[Congressional Record Volume 152, Number 56 (Wednesday, May 10, 2006)]
[Senate]
[Pages S4257-S4259]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
SMALL BUSINESS HEALTH PLANS
Mr. ALLARD. Mr. President, I am going to speak under morning business
on Senate bill 1955, the small business health plans legislation that
is going to be before us shortly for formal debate. I come to the floor
to talk about a piece of legislation that is important to my Colorado
constituents. I would like to talk about the Health Insurance
Marketplace Modernization Act, sometimes known as HIMMA.
This legislation, which is also known as the small business health
plans bill, would allow for small businesses to come together to form a
group which could then use their combined purchasing power to influence
insurance companies for affordable health plans.
It has been suggested that those who serve in the Senate have no
understanding of what small business folks are going through and that
most of us have never been faced with the reality of having no health
insurance and therefore don't understand the plight of the small
businessman. I come to dispel that rumor. I am a former small
businessman who couldn't afford the cost of health insurance for myself
or for my employees.
My wife and I discussed options for ourselves and for our employees.
Similar to many other small business owners across the country, we
decided it would be better to raise our employees' rate of pay and
allow them to purchase their own individual plans. My wife and I
decided to begin setting aside our own savings account to pay for
health care costs in case, for some reason or another, I had an
incident or she had an incident where we needed to go to the hospital
and thus needed health care coverage.
Being a veterinarian and lifting heavy dogs onto the exam table all
the time, and not expecting the dog owner to pick up the other half of
a giant breed such as a Great Dane, I ended up having back problems and
had to have back surgery. I didn't have health insurance, but I paid
for it myself out of my own pocket. Fortunately, my wife and I had the
foresight to set aside a savings plan so that if something such as this
did happen, we could pay for it. But it did set us back.
We were able to survive that particular incident. It was kind of an
interesting thing, what happened to me when I went to go to the
hospital. The administrators didn't want me to go into the hospital.
The hospital would not let us in because we did not have health
insurance. I said: Well, I will pay for it. When we got in there, I had
the surgery, and I did very well, and I am very active today. The
doctors did a great job on surgery. When we checked out of the
hospital, the administrator said that they would reduce our costs by 20
percent because they did not have to deal with the paperwork and with
the cost of having to process my claim. So much of the paperwork is
driven by trying to protect the hospital, the doctors, and the
administrators from frivolous lawsuits. That has been my personal
experience.
I must admit I was disappointed when, earlier in the week, Members of
the Senate chose to side with trial lawyers instead of women and
children. And I was disappointed that Members of the Senate decided to
support turning the medical profession into a cash cow for the legal
profession instead of allowing for legitimate compensation.
Again, in a matter of minutes, we will be debating the small business
health plans bill and another attempt to bring down the high cost of
health care, specifically for working class families who are employed
by small businesses that, similar to my own situation, cannot afford to
provide health insurance for their employees.
I think it is important for us to focus this debate on at least
giving small businesses the opportunity to make a choice on providing
health care for themselves and for their employees. Currently, because
of the prohibitive cost of health care coverage for their employees,
many small business employers don't even have the option of offering
coverage.
Some of my constituents have brought to my attention over the past
few weeks their worries that because of the lack of insurance benefit
mandates, they could lose important benefits such
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as diabetes services and supplies, and coverage of preventive services
such as colorectal screenings and mammograms. These worries are
unfounded. Today there are over 1,800 different State mandates for
health care coverage, including different coverage mandates in
different States for the same preventive care, services, and supplies.
This huge variation in mandates has made it nearly impossible to
provide standardized coverage on a national basis.
Additionally, the Government Accountability Office, which is an
agency which helps to watch our dollars, has also found that the cost
of mandates to a typical plan results in an increase between 5 and 22
percent. The Congressional Budget Office, another dollar-watching
agency, estimates that for every 1 percent increase in insurance costs,
a minimum of 200,000 Americans are left uninsured.
