[Congressional Record Volume 152, Number 64 (Monday, May 22, 2006)]
[Senate]
[Pages S4883-S4884]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
CREATING OPPORTUNITIES FOR PUBLIC-PRIVATE PARTNERSHIPS FOR SMALL
BUSINESSES
Ms. STABENOW. Mr. President, I wish to have included in the Record
statements of support for S. 2588, the Health Care Access for Small
Businesses Act, from all across the state of Michigan. I am proud to
have support from organizations as diverse as providers, insurers, and
elected officials.
The three share model is an innovative community-based concept that
has worked across the United States from California to Arkansas, of
course, to Michigan. The name, ``three share'' stems from the program's
payment structure. Premiums are shared between the employer who pays 30
percent, the employee who pays 30 percent and the community which
covers the remaining 40 percent of the cost.
I ask unanimous consent that the support letters be printed in the
Record.
There being no objection, the material was ordered to be printed in
the Record, as follows:
Ascension Health,
St. Louis, MO, April 28, 2006.
Hon. Debbie Stabenow,
U.S. Senate,
Washington, DC.
Dear Senator Stabenow: I am writing in strong support of
the legislation you recently introduced, S. 2588, the
``Health Care Access for Small Business Act of 2006,'' that
would expand health insurance coverage for employees who work
for small companies through a ``Three-Share Program'' modeled
on a successful initiative first developed in Michigan. As
you know, Ascension Health--through our sponsored hospitals
and heal systems in Michigan that include Standish Community
Hospital; Borgess Health Alliance in Kalamazoo; St. Joseph
Health System in Tawas City; Saint Mary's Medical Center in
Saginaw; Genesys Health System in Flint; and St. John Health
in Detroit--has a significant presence in Michigan. We
believe your legislation will help us in our work at the
local level in Michigan and across the country to achieve
100% access to health care.
Over the past 6 years, Ascension Health has fostered the
development of local community coalitions to expand access
and improve the quality of care provided to the uninsured.
Our experience led to the development of a 5 step model to
expand access to care. Step One is to build a formal
infrastructure that can support safety net services for the
uninsured. Step Two is to fill service gaps, such as dental
prescription drugs, and mental health services. Step Three is
to develop and implement a care model for the uninsured that
emphasizes coordinated services throughout the continuum of
care. Step Four is to recruit physicians to provide medical
homes and specialty care for the uninsured. Step Five is to
get funding to ensure the long term sustainability of the
initiative.
Since 2000, community coalitions in Michigan with an
Ascension Health partner have received over $11 million in
federal support through the Healthy Community Access Program
(HCAP) and approximately $2 million in matching funds from
Ascension Health. These funds have been used to develop and
implement many of the steps identified above to achieve 100%
access. We believe your legislation would help us reach the
final step of achieving long term sustainability by providing
small business, owners and their workers an opportunity to
afford insurance coverage.
We enthusiastically support your legislation. Please let us
know what we can do to further help you in your efforts to
expand coverage for the 47 million Americans without health
insurance, the additional 40 million Americans who go
uninsured during some part of the year, and the additional 80
million Americans who are only partially covered.
Sincerely.
Athony R. Tersigni,
President and Chief Executive Officer.
____
Upper Peninsula Health Plan,
Marquette, MI, April 20, 2006.
Hon. Debbie Stabenow,
U.S. Senate,
Washington, DC.
Dear Senator Stabenow: I am writing to express my
organization's support for Senator Stabenow's SB 2588,
``Health Care Access for Small Business Act of 2006.'' SB
2588 will provide grants to eligible ``three-share programs''
for the start-up and operation costs of providing specific
health care benefits to eligible covered individuals for a
period of five years.
A ``Three-Share Program'' is a basic plan for health care
coverage that brings together employers, workers without
health care coverage and outside funding to create a health
care coverage plan for those workers who have no other access
to health insurance. The plan encourages employers (formerly
not offering insurance coverage) to assist in the payment of
modest fees for their employees' health coverage. Additional
private, state, and/or federal funds are required to augment
fees paid by other parties to complete the reimbursement of
care. This transforms the ``slow pay/no pay'' patients into
``assuredly-pay/discount-pay'' patients.
Presently in Michigan, 1.2 million people do not have
health care coverage. Sixty percent of the 1.2 million are
employed and work full or part-time. Fifty percent of the 1.2
million are employed by small businesses and are not offered
health care benefits. Michigan has seen two successful and
separate community initiatives that began offering health
care coverage for employed, low-income persons using the
three-share model: HealthChoice in Wayne County (1994) and
Access Health in Muskegon County (1999). Both are received
grant monies for their start-up and operation costs.
