancer treatments. We also spend millions of dollars just on research
and development. This bill would take away a tool that is used to save
lives.
{time} 1415
The gentlewoman from California (Ms. Woolsey) and I offered an
amendment to this legislation both in committee and again last night in
the Committee on Rules. The amendment would have prohibited employers
from joining AHPs if it would mean a reduction in coverage for breast
and cervical cancer services. Unfortunately, the amendment was not
accepted.
Almost every State has recognized the need to cut health care costs
and still provide quality services to their citizens. The States know
that without guaranteeing these services, patients will not receive the
health care they need. Members have to remember the attorneys general
fought in their States to make sure that women would have this care.
Why did they fight for it? Because the insurance companies would not
offer it.
According to the American Cancer Society, over 211,000 new cases of
breast cancer will be diagnosed in the United States in this year
alone. In New York State, there will be 14,000 new cases of breast
cancer diagnosed this year alone. Breast cancer is a potentially fatal,
but very treatable, disease. However, early detection is the key to
proper treatment. Mammogram screenings are essential for the early
detection of breast cancer. Timely screening can prevent 15 to 30
percent of all deaths from breast cancer among women over 40 years old.
Currently, New York and 48 other States require insurance companies
to cover mammogram screenings. The U.S. Department of Health and Human
Services has stated that mammograms save women's lives. Former
Secretary Tommy Thompson stated, ``The Federal Government makes a clear
recommendation for women over 40 to have mammograms, get screened for
breast cancer with mammograms every 1 to 2 years. The early detection
of breast cancer can save lives.''
Preventive screening for cervical cancer is also vital for women's
health. Over 10,000 new cases of cervical cancer will be diagnosed this
year, and nearly 1,000 of those cases are residing in my home State of
New York. Nearly 4,000 women will die in 2005 from cervical cancer.
Preserving the coverage of mammograms and cervical screenings will
help save the lives of our wives, mothers and daughters, and also keep
down the cost of health care in this country. I know many of my
colleagues on both sides of the aisle have supported similar measures
while in their home States as legislators. They have shown commitment
to their home State, and now it is time to show commitment to the
Nation.
As a nurse, I know first hand the importance of early detection. I
have seen the hardships cancer patients endure. Since I have been here,
I have done outreach within my district to get women in for their
cervical exams and women over 40 in to get their mammograms. This is
very important, and we should not miss this opportunity to save lives.
For this reason, I oppose the rule and the underlying bill.
Mr. BISHOP of Utah. Mr. Speaker, I yield 1\1/2\ minutes to the
gentleman from Nebraska (Mr. Osborne).
Mr. OSBORNE. Mr. Speaker, I appreciate this opportunity to speak on
behalf of the rule and the underlying legislation.
Mr. Speaker, I would like to just mention a personal story. I have a
son-in-law who manages 150 stores. They are part of a franchise and are
spread across 40 different States. If they have to purchase health care
store by store, it is prohibitively expensive. Their costs are going up
10 to 20 percent a year. One of the previous speakers said it may not
add a whole lot of people, but what is happening is we are losing more
and more people out of health care plans each year because small
businesses simply cannot afford it.
If they can band together, those 150 stores, and pool their resources
and have 500 employees in a pool, they have a chance to keep their
health care. I think it is critical.
[[Page H6470]]
Mr. Speaker, 60 percent of all Americans work for small businesses,
and this is key to this legislation. Small businesses are particularly
important to rural areas like Nebraska. The measure would do three
things: one, increase small business' bargaining power with health care
providers; number two, give them freedom from costly state-mandated
benefit packages. In many cases, the State regulations simply stifle
the health care packages. And, number three, lower their overhead cost
by as much as 30 percent.
Republicans and Democrats alike have joined together in each of the
last two Congresses to pass this legislation. I urge support of the
underlying rule and the bill.
Ms. MATSUI. Mr. Speaker, I yield 4 minutes to the gentleman from
Wisconsin (Mr. Kind).
Mr. KIND. Mr. Speaker, I rise in opposition to the rule even though
it has made in order a substitute that the gentleman from New Jersey
(Mr. Andrews) and I will be offering.
The reason I rise in opposition is because this is such an important
issue that we really should have an open and fair and reasonable debate
on the floor of the House of Representatives. Eight of the Democratic
amendments offered last night were effectively blocked. Instead, we
have a closed rule that will allow some time for general debate on the
AHP underlying bill, an hour on the substitute, and that is it.
I think we can all stipulate that when we go home, this is clearly
the overriding issue we hear from our constituents: the rising cost of
health care and the inability, especially in small businesses, to be
able to afford and access quality health care which is crucial to a
growing and vibrant economy.
