[Congressional Record (Bound Edition), Volume 151 (2005), Part 2]
[Senate]
[Pages 2481-2483]
[From the U.S. Government Publishing Office, www.gpo.gov]




                   SMALL BUSINESS HEALTH FAIRNESS ACT

  Mr. TALENT. Madam President, I am hopeful that later in the day the 
Senate will be able to take up the Genetic Nondiscrimination Act. It is 
a bill I sponsored in the past. I know discussions are going on right 
now about getting it done, and hopefully we will be able to get it 
done. If that happens, it will be in no small measure because of the 
leadership of Senator Enzi, who has already shown in the brief period 
that we have been in session a great ability to work with Senator 
Kennedy and others on the HELP Committee to pass legislation.
  I was moved by that to come down and to discuss another piece of 
legislation that a number of us are discussing with Chairman Enzi. I am 
grateful to him for his openmindedness to it and the discussions that 
have been going on. I am talking about the Small Business Health 
Fairness Act which the chairman of the Small Business Committee, 
Senator Snowe, will introduce today for herself and a number of others 
who have sponsored this bill in the past.

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  I congratulate Senator Snowe on her great work on behalf of this 
bill. I am hopeful that we will be able to pass it this year in the 
Senate. It may be the most significant thing we can do to reduce the 
number of people in this country who do not have health insurance.
  I want to talk about that for a few minutes. There really is no 
problem in confronting small business and the economy greater than that 
problem. It is everybody's problem, even if you have health insurance.
  There are 44 million people in the country who do not have health 
insurance. We have about 500,000 people in Missouri--about 10 percent 
of our State's population, a little less than that, including 70,000 
children who get up and go to school without any health insurance 
coverage.
  Sixty percent of the people in the State of Missouri and around the 
United States who do not have health insurance are working people. It 
is a mistake to assume that most of these folks are people who are not 
employed. They are not classically the disadvantaged people as we 
normally think of that. Most of those folks we have made eligible for 
Medicaid, which certainly has a problem, but it is at least health 
insurance coverage.
  Health insurance costs have been increasing for small business 
employers and their employees on average about 20 percent per year, 
which means this is not just a health access problem but a huge 
economic growth problem as well.
  Those small businesses that are providing health insurance are having 
to deal with these enormous costs every year. They will have to take 
money out of wages or out of investments in the business to try to keep 
their heads above water in terms of providing health insurance.
  Over the years of my experience in the House and the Senate, I have 
encountered many such small employers. I have talked to hundreds of 
their employees. We have all done that. All of us, when we get around 
our States, hear about this problem. It is everywhere. It may be the 
biggest day-to-day problem the average person in our State confronts, 
at least if they work for a small business.
  Let me just tell you one story of a fine lady named Janet Hoppin from 
Missouri. Janet owns a small business in the St. Louis area. She wants 
to do right by her five employees by providing them with health 
insurance. Over the past few years, one of her employees became ill. 
She contracted breast cancer. As a result of that, the insurance costs 
for Janet's company have increased by $431 per employee per month, or a 
total increase over the last 2 years of 35 percent. Actually, it could 
have been a lot more than that.
  I have talked to people whose insurance costs have doubled or tripled 
over the course of several years, particularly if an employee actually 
gets sick and has the temerity to file a major health insurance claim.
  Like most small business owners, health insurance costs for Janet 
affect the rest of her business. There is downward pressure on the 
wages and salaries of her other employees and her own salary. She has 
resolved this by taking it out of her own salary so she can continue to 
provide health insurance for herself and for her employees.
  There are many small businesspeople around the country who are doing 
exactly the same.
  One of the bad things about this situation is because so many people 
who work for small businesses do not have health insurance, it is easy 
to assume that small businesspeople just do not care about their 