Facts suggest that things such as diabetes services and supplies and
preventive services such as mammograms and colorectal screenings are
usually covered by health plans, regardless of the State mandates. For
example, the five most populous States require that diabetes care be
covered. According to the American Diabetic Association and the GAO,
only 4 out of 50 States do not require diabetic coverage.
The General Accounting Office also studied States that are not
subject to mandated coverages of diabetic services and supplies.
Despite not being subject to mandated requirements for coverage,
several of the largest plans and many of the largest Fortune 500
companies provide comprehensive coverage for diabetes care.
This factual evidence also applies to preventive services such as
cancer screening. The Government Accountability Office found that the
majority of States that do not have mandates continue to provide
coverage in a majority of their employer plans for cancer screening.
The bottom line is that the small business health plan bill makes
logical sense. It will give small business owners what they want and
what they need, and they will offer insurance coverage for their
employees. It makes logical sense that plans covering preventive care
will be offered because preventive care costs less in the long run. It
makes logical sense that small business owners who currently cannot
provide their employees with health care would purchase coverage
because it is more affordable.
It is important to note at this point that a small business owner who
buys health care coverage is also naturally subject to the same health
care coverage that he provides his employees. Small business owners are
pushing for health insurance coverage for themselves and their
employees, which they otherwise could not afford. It is not logical
that they would pay money for a plan that does not provide them with
medical coverage. Also, the point of small business health plans is so
that small businesses can join together to use joint collaboration to
get their health care needs met.
I support the legislation because I support giving small businesses a
choice. I support giving small businesses the opportunity for health
care coverage that they currently do not receive. I support giving
diabetics the opportunity for health care coverage, instead of leaving
them completely without services and supplies. I support giving small
business employees the opportunity for cancer screening and preventive
care, instead of leaving them with nothing and no opportunity to
provide health care for themselves and their families.
I urge my colleagues to support the small business health plans
legislation, and I urge my colleagues to vote in favor of Senate bill
1955, the Health Insurance Marketplace Modernization Act. I urge my
fellow Senators to give small businesses the opportunity to access
health care for themselves and their employees.
Mr. President, I yield the floor, and I suggest the absence of a
quorum.
The PRESIDING OFFICER. The clerk will call the roll.
The bill clerk proceeded to call the roll.
Mr. ALEXANDER. Mr. President, I ask unanimous consent that the order
for the quorum call be rescinded.
The PRESIDING OFFICER. Without objection, it is so ordered.
Mr. ALEXANDER. Mr. President, I come to the Senate floor to speak
about getting some long overdue help for small business men and women
in Tennessee who have really been struggling to afford health insurance
for themselves, their employees, and their families. We have an
opportunity in this body to do something about it. This is not some
abstract discussion we are having here; this is about something every
single one of us hears--at least I know I hear it. Whether I go to
Mountain City or Sevierville or Lexington or Memphis--wherever I go in
Tennessee, a small business man or woman says to me: We cannot afford
health care costs; we need some help.
We have some help. We have a proposal by Senator Enzi that will
provide some help to small business men and women. Now is the time for
us to act. Now is the time for the people of this country who are
listening to this, who know we need this, to say to Senators: Let's go.
Let's do this. Let's take the Enzi bill and reduce health care costs
for small businesses across this country, and at the same time let's
cut into the millions of Americans who are uninsured because the people
for whom they work cannot afford to offer them health care insurance.
Here is the situation in Tennessee. We have well over 2 million
people at work in Tennessee, and 97 percent of all businesses are what
we would call small businesses. So that is whom we are talking about in
our State--more than 2 million people who work, many of whom are
working for companies that cannot afford to provide them health care
insurance or are gradually reaching the point where they can't give
them that benefit anymore. Increased health insurance costs are driving
employers and families away from comprehensive coverage. Increased
costs are taking away the opportunity for a working family in Tennessee
to be able to work for a company that can offer a basic insurance
policy that the family and the employer can afford. What we are doing
this week is moving away from that situation. What we are doing in the
Senate this week and next week is providing an opportunity to change
that situation.
