Health bill offers help to small firms
Posted on Thursday, April 3, 2008
URL: http://www.nwanews.com/adg/News/221637/
WASHINGTON — A bipartisan group of senators filed a bill Wednesday designed to make health insurance more affordable for small-business owners and their employees. But election-year politics and perennial disagreements over health insurance policy cloud the legislation’s chances for success.
The bill, sponsored by Illinois ’ Sen. Dick Durbin and Arkansas’ Sen. Blanche Lincoln, both Democrats, and Maine’s Sen. Olympia Snowe, a Republican, would give tax credits of $ 1, 000 per worker to small-business owners who pay for at least 60 percent of their employees’ health insurance. The business owners would be able to combine their covered employees into a national pool and use the resulting buying power to purchase insurance from carriers.
The bill’s sponsors called their proposal a “hybrid” approach that builds on the lessons of past failed attempts to craft federally regulated small-business health plans.
In 2006, during the 109 th Congress, Republican Sen. Mike Enzi of Wyoming and Snowe unsuccessfully pushed a bill that would have created a national insurance pool. Durbin and Lincoln pushed a Democratic alternative. Neither approach received a full Senate vote, Lincoln recalled, because of “philosophical differences” on how to provide health insurance.
Now, Lincoln said, the two sides have “found middle ground.”
“We had our different views and we all had our different legislative mechanism,” Snowe said. “The time has come to blend these approaches.”
Added Durbin: “We basically had to give and take.”
The resulting legislation combines ideas from both sides.
For instance, the national pool will be administered by the Department of Health and Human Services, with a large role for state insurance commissions.
The bill sponsored by Lincoln during the past congressional session was modeled after the federal employee benefit plan, which is administered by the federal Office of Personnel Management. Lincoln defended that approach, because it was “a known.”
Changes were made after the National Federation of Independent Business and others chimed in, saying the Office of Personnel Management was too heavyhanded.
To avoid “adverse selection,” or “cherry-picking,” which happens when plans are filled with either mostly healthy people or a large proportion of sick people, the current proposal would forbid insurance companies to base their rates on a person’s health status or claim history.
Amanda Austin, a lobbyist for the National Federation of Independent Business, said her group was originally in favor of the approach used during the previous Congress in the Enzi-Snowe bill, which was not as restrictive.
Since then, a poll of the group’s membership caused the federation to change course and support the restrictions in the current bill.
“Our guys didn’t want to be rated on health status,” said Austin, a Pine Bluff native.
On one difficult issue, the minimum level of coverage that must be offered, the bill seeks outside help. It would direct the Institute of Medicine at the National Academy of Sciences to set requirements on what kinds of services must be covered.
Austin said having independent scientific experts weigh in would take some of the politics out of the debate.
“We don’t want to be targeted as the group that’s against women having mammograms,” she said.
Snowe said setting a floor for basic coverage proved to be difficult when her bill was taken up in the previous Congress.
She predicted people would “have faith” in benefit determinations from the Institute of Medicine, “rather than having Congress dictating” the terms of coverage.
The three senators pitched their bill at a Wednesday news conference in the Capitol building. They were flanked by representatives of the National Association of Realtors, the National Federation of Independent Business and the Service Employees International Union.
The Service Employees International Union’s involvement and unlikely alliance with the National Federation of Independent Business, Durbin said, came after the union’s president, Andy Stern, had a meeting last year on the need for employee groups and management to work together on health policy with Durbin and Wal-Mart Stores Chief Executive Officer H. Lee Scott.
Missing from the announcement were representatives of the insurance industry.
“We’re just now getting a look at the bill,” said Robert Zirkelbach, a spokesman for America’s Health Insurance Plans, a Washington advocacy group for insurance carriers. Zirkelbach declined further comment.
Lincoln and Durbin, pointing to what they view as the success of the health-plan system for federal workers, predicted that health insurers would lend their support.
But a tight schedule and a bruising political environment could hamper progress on the bill. Lincoln is hopeful but acknowledged that the panel with jurisdiction, the Senate Finance Committee, on which she sits, is stacked up with other priorities.
Austin said presidential politics could get in the way, too.
“It’s doing to be tough to get anything done this year,” Austin said, “but we wanted to get started early. We wanted a seat at the table.”