[Congressional Record (Bound Edition), Volume 152 (2006), Part 6]
[Senate]
[Pages 7244-7246]
[From the U.S. Government Publishing Office, www.gpo.gov]




                      SMALL BUSINESS HEALTH PLANS

  Mr. ENZI. Mr. President, I rise today to support action on health 
care this week. There is a bill that will be voted on tomorrow morning 
that I think is extremely critical to the health of the Nation.
  As chairman of the Committee on Health, Education, Labor, and 
Pensions, I can attest that access to affordable health care is the No. 
1 issue for working families who contact my committee. I do need to 
explain where we are in this process.
  We have a bill that made it out of committee to provide for small 
business health plans. There has been unanimous consent requested to 
proceed to the debate. That was denied. That is just the right to 
debate the bill, but it was denied. So a cloture motion was put in, and 
we will vote on that cloture motion tomorrow. That will be the 3 days 
after the cloture motion was filed. So that is a 3-day delay that we 
already have in solving small business health plan problems.
  Tomorrow morning we will vote at 10. I can't imagine anybody voting 
against better health for people who work in small businesses. I am 
anticipating that we will get 60 votes. When we get 60 votes, we still 
will not get to debate the bill. We will have 30 hours of debate on 
that cloture vote before we will get to offer any amendments. Thirty 
hours. That could easily be 3 days. It could easily be Thursday before 
we get to offer the first amendment. I hope the other side will help to 
get cloture so that we can proceed to the debate. Then I hope that they 
would agree to shorten that time significantly so we could actually get 
to amendments and debate the bill.
  We need to have a debate over the rising cost of health care. More 
importantly, we need to take action. Americans are tired of the status 
quo. They are tired of more of the same from the Senate. They are tired 
of excuses. They do want to see change for the better.
  The majority leader announced his intention to bring a bill before 
the Senate that would allow small businesses to band together across 
the country and negotiate for better health care benefits at better 
prices. This bill sets up a system where we get a little bit of 
uniformity out there for the small businesses to band together across 
State lines and form a big enough pool that they have some power to 
negotiate against the insurance companies.
  It is probably important to do that vote. I have some actuarial 
studies that show how many more people will be brought into the system, 
and CBO has done some evaluations of how many more people will be able 
to be insured and what kind of savings there will be. But I don't think 
they have the numbers right. The numbers are far greater than what they 
list.
  Here is the reason I believe that. I had a lot of people call me 
Friday and

[[Page 7245]]

