[Congressional Record Volume 154, Number 70 (Wednesday, April 30, 2008)]
[Senate]
[Page S3599]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. BROWN:
  S. 2948. A bill to provide quality, affordable health insurance for 
small employers and individuals; to the Committee on Health, Education, 
Labor, and Pensions.
  Mr. BROWN. Mr. President, earlier this week, I spoke on the Senate 
floor about Cover the Uninsured Week and a bill I was introducing that 
would increase access to health coverage for small businesses and self-
employed individuals.
  I will formally introduce the Small Business Empowerment Act today, 
and I would like to discuss the bill in a bit more depth.
  First, why is it necessary?
  It is necessary because 82 percent of the uninsured are workers, and 
the overwhelming majority work in small firms.
  In Ohio, 99 percent of firms with more than 50 workers sponsor health 
coverage. About 44 percent of firms with less than 50 do.
  And small employers that do offer coverage are struggling under the 
weight of it. According to the well-respected Rand Corporation, small 
businesses saw the economic burden of health insurance rise by 30 
percent between 2000 and 2005.
  The situation is even worse for the self-employed, who must contend 
with staggeringly high premiums for individual coverage, if, that is, 
they can find an insurer willing to cover them.
  In the meantime, health insurers have been living large, their 
profits increasing by more than a third over the last 5 years. That's 
not revenue, it's profits.
  Middle class families are shouldering the burden of skyrocketing gas 
prices and ballooning food prices, even as the equity in their homes 
erodes and the cost of putting their children through college explodes.
  It would be ideal if they could also afford to pay a king's ransom 
for health insurance.
  They can't. They shouldn't have to.
  With those realities staring us in the face, inaction is the same as 
indifference.
  My legislation attacks the issue of health coverage access from 
several directions.
  To ensure widespread access, the bill would establish a national 
insurance pool modeled after the successful Federal Employees Health 
Benefits program.
  FEHB, which enables enrollees to choose from a variety of health 
plans whose rates and benefits are negotiated by the federal Office of 
Personnel Management, has served members of Congress and federal 
employees well for many years now.
  Under my bill, an independent contractor would manage a program that 
looks like FEHB, with a few modifications to accommodate the market 
segment it would serve.
  A few of those modifications are designed to hold down costs:
  The bill would establish a reinsurance program to pay claims that 
fall between $5,000 and $75,000. This approach minimizes premium spikes 
and makes coverage affordable for companies regardless of the age and 
health of their employees.
  The bill would also establish what is called a ``loss-ratio'' 
standard for insurers. Basically this means that insurers would be 
required to spend most of their premium income on claims, and hold down 
their administrative costs.
  And the bill would identify and apply strategies to ensure that 
providers employ ``best practices'' in health care, which means that 
they are providing the right care in the right amounts.
  Finally, the bill would target ``price-gouging'' by drug 
manufacturers and other manufacturers of medical products. Price 
gouging occurs in U.S. health care when a company exploits American 
consumers by charging them dramatically higher prices than consumers in 
other wealthy nations.
  Other modifications are designed to ensure that health coverage is 
non-discriminatory.
  Think about it: If you develop a mental illness like clinical 
depression and I develop a medical illness like heart disease, why 
should you be denied health benefits while I receive them? We both have 
paid premiums to cover health care costs and we both need health care. 
Why is my condition more worthy of coverage than yours?
  My bill charges a group representing providers, businesses, 
consumers, economists, and health policy experts with rethinking health 
care coverage to eliminate arbitrary differences in the coverage of 
equally disruptive, disabling, or dangerous health conditions.
  The bottom-line is this. We have an opportunity to expand access to 
health coverage in a way that advances fundamental goals:
  We can reach populations who can't find a home in the current 
insurance system.
  We stand up for American consumers who are paying ridiculous prices 
for essential health care.
  We can demand spending discipline on the part of insurers--they have 
chosen to play a pivotal role in the health of our nation; they can 
live with reasonable limits on their administrative costs.
  We can clean up duplication and random variation in the delivery of 
health care services; and we can end arbitrary coverage rules that turn 
health protection into a health care crapshoot.
  For the sake of small employers and their employees, for the sake of 
self-employed entrepreneurs, and for the sake of every American who 
didn't request a particular health problem and shouldn't be penalized 
for having it, I hope Members on both sides of the aisle will support 
my bill.

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