There is a reason why we are here year after year debating the same
issue, and that is because the underlying bill is bad policy. It is
recognized as bad policy by over 1,400 organizations nationwide that
have come out and publicly opposed it, including the National Governors
Association, both the Democratic and the Republican Governors
associations; including 41 of the States attorneys general; the
National Association of Insurance Commissioners; the National
Conference of State Legislatures, all of whom recognize this does not
make sense, it is bad policy and we should offer something more than
just a broken promise or false hope to small businesses and their
employees hoping to obtain coverage.
There should be an unwritten rule when we are debating any type of
health care policy changes, and that is following the Hippocratic Oath
that our doctors and health care providers follow: first, do no harm.
Unfortunately, the AHP bill before us today does plenty of harm. And,
again, it has been recognized by independent studies both within the
congressional body and outside. In fact, a recent Mercer Study
indicates that adoption of this AHP legislation could raise the ranks
of the uninsured by over 1 million people. You would think that alone
would be enough for a ``no'' vote on this underlying bill. Any policy
that is going to increase the number of uninsured, which is roughly
between 45 and 48 million today, is something that we should resist.
It also shows that those who do not join AHPs and are not part of an
association, who have health coverage for their employees, the premiums
are going to increase for those people by 23 percent. This is
consistent with what the Congressional Budget Office has shown in their
study that shows that adoption of this bill would leave 20 million of
the workers with higher premium payments overall.
Also, recently there was a study out of Georgetown University that
shows that adoption of this bill, and again it is consistent with past
GAO studies, would increase the likelihood of greater fraud and abuse
within the associated health plan system. The GAO in a study showed
that there are 144 illegal AHPs operating affecting every State in the
Union with unpaid claims affecting over 200,000 workers today.
The underlying bill is going to take oversight and accountability
away from the States where it has traditionally resided with oversight
powers and audit responsibilities, put it in the Department of Labor
with insufficient resources and no accountability and no oversight at
all. Because of that, the State attorneys general in a letter stated:
``The elimination of the State role and replacement with weak Federal
oversight is a bad deal for small businesses and consumers.''
Finally, as the gentlewoman from New York (Mrs. McCarthy) has
indicated, it does preempt consumer protection which has been
traditionally guaranteed by the States if they found that necessary.
So there are a lot of reasons why the underlying bill before us today
is bad policy. That is one of the reasons it has had a difficult time
moving through the Senate. We are going to have a substitute offered
that the gentleman from New Jersey (Mr. Andrews) and I and others who
support think is a viable and reasonable approach to deal with the
growing health care crisis that so many of our small businesses and
their employees are facing. It is a bill that does allow the purchasing
pool concept to go forward, but it is modeled after what Federal
employees currently have under their health care plan. And it also does
not preempt State law.
Mr. Speaker, I ask my colleagues to defeat the rule so we have an
honest debate and support the substitute and vote ``no'' on the
underlying bill.
Mr. BISHOP of Utah. Mr. Speaker, I yield 2 minutes to the gentleman
from Florida (Mr. Keller), a member of the committee who has gone
through this discussion many times.
Mr. KELLER. Mr. Speaker, I support the rule, and I support H.R. 525.
The number one problem facing small businesses today is the
skyrocketing cost of health insurance. Association health plans are a
big part of the solution.
I met with many small business people in my hometown of Orlando,
Florida, and they told me they need association health plans. I agree
with them, and here is why: of the 45 million Americans without health
insurance, 60 percent are small business employees and their families.
They do not have health insurance because their small business
employers cannot afford it.
If we would allow these small businesses to join together, they could
have the same bargaining power as large Fortune 500 corporations, which
could lower their health insurance premiums by up to 30 percent.
Association health plans will increase access to health care for
millions of Americans now without insurance.
It certainly is an issue that is personal to me. I had the happy
privilege of flying down to Orlando, Florida, with President Bush on
Air Force One on March 18 of this year. He asked me what, if anything,
he could do to help small businesses in my area. I told him what the
small businesses told me: the number one thing they want is association
health plans, and he pledged to support it and use his bully pulpit to
help it get through the Senate.
I also authored a Small Business Bill of Rights that passed this
House back in April. It called for the passage of association health
plans, fixing the death tax, and cracking down on frivolous lawsuits.
This House is on record as supporting that. It is time for us to take
the lead today and help small business people provide health insurance
to their employees. Vote ``yes'' on the rule and vote ``yes'' on H.R.
525. I urge my colleagues to do these things.
Ms. MATSUI. Mr. Speaker, I reserve the balance of my time.