employees and that is why they don't provide health insurance. It is 
terribly unfair. They do care about their people. They work with them 
every day. Most small business owners are employees of their own 
company. If they can provide health insurance to the company and the 
other employees, they will be able to get health insurance under a 
group policy rather than having to try to go out and buy it on the 
individual market. It affects their ability to compete for employees.
  For a while, when I was chairman of the Small Business Committee in 
the House, I would meet with groups of small businesspeople and I would 
ask them to raise their hand if they had lost an employee or had been 
unable to hire an employee because the employee wanted to work for a 
big business that had health insurance. Whenever I asked that question, 
at least half of the people there would raise their hand. They have a 
disadvantage of getting good employees because of their competitive 
disadvantage in buying health insurance.
  What do we do about it? Fortunately, there is a solution. The 
legislation has passed the House I think 4 or 5 years running by large 
bipartisan votes. It passed the House by 100 votes the last time it 
passed. It is a solution that the President strongly supports. It is a 
solution that had bipartisan sponsorship in this body last year. What I 
am about to say is not unimportant at the same time when we are all 
suffering under a tight budget. It is a solution that doesn't cost the 
taxpayers any money. It is not a Government program as such. It is not 
the Government deciding to buy health insurance for somebody, or 
expanding Medicaid. Those may be good things to do.
  We do not have to do it here. We need to empower small business 
people to do what the big companies already do. We need to allow them 
to buy health insurance as part of big national pools which will save 
money because the overhead costs, the administrative costs of buying 
health insurance, are a lot greater per employee for small businesses 
than for big businesses. The reason for that is there are economies of 
scale in insuring large pools.
  That is what the small business health plan would do. It would take 
advantage of the same national structure currently used by 275,000 
plans which already cover over 72 million people, including union 
members, people who work for Fortune 500 companies. The irony is that 
everyone else in the country, except the employees of small business, 
everyone else who has health insurance, has it now as part of a big 
national pool, either private or public. Either you work for a big 
company--in Missouri at Anheuser-Busch or Sprint or Hallmark--and you 
are part of a big national pool or maybe you are a labor union member 
and you get it through one of their health and welfare plans or you are 
on a public plan, in Medicare, a big national pool, or Medicaid or you 
are a Federal employee or a retired Federal employee.
  There is a reason everyone else gets their health insurance as part 
of a big national pool. It is cheaper that way. It is administratively 
easier. The overhead costs are less. It is common sense to believe it 
costs less to set up and administer a plan where you can spread the 
costs over a pool of hundreds of thousands of people, rather than a 
pool of 5 or 10 employees or fewer, which is what people such as Janet 
Poppin have to face every day today.
  All we want to do is allow the trade associations, in which small 
businesses currently organize for other purposes, to sponsor national 
health insurance pools. The National Restaurant Association, as an 
example, could go out, contract with insurance companies nationally, 
and then you join the restaurant association if you own a small 
restaurant, as my brother does, and you become part of this big pool. 
The easiest way to think of it is a small company would get health 
insurance on the same terms and conditions as if you had been acquired 
by a Fortune 500 company. You become like a little division of that 
company. It would be exactly the same thing.
  What would it mean for this country if at no cost to the taxpayers 
every working person has access to health insurance as if they worked 
for a Fortune 500 company? When I chaired the Committee on Small 
Business, we had a number of hearings on this. Senator Snowe has had a 
number of hearings. We estimate a reduction in the cost of health 
insurance to small business of 10 to 20 percent, and for very small 
businesses it would be much less than that. For every percent you 
decrease the cost of health insurance, many people become insured. 
Small businesses, such as my brother's, who runs this little