The three-share program is a successful model for other
regions to replicate. However, without start-up seed money in
which to build community involvement, determine market needs,
and establish administrative systems to carry out operational
functions, these programs cannot get off the ground. In order
to begin solving the health care crisis on a local level,
communities need monetary supports in which to fund
initiatives such as three-share programs.
Michiganders want access to high-quality, affordable health
care. Thank you for initiating this legislation to help them
receive it.
Sincerely,
Dennis H. Smith,
President & CEO.
____
Trinity Health,
Novi, MI, May 12, 2006.
Hon. Debbie Stabenow,
U.S. Senate,
Washington, DC.
Dear Senator Stabenow: I am writing to congratulate and
thank you for your legislation, the Health Care Access for
Small Businesses Act of 2006, and to offer Trinity Health's
support and assistance in its passage.
As you know, Mercy General Health Partners, one of Trinity
Health's twelve hospitals in Michigan, was instrumental in
the creation of Access Health, one of the nation's most
successful community-initiated programs for the working
uninsured. Access Health now has a seven year track record.
We are proud to be associated with Access Health, and
appreciate your past contributions in helping to make it the
success that it is.
The Health Care Access for Small Businesses Act of 2006
will help communities across the nation replicate the Access
Health model, and thus become an important piece of the
solution for the country's millions of uninsured individuals.
Specifically, your bill would leverage a federal
contribution with community funds to help small businesses
and their employees purchase a health coverage product
developed by the community. In addition to reducing the local
uninsured population, increased access to health care in a
community will result in community-wide economic benefit.
Employers in the community will experience less health care
cost-shifting, and increased productivity and employee
retention. With greater emphasis on preventive and chronic
care, communities' uninsured populations will become less of
a financial burden on state and local budgets.
Thank you for your very thoughtful effort to help
communities, small business, and to ensure that the uninsured
are not forgotten. We look forward to working with you on
this national effort.
Sincerely,
Marsha J. Casey,
President, Michigan Ministries.
____
Detroit, MI, May 9, 2006.
Hon. Debbie Stabenow
U.S. Senate,
Washington, DC.
Dear Senator Stabenow: I am writing to express Wayne
County's strong support for S. 2588, the Health Care Access
for Small Businesses Act of 2006. As you know, Wayne County,
Michigan has long been on the forefront of developing
innovative health coverage for small business employees and
the uninsured. Our experience demonstrates that
[[Page S4884]]
these programs have a meaningful impact on employee retention
and well-being and provide a much-needed safety net to scores
of workers in Wayne County. As such, we appreciate Senator
Stabenow's leadership and strongly support the authorization
of federal grant programs for pilot demonstrations that will
help ensure the establishment and the continued success of
three-share health coverage programs across the country.
The ``three-share'' programs developed in Wayne County
provide affordable coverage and quality medical care to
working uninsured residents. As you are aware, the two
primary three-share programs operating in Wayne County are
the Health Choice program and the Four Star Program. Under
both programs, workers receive coverage for primary health
care, prescription drugs, emergency and urgent care, hospital
care, and diagnostic services. Employers, employees, and the
County each pay roughly one-third of the premium cost of the
coverage, which is less than $60 per month for employees.
There are currently 607 employers, including 3,700 members,
participating in Health Choice and approximately 40
businesses, including 150 members, participating in Four
Star.
These three-share programs not only provide coverage to
individuals who badly need it; but they also help small
businesses attract and retain skilled employees. In Wayne
County, roughly 280,000 persons are uninsured, many of whom
are employed by small businesses that cannot afford to bear
the cost of providing a health insurance benefit to their
employees. The three-share programs operating in Wayne County
provide these employers with a low-cost way of providing
health insurance to their workers, which in turn reduces sick
days, builds employee morale and loyalty, and ultimately
improves our local economy.
Federal grants that would be authorized by S. 2588 could
enable Wayne County to expand these programs to serve more
persons or include additional benefits. Currently, Wayne
County's three-share programs only cover employees and their
spouses, as the County is unable to provide coverage to the
children of employees. Funding could also support the
County's outreach efforts to eligible employers, including
reaching out to the Hispanic and Arab American communities to
ensure awareness of the program and how it operates. Finally,
it is possible that federal grant money would allow the
County, working with its underwriters to lower the portion of
premiums that employers have to pay, thus providing an
incentive to additional small businesses to participate in
the program. Numerous other counties would similarly benefit
from a federal grant program for three-share programs.
