Small business health care bill faces test in House

WASHINGTON -- Small businesses would be able to band together in nationwide health plans under legislation that cleared a House committee Thursday.

The measure is part of the Bush administration's plan to extend health coverage to some of the nation's 41 million uninsured.

It would put small businesses on equal footing with big corporations and labor unions by allowing them to buy insurance through trade associations such as the National Restaurant Association or the National Federation of Independent Business.

"Costs are rising, businesses are dropping coverage, and more people are going uninsured," said Rep. Sam Johnson, R-Texas, one of the bill's sponsors.

One in seven Americans don't have health insurance, Johnson said. According to the 2000 census, the main reason people lose coverage is that they work for small employers who, because of soaring costs, stop offering it.

So-called association health plans exist now but on a much smaller, state-by-state scale.

Opposition came from Democratic committee members who warned the measure would pre-empt tough patient protections passed by states, such as requirements that insurers cover mammograms, obstetrical care and mental health treatment, and provide mandatory grievance procedures.

"This wipes out the patient protections so many states have established in the last couple of years," said Rep. Rob Andrews, D-N.J.

The leader of the opposition is Blue Cross and Blue Shield Association, which is a major provider of coverage for small businesses.

The vote in the House Education and the Workforce Committee was 26-21 on the morning after a daylong, contentious debate. The only lawmakers to cross party lines were Georgia Republican Rep. Charlie Norwood, who voted against it, and Hawaii Democratic Rep. Ed Case, who voted for it.

The measure has passed the House three times, so the real test will come in the Senate, where it has been ensnared in the long-running battle over a patients' bill of rights.

"Now, the time has come for the Senate to recognize that small businesses all across the country are desperate for change," said Republican Sen. Olympia Snowe of Maine, chairwoman of the Small Business Committee.

Foes worry the plan will gain footing because the administration has embraced it and a prominent GOP supporter, Missouri Republican Jim Talent, was elected to the Senate last year. Talent, Snowe and Missouri's Kit Bond are sponsors of the Senate bill.

Talent said Wednesday the only thing standing in the way is a big insurance monopoly "who doesn't like the plan because they would be forced to compete and lower their prices."

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On the Net:

Senate Small Business Committee: http://sbc.senate.gov/

National Federation of Independent Business: http://www.nfib.org/

Blue Cross Blue Shield: http://www.bcbs.com/

Congress: http://thomas.loc.gov

Labor Department: http://www.dol.gov/