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restaurant, are in a position now to afford health insurance for their 
employees and, by the way, for themselves because the owners of the 
companies are almost always employees of the company themselves and 
they will go out and get health insurance this way.
  Think of the savings from their perspective, not just in money but 
time and effort. I use my brother as a example. He and my sister-in-law 
run the place. Getting health insurance for their business means 
spending hours and hours soliciting bids, trying to work their way 
through it, making sure they are not cheated, dealing with all the 
legal risks today of making a contract like that. They do not know 
whether they might get sued for something if they contract with an HMO 
and there is a screwup. If you can join the restaurant association, 
they send him the papers, the papers describe what options are 
available for the employees, and he says I will pay this much for you, 
you choose what you want.
  It is easier, it is cheaper, it is safer. It will mean millions of 
people who currently do not have health insurance coverage will get it 
and millions of others will get better, more secure, lower cost, higher 
quality health insurance--again, at no cost to the taxpayer.
  There isn't any reason not to do this. We have been working with 
those who have had concerns about solvency. How do we make sure these 
association health plans are solvent? That is a legitimate concern. We 
already have in the bill tough standards to try and guarantee that. We 
want to work with people to try and make certain that everybody is 
satisfied on those points.
  We can work our way through this and produce a bill that will make a 
big difference for America. I am not the only one who thinks so. In 
addition to Senator Snowe and her great leadership, nine other Members 
of the Senate who cosponsored this bill last year, Association Health 
Plans, or the Small Business Health Fairness Act, strongly supported by 
the administration, 170 organizations representing over 12 million 
employers, and 80 million American workers support it. The coalition is 
as broad as the U.S. Chamber, National Federation of Independent 
Business, the American Farm Bureau, the Associated Builders and 
Contractors, the Latino Coalition, the National Black Chamber of 
Commerce, the National Association of Women Business Owners. They all 
support it.
  I mention the Farm Bureau. The Presiding Officer and I have a number 
of farmers in our States. One of the big problems they have is getting 
health insurance for themselves and their families. This is a classic 
example of people trapped in a small group for individual markets 
situation. What if they could join the American Farm Bureau and become 
part of a pool of tens and tens of thousands of people?
  In recessions, when people get laid off from big businesses--and I 
have talked to many people in this situation--one of the biggest and 
most immediate problems when you are laid off is what do you do about 
health insurance, particularly if you have kids. Many people are able 
to get another job pretty quickly, maybe with a small business, or they 
want to start their own spinoff firm when they get laid off from a big 
company. This is increasingly common today, and a big problem they have 
is health insurance. What do they do about health insurance? A sole 
proprietor can join the Chamber of Commerce and the National Chamber of 
Commerce would be able to start an association health plan under this 
bill. You would be part of a pool of tens and tens of thousands of 
people. You would not be at the mercy of a big company deciding it is 
going to cut your job.
  I could go on and on on the subject. I am sure the Senate has become 
convinced of that, if I have convinced Senators of nothing else. I am 
very enthusiastic about it. I cannot compliment enough the work of 
Senator Snowe. Her leadership on this is crucial. Her credibility in 
this Senate is great. She has taken the whole Small Business Committee 
in the Senate in the direction of supporting this. I am very pleased to 
be helping her in this and grateful again to Senator Enzi for his open-
mindedness. I cannot speak for him and do not want to, but I remember I 
was presiding and the Senator from Wyoming was speaking about what he 
intended to do with the HELP Committee. He said his door was open; he 
wanted to hear ideas from Senators. He wanted to work with them. He has 
been as good as his word. I am grateful to him for that.
  Let's do this. Members have concerns and we want to address them. I 
believe we can address them. This is too good an idea to pass up. There 
is no reason to. I have said for several years, what is the downside? 
Suppose we allow these associations, however they are constructed, to 
set up these association health plans, and it doesn't work as well as 
we think it will work; they do not lower costs quite as much as we 
hope, and not as many people take advantage of them. What is the 
downside? Not so many people use the plans as we hope will use the 
plans. There is no cost to the taxpayers. It is not as though we are 
spending billions and billions of dollars for something and if it does 
not work, there is an enormous loss. We are giving people another 
option, the same option big companies already have. There is no reason 
not to do it.
  Let's work out whatever concerns we have, pass this on a bipartisan 
basis as they have in the House, and empower our small business people 
and their employees to have health insurance and to have protection 
against these rising costs.
  I yield the floor and suggest the absence of a quorum.
  The PRESIDING OFFICER (Mr. Isakson). The clerk will call the roll.
  The legislative clerk proceeded to call the roll.
  Mr. DORGAN. 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. DORGAN. Mr. President, I ask unanimous consent to speak in 
morning business for as much time as I may consume.
  The PRESIDING OFFICER. Without objection, it is so ordered. The 
Senator is recognized.

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