Dennis Akin runs the Wash Wizard car wash in Hendersonville, TN. We
are not talking about big-time CEOs who make $350 million a year and
fly corporate jets somewhere. We are talking about Dennis Akin who runs
the Wash Wizard car wash in Hendersonville, TN, just outside of
Nashville. This is what he says:
I am currently providing health care for all my employees
and their families. The cost at the present time is over
$44,000 per year for 5 employees, up 28 percent from last
year. The premiums have escalated at about that rate for the
last several years, and twice I have had to drop to plans
with lesser coverage to be able to pay the premiums.
Dennis Akin went on to say:
We really need to be able to find some kind of relief or
we'll have to reduce our benefit level to where the financial
burden on my staff could be devastating. In a business as
small as mine health care costs are my largest expense and
there seems to be no end in sight.
According to the Kaiser Family Foundation, about a third of Tennessee
firms with 50 or fewer employees offer health insurance to their
employees. In contrast, 95 percent of Tennessee firms with 50 or more
employees offer health insurance to their employees.
Our economy is not static. It changes all the time. Every year, we
lose an estimated 5 to 8 percent of our jobs. That is a lot of jobs.
That is between 100,000 and 150,000 jobs just in Tennessee. The good
news is we have the strongest economy in the world and we are gaining
more jobs than we lose. But where do those jobs come from? They don't
primarily come from Federal Express or Eastman Chemical or the Aluminum
Company of America or DuPont. We are glad to have all those great
employers in Tennessee, but most of the new jobs come from the Wash
Wizard car wash in Hendersonville, TN, and companies like that. These
are new companies, small companies. They may be adding two or three
employees a year. Currently, only a third of those firms, those firms
with 50 or fewer, can afford to offer health insurance of any kind to
their employees.
What does that mean? That means that most Tennesseans are simply left
without any access to health care that they can afford because in our
country, the way things are today, most people
[[Page S4259]]
get their health insurance from their employer. Maybe that is not the
way it should be. Maybe 10 years from now, we will be in a different
sort of system. But since World War II, that has been the way it has
been. By an accident of our history, most Americans get their health
insurance at the place where they work.
What we are saying is, in States such as Tennessee, and all across
this country, only a third of the people who work for small
businesses--which is where 97 percent of the people work--can get a
health care plan there. No wonder we have a lot uninsured people, and
no wonder we have a lot of families worrying about the rising cost of
health care.
The reason we are having this debate is the chairman has a bill that
will fix that situation. It will lower health care costs for small
businesses and help families be able to afford a basic health insurance
plan. Every American ought to want that to succeed, and we need to pass
this bill. We need to do this, and it is important for the American
people to know that we intend to bring this to a vote in the next few
days.
The discrepancy between what is available in the big companies and
what is available in the small, independent companies is absolutely
unfair. There is no reason for it.
Earlier this month, the National Federation of Independent Business,
Tennessee's largest small business advocacy group, delivered 10,905
petitions in support of this bill signed by small business owners in
Tennessee who want lower health care costs. We must make health
insurance affordable for Tennessee's small business owners and for
working families.
How will the Enzi bill help? When I say the Enzi bill, that is the
chairman of the committee who has worked on this bill and who has been
able to work through a lot of obstacles that prevented this from
happening in the Senate before.
The Small Business Act--a fancy name is the Health Insurance
Marketplace Modernization and Affordability Act--I, like Chairman Enzi,
like to call it the Small Business Health Insurance Act. That is a
pretty good name because that says what it does. Here is what it will
do.
It will allow businesses and trade associations to band their members
together and offer group health insurance coverage on a national or
regional basis.