Wayne County's programs have enhanced access to health
services for the most needy in our community and we commend
your leadership and vision for seeking expanded nationwide
access to this model. We are confident other municipalities
will find your legislation attractive as well. Expanding
insurance opportunities for our nation's uninsured and
providing small businesses with a meaningful way of offering
health coverage to their employees are significant challenges
to many, if not most, municipalities. Three-share programs
can positively impact other counties and cities nationwide so
that both employers and employees benefit from the continued
strength of these programs. Thank you again for all your
leadership and all your efforts to address pressing national
health coverage access problems.
Sincerely,
Robert A. Ficano,
Wayne County Executive.
____
Oakwood Healthcare, Inc.,
Dearborn, MI, May 16, 2006.
Hon. Debbie Stabenow,
U.S. Senator,
Washington, DC.
Dear Senator Stabenow: Thank you for introducing Senate
Bill 2588 that certifies and supports programs to provide
uninsured employees of small businesses access to health
coverage.
As the Chief Executive Officer of a health system in a
market experiencing high unemployment and increasing numbers
of uninsured patients among the employed, I am hearing of
many individuals avoiding visits to their healthcare provider
due to lack of insurance. This has resulted in significant
decreases in hospital admissions in Southeast Michigan during
the past six months.
Of course, the underlying health problems of these
uninsured individuals are not going away. We fully expect to
see many of them in our Emergency Room when their condition
reaches a crisis stage.
While the problem of the uninsured is entrenched and
growing, there are potential solutions. Our governor in
Michigan is working to create a statewide plan that would
cover significant numbers of uninsured residents. While we
support this work, we also believe that development of shared
resource insurance programs could very quickly begin
addressing the problem in a number of local markets.
Oakwood has already established one such program, known as
the ``Four-Star'' health plan, in which Oakwood Healthcare
System, St. John Health System, Henry Ford Health System, and
the Detroit Medical Center, partner with the Wayne County
Health Department to provide coverage to qualified
individuals who share the cost with their employer and the
county.
We believe this program and others like it offer a timely
and viable approach to providing health care access to the
uninsured employed by small businesses. It is exactly the
approach described in S. 2588.
We welcome the support this bill would provide to build and
market plans like ours. While we believe such three-share
plans offer the right solution to many employers and their
employees, they require significant startup investment. The
grants called for in Section 2201 would do much to encourage
additional three-share programs, thus providing access to
health care for thousands of employed individuals while
adding to the viability and competitiveness of many small
businesses. We heartily endorse passage of this legislation.
Sincerely,
Gerald D. Fitzgerald,
President and CEO.
____
www.CoverTheUninsured.org,
Dearborn, MI, May 2, 2006.
Hon. Debbie Stabenow,
U.S. Senate,
Washington, DC.
Dear Senator Stabenow: I want to thank you for developing
and introducing the ``Health Care Access for Small Businesses
Act of 2006.'' I support efforts to expand coverage for the
uninsured, and I am pleased that your legislation is modeled
on the successful multi-share program in Muskegon that
provides affordable health insurance options for small
businesses. It is this kind of program that should be
replicated to reduce the number of working uninsured in our
country.
I hope you will find other ways to bring the urgent issue
of the uninsured to the forefront of the national political
agenda. Nearly 46 million Americans are living without health
insurance, including more than 8 million children. As you
know, more and more Michigan families are facing the hardship
of being uninsured as cutbacks in manufacturing leave them
unemployed or in jobs without health benefits.
The economic impact of the growing uninsured is most
evident for states and localities like ours trying to attract
job-creating investments. Small businesses often find that
insurance coverage for their employees is either unaffordable
or simply unavailable. Large employers that do provide health
insurance are bearing many of the uninsured treatment costs,
which are shifted to them through steeply rising premiums.
The result is an uneven playing field for employers.
More importantly, the uninsured often receive care that is
``too little too late.'' Minor illnesses become more severe
because care is delayed. The Institute of Medicine has
determined that thousands of uninsured people die each year
because of this delayed care.
I hope you will work to find bipartisan support for the
``Health Care Access for Small Businesses Act of 2006,'' and
that you can continue to support other legislative
initiatives on behalf of the uninsured. ``Coverage and access
for all'' makes economic sense because it will mean more
efficient and effective care, a healthier population, and a
more competitive local economy. More importantly, coverage
and access for all is the right thing to do for our
community. In a just society, no one should be left behind.
Thank you for your efforts on behalf of the uninsured.
Sincerely,
Stanley Goldberg.
____________________