Saturday and Sunday and let me know about the ads being run across the 
country. They are not referring to it as the small business health 
plans or even the Health Insurance Marketplace Modernization and 
Affordability Act. They are not even referring to it as S. 1955. They 
are referring to it as the Enzi bill. It is not the Enzi bill. It is 
the small business health plan bill. There are even Web sites set up. 
Thousands, if not millions, of dollars are being spent on advertising 
against it, which tells me that perhaps the ability for small companies 
to get together and negotiate against the insurance companies might be 
worth a lot more than anybody anticipated. That is where the ads are 
coming from.
  Tomorrow morning we will be voting on the motion to proceed to the 
consideration of S. 1955. The bill will reduce the cost of health care, 
especially for America's small business owners and working families. 
Today, of the 45 million people without health insurance, 22 million 
own or work for small business, according to the Small Business 
Committee definition of a small business, or they live in families that 
depend on that small business for wages. Besides the 22 million out of 
the 45 million, there is another 5 million who are self-employed who 
could take advantage of this bill. That makes 27 million people who 
can't afford decent health insurance right now.
  It is long past time for Congress to take action. The American people 
aren't going to accept excuses any longer. It is time for the Senate to 
take the first major step in nearly 15 years toward more affordable 
health insurance options for small businesses and working families.
  There has been a bill on the House side that has passed 8 times in 
the last 12 years for association health plans. The Senate has never 
gotten any kind of a bill like that out of committee until now. This 
bill is not quite like that bill. This bill was derived by talking to 
the insurance companies, talking to the insurance commissioners, having 
them sit down with the associations and try to find a workable way that 
would not unlevel the playing field so that some people would be paying 
more for their health insurance while others were paying less. They 
worked for almost a year with me. All of them were convinced that 
something needed to be done. All of them were willing to work in a 
positive manner to come up with a bill that would work. That is what we 
have before us now.
  That is not to say that the bill won't be changed through the debate, 
if we can get to the debate. There probably will be changes. There can 
be amendments to the bill. One of the things I have learned being in 
the State legislature as well as in Congress is that quite often 
amendments do help make a bill better. I do know that the American 
people support giving small businesses the same power that big 
businesses have had to negotiate for better benefits and better prices.
  The fact that it has taken us so long to get to this point has to be 
frustrating for our constituents and the small businessmen. That is 
most of the people in the United States. They are either small business 
or they work in small businesses. When they work in a small business, 
they understand the plight of the business much better than in a big 
business. We already gave big business a lot more opportunity to 
negotiate than what we have in this bill for small business. This is a 
great start for small businesses to bring those costs down.
  Small business owners and working families do want an up-or-down vote 
on small business health plans. They think they deserve it, and I 
believe they deserve it. I believe almost everybody here thinks they 
deserve a vote on whether they ought to be able to have a fraction of 
what the big companies have as an advantage in working with the 
insurance companies.
  For years the small business owners have been asking the Senate to 
grant them the power that the big businesses have so they can secure 
affordable health care for their employees and their families. For the 
first time in over a decade, the Senate committee has reported a bill 
that gives small business owners the power they are seeking. Americans 
have sent hundreds of thousands of letters, petitions, phone calls, e-
mails, faxes to the Senate over the past few weeks in support of small 
business health plans. The National Federation of Independent 
Businesses, one of the associations interested in this, delivered 
500,000 petitions from across the United States asking us to do 
something. The people have taken time out of their busy days to demand 
action, and they deserve that up-or-down vote.
  I remember getting permission, shortly after I got to the Senate, to 
hold a small business hearing in Casper, WY. That is the big city in 
the center of Wyoming. I held that hearing. I was pleased. I had about 
100 small businessmen show up to lend their support and express their 
needs.
  Afterward, one of the reporters asked: Aren't you disappointed you 
only had 100 people show up?
  I said: Actually, this is small business. I am kind of surprised that 
100 showed up because in small business, if you have an extra person 
who can spend a day at a hearing, you would probably fire them because 
you would have one more person than you needed.
  In small business, they don't have nearly the diversity or the 
specialization, but they have a lot of personal ability and flexibility 
to take their product to market and to make a difference against the 
big companies that way. But they need some extra help. I know the 
minority leader will want an up-or-down vote on a bill sponsored by 
Senators Durbin and Lincoln. I believe the minority leader should get 
that up-or-down vote, even though I don't believe the bill he supports 
would provide the kind of change small business owners want and need. I 
know what the support is for that bill. I would love to do the 
comparisons between what we are trying to do in small business health 
plans and that. Let's see what the will of the Senate is, and let's not 
resort to blocking consideration through procedural motions.
  I am sure some of my Democratic colleagues will want to use their 
share of the 30 hours of debate after this vote to discuss a variety of 
health care issues. Some Members of the minority will want to discuss 
the Medicare drug benefit. I have heard that on the floor in this 
preliminary time. Some will want to talk about drug importation. Some 
will want to talk about stem cell research. I know that from the debate 
we have had on the floor today. It is their right under the Senate 
rules.
  I am not sure how I would go about explaining that to the small 
business owners and the working families who work in those small 
businesses. I suppose that the vast majority of those small business 
owners are going to be too busy during the day and night to watch the 
Senate debate on C-SPAN2. But those who do will understand that the 
issues we are talking about are not the solution they are expecting, 
and that they are external to the bill we are debating at this time. 
Those are important issues. But if they are just being done to block a 
bill--and that will be the way it will be termed by small business--I 
suspect there will be a price to pay for that kind of action.
  I hope, for all our sakes, that the TVs in hospital emergency rooms 
are not tuned to C-SPAN. Some of those Americans who depend on small 
business and are in the emergency room may have no health insurance. 
Maybe their company dropped the coverage last year or maybe the company 
could not afford health insurance in the first place.
  What would they say if they were watching us this week? After all, 
the caption on the screen will read that we are supposed to be debating 
health insurance for working families. But instead of debating two 
competing visions for providing more affordable health care options for 
small businesses, we will be talking about Democratic amendments on a 
number of issues, including the Medicare drug benefit, which has 
already been done, and people are signing up in numbers that had not 
been anticipated. There is also already enough competition out there 
that it has driven the prices down. That is what competition does. It 
is working for seniors and they are saving money.

