Senator Wants Democrats Help on Small-Business Hea
Washington, DC, January 16, 2007--Stymied in his attempts to pass small-business health-plan legislation while his own party controlled Congress, Sen. Mike Enzi nonetheless is expressing optimism that he can work with Democratic leaders to move the legislation this session.
Speaking during an informal roundtable with health-care leaders hosted by the Senate Health, Education, Labor and Pensions Committee, Enzi, R-Wyo., the panel's former chairman and current ranking member, reported "good progress" in talks that could see the introduction of a new version of his Health Insurance Marketplace Modernization and Affordability Act.
Offered as a compromise alternative to the "association health plan" proposal contained in the Small Business Health Fairness Act, which passed the Republican-controlled House by a 263-165 margin in July 2005, Enzi's proposal was taken up by the Senate in May 2006, but fell five votes short of the 60 needed to close off debate and bring the bill to a floor vote.
Like the AHP proposal, Enzi's bill would allow trade associations and other groups to pool membership on a cross-state basis for the purposes of obtaining group health coverage. However, unlike the House-backed plan, the Health Insurance Marketplace Modernization and Affordability Act would keep primary oversight and supervision of small-group plans at the state level, rather than with the U.S. Department of Labor.
Enzi's proposal also would have required the groups offer an "enhanced" plan that complied with existing benefit mandates in one of the five most populous states, California, New York, Illinois, Texas or Florida. Enzi offered the changes in an attempt to blunt criticism leveled against association health plans both by health insurers, who claimed exemption from state benefit mandates would allow association plans to cherry-pick healthier businesses, and by state regulators, who argued association plans, like multiple-employer welfare arrangements before them, would be prone to fraud.
Despite being cosponsored by Sen. Ben Nelson, D-Neb., a former state insurance commissioner, Enzi's proposal ultimately drew little support from the Democratic side of the aisle in the 109th Congress. But Enzi said he believes that could change, and alluded to possible efforts to combine small business pooling with tax breaks targeted to help small business pay for low-wage employees' health coverage.
"I am prepared to seriously explore such an approach, provided it is fiscally responsible, operationally sound and fully paid for," Enzi said. "In recent months and weeks, I have heard from many members of both parties, expressing strong interest in working on a bipartisan compromise on small business health-care cost and access."
Enzi said he has "begun conversations toward that goal," and he expected to work with HELP Committee Chairman Edward M. Kennedy, D-Mass., among others.
One possible vehicle for Enzi's proposal to gain traction with the Democratic leadership is S.99, the Small Business Health Care Tax Credit Act, introduced earlier this month by Sen. John Kerry, D-Mass. The newly installed chairman of the Senate Committee on Small Business and Entrepreneurship, Kerry is proposing a refundable tax credit covering up to 50% of health-care costs for employees who earn between $5,000 and $50,000 annually. To qualify for the credit, a firm must have fewer than 50 employees and must contribute at least half the cost of health insurance premiums.
In remarks on the Senate floor while introducing the bill, Kerry noted the Kaiser Family Foundation Employer Health Benefits Survey found the number of U.S. firms offering health benefits dropped from 69% in 2000 to 61% in 2006. He also pointed out while 90% of firms with 50 or more employees offer health insurance, less than half of firms with 10 or fewer employees do.