It will empower small business owners and give them the opportunity
to choose a health plan that is best for their families and best for
their employees. This bill will promote lower costs and greater access
to health care. Lower cost means the employer can afford it. The plan
itself, with the employee contribution--if the employee can afford it--
being available means there will be more access to it. It will do that
by, No. 1, permitting the creation of fully insured small business
health plans; No. 2, creating more options in benefit design--in other
words, you will have more choices; if you want this or this, if you
can't afford that, you can try this--and, No. 3, it harmonizes
insurance regulations across State lines while keeping States as the
primary regulators.
I am a former Governor. I am for States rights. You often see me on
the Senate floor asserting the principle of federalism. I believe
strong States and strong communities are important for our country and
that we ought not be constantly passing national solutions to problems
without recognizing that.
But I believe the Enzi bill properly respects the principle of
federalism. It protects State oversight. It protects State authority. I
also believe it is important to have a level playing field for everyone
in the market--and the bill does that as well.
A study prepared by the Milwaukee firm of Mercer Oliver Wyman for the
National Small Business Association found that the Enzi bill would,
one, reduce health insurance costs for small businesses by 12 percent,
about $1,000 per employer, and reduce the number of uninsured and
working families by 8 percent, approximately 1 million people
nationwide would have basic health insurance who today don't have it.
This bill would cut the cost of health insurance for small
businesses, which is 97 percent of where the people in my State work.
That is No. 1. No. 2, it reduces the number of uninsured and working
families by 1 million people across this country.
This is a piece of legislation worth passing. It actually does
something for somebody. This is a rare opportunity to help small
businesses. It is a real milestone moment, and Chairman Enzi is to be
commended for getting the bill this far.
The House of Representatives has passed this legislation, on which
the Presiding Officer served, and I am sure he has voted for it three,
four, or five times over in the House of Representatives. But then it
gets over here to the Senate, and we have been in gridlock for 10 years
on this issue. The House of Representatives has passed this legislation
eight times, and for 10 years we haven't been able to find a way to say
we are going to reduce the health care costs for small businesses by 12
percent and decrease the number of Americans who are uninsured, that we
are going to give 1 million of them insurance. That was until Chairman
Enzi set his sights on trying to unravel the stalemate. He did it. He
got the small business community together with the insurance
commissioners and the insurance companies all around one table to
discuss how to make it work.
We need to take advantage of this rare opportunity to help the small
business men and women in Tennessee and across this country to find
affordable health insurance by passing this important legislation.
We have said on the Republican side that this is Health Week; that we
have heard the American people; we know that there are uninsured
Americans; and, we know that small businesspeople are struggling. They
are struggling with the cost of runaway litigation. We are trying to
stop that, but the other side of the aisle blocked that twice this week
when we put up legislation that would have given mothers and babies a
chance to be better served by OB/GYN doctors.
Who can be against that? The other side of the aisle was against it.
They basically kept Tennessee mothers who are pregnant from having a
chance to be served by OB/GYN doctors. Now they have to drive a long
way to have their babies. Unfortunately, they are going to have to keep
driving because the other side of the aisle said, no; you are not going
to even be able to vote on that.
Now we have moved to the next issue that will help small business. If
we couldn't this week help mothers who are about to have babies by
giving them better access to health care, at the very least we can take
the Enzi bill and pass it and say to the thousands and thousands of
realtors, to the thousands and thousands of barbershops, gas stations,
and say to Dennis Akin who runs the Wash Wizard car wash in
Hendersonville, TN, we can say to the small businesses in Tennessee--
which is 97 percent of all the businesses--we will cut your insurance
costs by 12 percent, or at least give you that option, and to the
people of this country we will increase by 1 million the number who are
able to get insurance.
This legislation is a good piece of legislation to help lower the
cost of health insurance. I hope very much that in the next several
days we can pass it. The House has passed it eight times. We can at
least pass it once, and then the American people will see that we hear
them and we are doing the job they want us to do.
Thank you. I yield the floor.
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