On April 27, the House Small Business Subcommittee on Workforce, Empowerment, and Government Programs examined proposals aimed at making health care more affordable for small businesses.
Chair Marilyn Musgrave (R-CO) argued that the current health care system “is clearly not working,” pointing out that 45 million Americans are uninsured. She explained that the hearing would focus on legislation to create association health plans (AHPs), limit noneconomic medical malpractice awards, and expand the use of health savings accounts (HSAs). Rep. Musgrave also expressed her support for the Health Care Choice Act (H.R. 2355), which would allow an insurance company to provide coverage in all 50 states with less regulation.
Calling affordable health care “the overriding issue for small businesses,” Ranking Member Dan Lipinski (D-IL) said that small firms have an insurance coverage rate of less than 50 percent. He voiced his support for AHP legislation (H.R. 525) approved by the House in July (see The Source, 7/29/05), but urged his colleagues to consider all proposals before the panel “because of the depth of the problem.”
Deputy Assistant Secretary of Treasury for Tax Analysis Robert Carroll outlined the administration’s health care initiative, which he said “is aimed at making health care more accessible, affordable and portable, thus better enabling Americans to obtain health care and to retain their health care when they change employment.” He explained that the proposal includes a tax deduction for high deductible health care premiums and out-of-pocket expenses associated with HSAs and a refundable tax credit for low-income individuals. Mr. Carroll also noted that the initiative would create a portable HSA plan, permit individuals to purchase health insurance policies across state lines, allow small businesses to form AHPs, and provide for medical liability reform.
Testifying on behalf of the American Medical Association (AMA), Dr. Cecil Wilson stressed the need for medical liability reform: “Escalating jury awards and settlements, and the high cost of defending against lawsuits, even those without merit, are driving medical liability insurance premiums to unprecedented levels. As insurance becomes unaffordable or unavailable, physicians are being forced to relocate, close their practices, or drop vital services all of which seriously impede patient access to care.” He further noted that “of 3,143 counties in the nation, 1,541 do not have a practicing ob-gyn to provide needed care,” and “almost half of America’s medical students in their third or fourth year of medical school indicate the liability crisis was a factor in their choice of specialty, threatening America’s future access to high-risk medical services such as surgical and obstetrical care.” Dr. Wilson expressed the AMA’s support for expanding HSAs and creating AHPs, but cautioned, “Our support for AHPs…is strictly contingent upon the safeguarding of state and federal patient protection laws, including but not limited to those state regulations regarding solvency requirements for insurers and prompt payment of insurance claims. In addition, AHPs should offer affordable premiums, reasonable cost sharing, and adequate coverage.”