Mr. BISHOP of Utah. Mr. Speaker, I yield 2 minutes to the gentlewoman
from Tennessee (Mrs. Blackburn).
Mrs. BLACKBURN. Mr. Speaker, increasingly, one of the things I hear
from small business owners back in Tennessee is they want Congress to
open the way, just to open the way and set the stage for more
affordable health care choices.
Over 90 percent of the jobs in Tennessee are small business jobs. It
is the largest employer in my district.
Mr. Speaker, one of the things that we hear is that these employers
want to do the best they can for their employees. They feel like they
are a part of their family. The gentleman from Texas (Mr. Sam Johnson)
really should be applauded for introducing the Small Business Health
Fairness Act of 2005. It is one of those things that will help small
businesses, as we have heard from so many of the speakers, to pool
together and to purchase association health plans through their
national trade groups.
I have joined him as a co-sponsor of the legislation, and I believe
we do
[[Page H6471]]
have that opportunity to extend affordable, quality health care to
millions of Americans. Every small business owner knows that providing
quality health care is one of the most costly items in running a
business. It is a very difficult part, handling the mountains of
paperwork and finding the right policies. We have the power to help by
passing this commonsense legislation. I ask my colleagues to support
the rule and to support the underlying legislation.
Ms. MATSUI. Mr. Speaker, I reserve the balance of my time.
Mr. BISHOP of Utah. Mr. Speaker, I yield 2 minutes to the gentleman
from Texas (Mr. Hensarling).
Mr. HENSARLING. Mr. Speaker, today I rise in strong support of the
rule for H.R. 525, the Small Business Health Fairness Act of 2005,
offered by the gentleman from Texas (Mr. Sam Johnson).
Mr. Speaker, if we do not act soon, America will face a health care
crisis. Health care costs are skyrocketing. We all know it; and,
unfortunately, so do the ranks of America's uninsured. As usual,
government is part of the problem. More freedom and more competition is
part of the solution.
With nearly half of the 45 million uninsured Americans employed by
small businesses, or dependent upon someone who is, H.R. 525 will help
more Americans get access to the affordable health insurance they need.
{time} 1430
H.R. 525 would allow the creation of association health plans to help
alleviate the enormous health care burden on America's small
businesses. They will empower small businesses to join together to
bargain with insurance carriers to get health care coverage for their
workers at an affordable cost. No affordable cost, no insurance. Under
current law, large employers that self-insure are exempt from State
mandates while small businesses are not. This increases the cost of
health insurance up to 13 percent and bars up to one-quarter of the
uninsured from acquiring health care.
Mr. Speaker, that is not right. Small businesses and their employees
should have the same right to quality health care insurance that large
corporations and unions already enjoy. The Congressional Budget Office
estimates that association health plans could actually reduce premiums
for small businesses up to 25 percent. That could mean an average
savings of $1,000 to $2,000 for the average family health plan offered
by a small business. That means more people covered, more lives saved.
I urge all my colleagues to support the rule for H.R. 525 and the
underlying legislation. With association health plans, we can
dramatically reduce the number of uninsured Americans while increasing
health care access, affordability, and choice.
Ms. MATSUI. Mr. Speaker, I reserve the balance of my time.
Mr. BISHOP of Utah. Mr. Speaker, I yield myself such time as I may
consume.
I must admit that much of the opposition gloom-and-doom predictions
are based on assumptions of what people and companies will choose to do
and, therefore, the government should make those mandates. I am pleased
that this particular piece of legislation is based on the assumption
that people have the ability to make good choices for themselves
without the assistance of the heavy hand of government.
Mr. Speaker, I am pleased to yield 2 minutes to the gentleman from
Texas (Mr. Sam Johnson), the sponsor of this bill.
Mr. SAM JOHNSON of Texas. Mr. Speaker, I am pleased to be here today
to support the rule to govern H.R. 525, the Small Business Health
Fairness Act of 2005. As costs continue to escalate annually at
unprecedented rates, our employers are being forced to drop health care
coverage, or not be able to afford it at all. Our small businesses
share a large part of that burden because they are forced to shop for
health insurance in the costly small group market. Large employers
bring bargaining clout to the table when they work with insurance
companies. Small businesses have fewer employees and thus have little
or no bargaining power. Not only that, but large employers and unions
are exempt from burdensome State mandates. These mandates dictate what
health plans must cover and which vary from State to State. Small
employers do not have that luxury.
We know that more than 60 percent of the over-40 million uninsured
Americans either work for a small business or are dependent upon
someone who does. The clear course of action here is to help our small
businesses afford health coverage by giving them the same opportunity.
