On May 11, the Senate defeated, 55-43, an effort to override a filibuster on a bill (S. 1955) aimed at making health care more affordable for small businesses; the vote fell 5 votes short of the 60 votes necessary to limit debate. On May 9, the Senate voted, 96-2, to allow debate to begin on the measure. The Senate Health, Education, Labor and Pensions Committee approved the bill on March 15 (see The Source, 3/17/06). The House approved a similar bill (H.R. 525) last July (see The Source, 7/29/05).
Over the three days of debate on the bill, a number of Senators expressed concern with the pre-emption of state laws allowed under the bill, particularly as they related to coverage mandates, such as breast cancer screening or contraceptive coverage. Sen. Olympia Snowe (R-ME) planned to offer an amendment to address that concern; her amendment would not have allowed the preemption of state laws if coverage mandates were in place in at least 26 states.
Sen. Susan Collins (R-ME) expressed her concern with the preemption issue: “The legislation preempts the States’ traditional authority to regulate insurance and allows not just small business health plans but all health insurers to exclude important benefits like cancer screenings, mental health coverage, and diabetes care that currently are guaranteed under many State laws. States have had the primary responsibility for the regulation of health insurance since the 1940s, and based on my experience in overseeing the Maine Bureau of Insurance for five years, I believe that States have generally done a good job of responding to the needs and concerns of their citizens.”
Sen. Barbara Mikulski (D-MD) echoed her view, saying, “The benefits I am most concerned about protecting are preventive services. There is a reason that so many of these benefits mandated by States are preventive service–they wouldn’t have been included otherwise. There is a reason Maryland guarantees access to mammography–insurers were not covering it.”
A Democratic alternative to the bill, sponsored by Sens. Richard Durbin (D-IL) and Blanche Lincoln (D-AR), would have provided health coverage for small businesses modeled on the Federal Employees Health Benefit Program. Referring to the week’s focus on health issues, a number of Democrats used the debate to discuss what they viewed as pressing health priorities, including stem cell research and an extension of the deadline for enrollment in the Medicare prescription drug plans.
Closing the debate prior to the cloture vote, the bill’s sponsor, Rep. Michael Enzi (R-WY), concluded: “The Democrats’ argument is: We are going to deny small business anything until we get them everything. Of course, they are promising everything in their bill. As an accountant, I have to remind you that this is not a case of subtraction. This insurance plan is an addition. We are bringing in newly insured people. Anybody who votes against cloture needs to go to their dry cleaners tonight to pick up their laundry and look that person in the eye and say: I do not think you deserve health insurance because you might not demand enough for yourself. So you know what? I saved you from yourself. Can you say that to the mom and pop running the business down the street from your home? Can you say that they do not deserve health insurance? As you go home today after you leave the Hill, think about the people around you, the regular people–the cab driver, the worker at the dry cleaners, the person in the neighborhood restaurant, all of those people you may not notice who really make the world operate. Many of them do not have any insurance.”
