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Sunday, Oct 1, 2023

Hurrah! Congress Has Not Forgotten Small Business

For most of the recent months-long health care debate in Congress, Washington ignored the real crisis in the American health care system: the problem of the uninsured.

While this problem is paramount in small business owners’ minds, it took a back seat to HMO reform for most of the debate. But small business was persistent in our cries for reforms that would make health care more accessible and more affordable and, in the end, we had the ear of Congress.

The U.S. House of Representatives showed that they do understand, and they do care about the uninsured, by passing the Quality Care for the Uninsured Act.

If passed by the Senate and signed into law, this legislation would increase the number of Americans with health insurance by giving small businesses the right to band together to purchase health insurance through association health plans, providing tax benefits to individuals who purchase their own health coverage , similar to those already enjoyed by businesses that purchase health insurance for their employees , and enhancing medical savings accounts.

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This is the first time in this country’s modern history of health care reform that such a strong market-based reform solution has gained the majority approval of a body of Congress. The bill was designed with small business owners and their employees in mind, and every entrepreneur in the United States ought to be heartened by that. The message from the U.S. House to the small business community: Yes, folks, we are listening.

You see, thanks to a clamor from small business at the grass roots, members of the House now know that small business faces a real disadvantage when it comes to purchasing health insurance. Their purchasing pools are small (many small firms have less than five employees) and they are subject to every cost-increasing state mandate on the books while big businesses that self-insure are exempt.

So the House passed this bill that would give small business the purchasing power that comes with economies of scale and exempt them from those expensive state mandates. And this happened in spite of the fact that, for months and months, the majority of health reform news coverage and general debate focused on the troubles with managed care.

Proposals to fix those woes included ideas that, however well intentioned, would hurt those least able to afford health insurance in the first place. These reform ideas had an expensive bottom line that would add to the staggering ranks of over 44 million uninsured Americans.

Public opinion and political pressure was fierce on elected officials this summer. Cries for managed care reform, for the right to sue HMOs, were loud. And the House did pass a bill containing these measures as well. But they did not turn their back on the uninsured.

For this action, small business ought to be grateful, and relieved. After all, 61 percent of the uninsured in this country are from a family headed by an entrepreneur or a small business employee. Washington hasn’t forgotten about us yet, ladies and gentlemen. There is still hope for reducing the number of Americans without health insurance in the near future. And that would be the greatest victory of all.

Faris is president of the National Federation of Independent Business.


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