Association health plans, or AHPs, do just that. Small businesses
would be able to group together in bona fide trade associations. AHPs
would then be able to use economies of scale to their advantage and
provide more affordable health care for working families while avoiding
the administrative cost of State mandates. AHPs are expected to save
small business owners and their employees as much as 30 percent on
their health insurance.
This bipartisan bill makes sense. The time to act is now. I urge a
``yes'' vote on this rule.
Ms. MATSUI. Mr. Speaker, I yield 3 minutes to the gentleman from New
Jersey (Mr. Andrews).
(Mr. ANDREWS asked and was given permission to revise and extend his
remarks.)
Mr. ANDREWS. Mr. Speaker, I thank my friend from California for
yielding me this time.
I hear the phrase ``burdensome State mandates.'' A woman has a C
section and gets to stay in the hospital for at least 48 hours. A woman
has the right under a health insurance policy to get a mammogram paid
for by the insurance company every year. A diabetic has the right to
get insulin provided and other blood care paid for by their insurance
company. These are the burdensome mandates that we hear talked about on
the floor. One of my other friends talked about the heavy hand of
government. That heavy hand of government in this case is evidently
shared by Republican Governors around the country, because the National
Governors Association opposes this bill. Republican and Democratic
Governors have looked at this bill and said laws that they have passed
that many of our friends on the majority side voted for in State
legislatures around the country, laws that protect C sections,
mammograms, diabetic care, substance abuse care, mental health care,
these laws should not be repealed and thrown aside by the heavy hand of
government at the Federal level. That is what this is really about.
Amendments that would have addressed these issues, that would have
let us discuss these issues on this floor, were prohibited by the rule
that we are debating right now. I would suspect that maybe one of the
reasons they were prohibited is because Republican attorneys general
and Republican Governors around the country would have supported such
amendments because they oppose the good work that is undone by this
bill. Members should oppose this rule and eventually, after debate,
oppose the underlying bill.
Mr. BISHOP of Utah. Mr. Speaker, I am pleased to yield 3 minutes to
the gentleman from Georgia (Mr. Gingrey).
Mr. GINGREY. I thank the gentleman for yielding me this time.
Mr. Speaker, I rise today in strong support of H. Res. 379 and the
underlying bill, H.R. 525, the Small Business Health Fairness Act of
2005. My good friend, the gentleman from New Jersey, just spoke about
some mandates regarding OB care and, of course, there are mandates that
have been passed in the several States, all 50, in fact, that are very
compassionate sounding. The gentleman from New Jersey is right. Many of
us have, as former members of State legislatures, voted for mandates.
I am one of them. In fact, in the State of Georgia, there was a
mandate, because of managed care intrusion and the requirement that
everybody go through a gatekeeper and not to a specialist, that women
in the State of Georgia, if any health insurance policy was written,
they would have direct access to their OB-GYN. Certainly, as an OB-GYN
specialist, I liked that mandate. In fact, I think I voted for that
one. But shortly after that along came the dermatologists and they
wanted direct access to everybody who had an itch, to have to be able
to go, demand to be seen by a specialist, a dermatologist, rather than
their family practitioner.
I want to tell you about a couple of other mandates in the State of
Georgia. There was one to require that every woman would have the right
to
[[Page H6472]]
have a blood test to be screened for ovarian cancer. It is called CEA-
125. Any cancer specialist would tell you that that screening test for
ovarian cancer is absolutely worthless. A better mandate would have
been to say that anybody over age 30, any woman, could have an
ultrasound done every 6 months to look at the ovaries, but that would
be astronomically expensive. Another mandate in the State of Georgia
says that every baby born in a hospital in the State of Georgia has to
be screened for sickle cell anemia, even when they are a part of an
ethnic group where the percentage of sickle cell anemia is zero. Nada.
These mandates just go and on, and you have got them in all 50 States.
Clearly, we need to do something about that because they are driving
up the cost of health care. We need to give people the opportunity to
join their other employees in trade associations.
This is a good bill. It will reduce the rolls of the uninsured by 8
million people. I commend it to my colleagues on both sides of the
aisle. I urge you to support this rule and pass the Sam Johnson
legislation. It is a good bill. It will get people the protection they
need and provide health care for so many who do not have it.
Ms. MATSUI. Mr. Speaker, I yield myself the balance of my time.
Earlier this month, the Los Angeles Times ran a story that I think
cuts to the heart of this discussion. It is the story of a husband and
wife living in Southern California. After successfully battling bone
cancer 7 years earlier, Doug did what so many Americans would like to
do. He started a small business making boat parts. Soon, he was
approached by an AHP offering a $400-a-month health insurance policy
which even included special cancer coverage.
