[Congressional Record Volume 152, Number 56 (Wednesday, May 10, 2006)]
[Senate]
[Pages S4241-S4242]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                      SMALL BUSINESS HEALTH PLANS

  Mr. FRIST. Mr. President, I want to take this opportunity to paint 
the larger picture of why the small business health plans are so 
important to our Nation, to everyday Americans, and to the 46 million 
people who do not have health insurance today, and how it affects the 
cost of health care and thus the quality and access to health care.
  Much of the discussion that has gone on and that will go on as we 
proceed with this bill centers on the fact that America is facing a 
health insurance crisis. It centers on the fact that health care 
premiums are growing. They are growing faster than individuals' wages 
or income, and this growing cost--skyrocketing cost--of premiums 
translates into a significant portion of the 46 million people who 
don't have insurance today--solely because of the price of the premiums 
of health insurance. I do think--in fact, I know--that is unacceptable 
in a country that is as prosperous as ours.
  The medical impact and the impact on quality of life and life itself 
is embodied in the statistic that the Institute of Medicine reported in 
the fact that 18,000 Americans die prematurely each year because they 
don't have health insurance. A lot of people say why, because you 
eventually can get into a hospital, but it boils down to the fact that 
if you have some health insurance--just some health insurance--you do 
better than if you don't have health insurance. People can still go to 
emergency rooms whether they have health insurance, but entry into our 
system is much easier if you have health insurance.
  So this is a big problem that troubles me as a Senator and as a 
physician, and it troubles and should trouble every American. That is 
why we are on this issue today.
  About 60 percent of uninsured employees today work for small 
businesses. Unfortunately, these skyrocketing health insurance costs, 
coupled with very complicated State regulations, are pricing small 
businesses out of the health insurance market. They simply can't afford 
to buy insurance and to offer that insurance to their employees.
  We hear a lot of statistics on the floor, we have already heard a 
lot, and you will hear them continually over the next couple of days as 
we address this issue. In the past 5 years, the cost of health 
insurance to companies has nearly doubled from roughly $4,200 per 
family--almost double--to $8,100. In 2005 alone, health care costs rose 
three times faster than inflation, and even faster for many small 
businesses. Consequently, the small firms, the small

[[Page S4242]]

businesses are the ones that are hit the hardest.
  Many of them are operating on a very narrow margin already. They have 
had to cut benefits and, in many cases, eliminate coverage altogether 
for their employees. Some of them have been forced to lay off workers 
because of the cost of health care. They simply can't sustain it; it 
eats into their profits and they can't stay in business. So it is no 
wonder that small businesses across America have said to us and have 
made it known that access to affordable health care is their No. 1 
concern: access to affordable health care.
  That is what this small business health insurance debate is all 
about. It is the guts, the thrust of the bill on the floor today. Small 
business owners want to take care of their employees and their 
families. They want to do everything they possibly can. Most small 
businesses are family affiliated, many of them family run, but it is 
becoming impossible to do in the face of increases that are so far 
greater than any margins they have, these double-digit increases in 
health insurance every year.

  One survey reports that only 41 percent of firms with 9 employees or 
less can afford to offer health benefits, compared to 99 percent of 
large firms. That hurts the ability of small businesses to attract 
capable workers, to stay in business, to stay competitive in the larger 
marketplace. Unfortunately, the system is broken and small businesses 
are caught. They are stuck.
  Eighteen hundred State mandates are choking the ability of the 
private sector to offer affordable choices, reasonable choices. We have 
to cut out the redtape. We have to streamline the process itself. We 
have to get rid of the waste and abuse in the system.
  We all know that small businesses are the engine of economic growth 
in our economy. These small businesses are where innovation occurs and 
these innovators create 60 to 80 percent of all new jobs nationwide. 
They generate more than 50 percent of the gross domestic product. In my 
home State of Tennessee, 97 percent of all businesses are small 
businesses. This aspect of affordable health care is their No. 1 
concern.
  It makes sense that if we want to expand health care coverage, if we 
want to diminish the number of uninsured, we need to start to at least 
make a major advance in an area where we know we can make a difference, 
and that is where the jobs are. That is why the Enzi-Nelson-Burns small 
business health insurance bill that we bring to the floor and will 
formally open debate on here in about an hour is so important.
  I want to applaud Chairman Enzi for his tremendous work to pull 
people together on both sides of the aisle to address these issues. 
This bill represents the first real, major, solid step to end the small 
business health plan stalemate that has characterized this body in over 
a decade. Its purpose is to deliver meaningful reform for millions of 
Americans employed in the small business sector.
  Under this plan, small business firms would be able to combine their 
negotiating power and to group that negotiating power in a way that 
purchasing clout can be used to purchase more affordable plans. By 
allowing that to happen, they could reduce the cost of health insurance 
by as much as $1,000 per employee, while reducing the number of 
uninsured, people who are uninsured today, by more than 1 million. The 
CBO recently estimated the Enzi-Nelson-Burns plan would increase 
Federal revenue by $3.3 billion between 2007 and 2016, while saving 
States an estimated $600 million in Medicaid spending during the same 
period.
  I know this is a very important bill. I am delighted that we will 
begin on this bill in an hour, or a little over an hour from now. It 
will be a substantive debate and will go right to the heart of a major 
problem facing this country, and that is the uninsured. It will address 
the issues of cost, access, and quality. I encourage Members on both 
sides of the aisle to participate in this debate, to stay on the 
issues--we are talking about small business health reform--to not bring 
in extraneous issues, and with that pass a very important and 
substantive bill for the American people.

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