[[Page 7246]]

  But instead of talking about things that are working for Americans, 
we should be debating the challenges that still face us, such as the 
rising cost of health care for America's working families.
  Every day, emergency rooms treat more than 30,000 uninsured Americans 
who work for or depend on small business. That is at least 30,000 
reasons why we should move right away to the consideration of S. 1955 
to create small business health plans.
  For the first time in more than a decade, the Senate has been 
presented with a bill that would create a whole new set of affordable 
health care choices through small business health plans.
  Is it the perfect bill? No. I have never seen one in my 9 years in 
the Senate. We won't get to see anything even near perfect if we don't 
get to debate it. I believe most of my colleagues like the concept of 
getting as much perfection through amendments as possible and do want 
to work with me on it. Procedural votes won't get that done.
  If we are waiting for the perfect bill, the one true and 
comprehensive solution to fix our health care system, then someone 
needs to bring us a tent, flashlights, and field rations, because we 
are going to be a very long time waiting for that. I am hoping it is 
not a series of 30-hour waits to debate things that won't have anything 
to do with getting small business health plans for small businesses. 
Americans are never waiting for perfection from Congress. They have 
given up on that long ago. But they do want action.
  We have a good bill before us. We have a bipartisan bill before us. I 
am a former small business owner and I know something about the 
struggle to provide affordable health care to my family and to my work 
families.
  Senator Ben Nelson, who coauthored this bill, is a former State 
insurance commissioner, so he knows something about the importance of 
protecting consumers. Senator Nelson and I have spoken about this bill 
with just about every Member of the Senate. We think it is a very good 
bill, and we have reached out to our colleagues over the last several 
months to take their concerns into account as we put the bill together.
  Some of our colleagues will have amendments they believe will make it 
even better, and they should have the opportunity to offer those 
amendments. Neither Senator Nelson nor I are afraid of that, nor are we 
afraid of any alternative bills that Members might want to propose.
  I urge my colleagues to set aside tomorrow's motion to proceed to the 
consideration of the bill. Let's get on with it, debate it, and have 
some amendments. We can have constructive votes on the floor on a 
number of issues that will improve this bill. But if we have to go 
through the procedural motions, let's keep in mind those 27 million 
uninsured Americans who work for or depend on small businesses. Those 
are 27 million Americans who are counting on the Senate to act now--not 
next month, not next year, but now.
  Let's take the step toward more affordable health care for all 
Americans by giving small business owners the power to create small 
business health plans for themselves, their families, and their 
workers. Give them the chance they are seeking, instead of more of the 
same excuses for not acting. I don't think they will buy that.
  I am hoping some of the media that is doing coverage will do a little 
bit better job than I happened to see last weekend. PBS did a special. 
They forgot to talk to anybody who worked on the bill. They talked 
about some problems with California's health care and attributed it to 
this bill. This bill cannot be the cause of that yet because it is not 
in California.
  There have been concerns by a number of other groups. One was the 
attorneys general for a number of States. Again, it would have been 
nice if they would have talked to us to be sure they had the right bill 
and had read it before they took their action. So we will be covering 
that in the next few days.
  If we have to talk for 30 hours, we will be plenty willing to do 
that. There are a lot of people in small businesses who see this as a 
primary concern and need, and they wish to see it done as soon as 
possible. They will not be very forgiving if people are holding things 
up to try to defeat the bill instead of making constructive progress.
  I appreciate all those who have worked with me and all of those who 
are still working on amendments. Particularly, I would appreciate it if 
they would talk to me. There are some good ideas out there, things that 
would work. Many are for clarification. It will make a difference to 
small business. I hope everybody will get past this motion to proceed 
and the 30 hours of debate will get finished.

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