Tragically, a few months after he purchased the policy, his cancer
returned and it became quite clear that the quality of that association
plan was not what Doug or his wife, Dana, expected. It turned out that
this particular plan covered less than 18 percent of Doug's $550,000
treatment cost. Doug and Dana rapidly found themselves buried under
hundreds of thousands of dollars in bills. And as his wife recounted to
the Los Angeles Times, at several points before the cancer ultimately
claimed his life, Doug begged her to divorce him so that she would not
be responsible for his debt.
I cannot believe this is the solution we are offering to small
business owners like Doug and Dana. The American people deserve better.
Mr. Speaker, this bill offers no health care solutions for small
business owners. It raises premiums on 80 percent of small businesses;
will increase the number of uninsured by 1 million people; and reduce
coverage for another 7 million individuals who are most in need of
care. My friends on the other side might find these facts inconvenient,
but that does not make them less true. And it will accomplish all of
this by loosening or removing consumer protections and by walking away
from State mandates that guarantee treatment for diabetes and
screenings for breast cancer.
We can do much, much better than this for America, Mr. Speaker. I
urge Members to oppose the rule, oppose the underlying bill, and
support the Kind-Andrews substitute.
Mr. Speaker, I yield back the balance of my time.
Mr. BISHOP of Utah. Mr. Speaker, I yield myself the balance of my
time.
I appreciate those who have spoken on the bill today. I appreciate
the gentleman from Georgia (Mr. Gingrey), a member of the medical
profession, who so eloquently talked about some of the realities of
this particular bill and what we are looking at. And I appreciate the
gentlewoman from California and her wonderful and kind way in which she
handled the rule on the minority side.
Just as a means of criteria of what we are going through as far as
the rule itself, every amendment that was proposed for this particular
rule was discussed thoroughly and voted upon in the committee, with the
exception of obviously the motion to recommit. With the debate we have
had in previous years, every element of this bill has been thoroughly
debated both on the floor and in committee, this year as well as in
years past.
I have to admit, Mr. Speaker, my favorite Senator, even though I am
not supposed to have one, is the junior Senator from Kentucky who is
the only one to have won 100 games in both the American and the
National League. Because of that, I have his baseball cards. I hope he
does very well over there because if they continue to rise in value,
that may be the only way I pay for my health care in the future.
I was reading on the airplane coming back yesterday of a story of
Senator Bunning when he was a pitcher for the Detroit Tigers and he was
facing the Yankees. The Yankees sent out Bob Turley to be the first
base coach because he was great at picking off signals. Sure enough, he
knew what the signals were. His signal would be every time a fastball
was coming, he would whistle at the batter. Hank Bauer is the first
batter up there. Fastball, he whistled, Bauer hit a screamer into left
field. The second batter is Tony Kubek. Fastball, whistle, he hit what
would have been extra bases into right field except the second baseman
caught the ball in self-defense.
The third hitter up is Mickey Mantle. By this time the pitcher is
upset with what is going on and takes a couple of steps to Turley and
says, ``Next time you whistle, I'm going to drill the batter.'' He
takes a couple of steps to the batter and tells him the same thing.
Sure enough, a fastball, the whistle, Mantle does not swing. The next
pitch is a slider which hits Mantle right in the legs. He is upset,
takes a couple of steps towards the mound, but the catcher and the
umpire direct him to first base.
The next batter up is Yogi Berra. Once again, fastball, the whistle
comes, Yogi does not take it, but then remembering what happened, he
steps out of the batter's box, cups his hands and yells back at Senator
Bunning who is the pitcher at this time and says, ``He may be
whistling, but I ain't listening.''
Mr. Speaker, there are a lot of people who have been whistling at us
on this particular issue. Every time I go to a town hall meeting, I
face people who want some kind of relief in the ability of getting
insurance. I get letters from them all the time. When small
businesspeople come to my office, they are talking repeatedly about
this particular issue. They are all whistling, asking for some kind of
relief.
I realize I talked about my three sons who did not have insurance. My
two that still do not will not have it under this bill because the
provisions do not allow them to participate. But my next-door neighbor
who is trying to make a living in a shop down on Main Street that does
not have insurance could under the provisions of this bill. Those are
real-life people who need this kind of assistance and help, and they
cannot get it any other way. The status quo does not offer this kind of
assistance. This is one of those few rays of hope that they will have.
These people are truly whistling at us. Our job as Congress is to
finally listen.
Mr. Speaker, I urge support of the rule on the underlying bill, H.R.
525.
Mr. Speaker, I yield back the balance of my time, and I move the
previous question on the resolution.
The previous question was ordered.
The resolution was agreed to.
A motion to reconsider was laid on the table.
____________________