Senate Health Care Bill Includes Small Business Provisions

As the Senate gets set to pass its health care reform bill, "The Patient Protection and Affordable Care Act," the small business community remains divided over some aspects of the complex legislation. Early Monday morning, the Senate voted 60 - 40 for cloture, which clears the way for final passage of the bill. Most experts believe the Senate bill will pass by Christmas. Once the Senate bill is passed, it will be reconciled with the House of Representatives health care reform bill in conference committee.

This past weekend, several provisions authored and promoted by U.S. Senate Committee on Small Business and Entrepreneurship Chair Mary L. Landrieu (D-LA) were included in the Senate compromise amendment to the bill.

Sen. Landrieu noted that, while the underlying legislation already lowers costs and increases choices for small businesses, her amendments expand the tax credit to more small businesses, make the credits available immediately, and give entrepreneurs a greater voice in the reform efforts. The Landrieu initiatives provide $13 billion more in tax credits for small businesses that want to offer affordable, quality health care coverage to their employees.

"Throughout this debate, small business owners and advocates have remained at the negotiating table and the Senate compromise announced today is a direct result of their input and support," Sen. Landrieu said. "By working together we have added an infusion of about $13 billion to the small business tax credits in the underlying bill to help small businesses struggling to provide their employees with affordable health care. Expanding the tax credits to more small businesses and making the 'bridge' credit available immediately will ensure that health insurance is even more accessible for small business owners and workers. Additionally, the programs created by the bill will be better targeted to make the health insurance process more accessible and user-friendly. Together, these changes will help small business owners can get back to what they do best -- running their businesses."

Meanwhile, some in the small business community expressed disappointment over the bill.

In a letter to Sen. Majority Leader Harry Reid (D-NV), John Arensmeyer, founder and CEO of the Small Business Majority (SBM), stressed the group's support of the health care reform bill and said the status quo is "unacceptable." He explained that while the "necessary compromises" have been disappointing to some, "it's clear that you and your fellow senators have heard the voices of small business owners, who so desperately need relief from an unfair, overly expensive health insurance system. Many of the recently proposed amendments contribute to an overall bill that will be even more helpful to small business owners and the self-employed."

Arensmeyer noted specific provisions in the health care reform bill that are essential to small businesses, including:

• Stringent insurance reforms, such as the elimination of preexisting condition rules and discrimination based on gender or health status;
• Cost-control measures that will reduce the rate of healthcare inflation and ultimately result in more affordable health plan choices for small business owners and their employees;
• Strong tax credits to help the smallest businesses afford to provide insurance to their employees; and
• A system of exchanges that will enable small business owners to join a pool that will give them more options and greater clout when negotiating for coverage.

"Our economic research shows that without reform, $52.1 billion in small business profits and $834 million in wages will be lost by 2018," Arensmeyer wrote.

Last week, the Small Business Majority and Small Business California hosted a conference call with California businesses to provide information about the Senate health care bill and to answer questions from small businesses. The call, which was moderated by John Karatzas, state outreach director for the Small Business Majority, featured Terry Gardiner, the group's national policy director, and Scott Hauge, president of Small Business California.

Gardiner told conference call participants he believes that if health care reform gets derailed, there would be no starting over and it would mean the end of health care reform for some time.

Gardiner also discussed some of the key differences in the House and Senate health care bills. For example, he said, the Senate has no public option, and instead of a national health insurance exchange, it has created 50 state insurance exchanges. Each state can set up a public plan, however. "In the coming years, additional legislation will build on [the health care bill]," Gardiner added.

Another small business group, the Main Street Alliance, expressed its disappointment that the Senate bill does not include a public option, though it held out hope that a public option would be added back into the bill during conference committee. On Sunday, December 20, in the hours leading up to the cloture vote, the Main Street Alliance told its members, via e-mail: "[W]e know a public option that gives small businesses a real alternative would be the best way to bring new competition to the insurance marketplace and force insurance companies to give small businesses a fairer shake."

The Main Street Alliance said that after the bill passes the Senate "there will be one more round of this fight, one more opportunity to make changes to strengthen and improve the final package. Our 'Round 12' is the conference committee, where the stronger House bill and weaker Senate bill will be combined into one final package."

As BTW reported earlier this month, the Senate Committee on Small Business has released two documents to help small businesses learn more about the health care reform bill and how it will affect their business:

• A fact sheet on the small business amendment package, and
• A rundown of the small business provisions in the Senate health care bill. --David Grogan