Health care decision hinges on effect on small businesses, Sen. Mary Landrieu says

October 20, 2009  |  Times Picayune

Sen. Mary Landrieu, D-La., a key vote on efforts to overhaul the nation's health care system, said her decision will be largely based on whether small businesses and their employees get access to affordable coverage.

Susan Poag/The Times-PicayuneSen. Mary Landrieu, D-La.

She called a package recently adopted by the Senate Finance Committee a "step in the right direction," although she added "we have more work to do."

Tax increases feared

At a hearing Tuesday by Landrieu's Senate Committee on Small Business and Entrepreneurship, members of the Obama administration said the Finance Committee's proposal to establish insurance exchanges would give small businesses the bargaining power they need to get affordable coverage.

But Amanda Austin, representing the National Federation of Independent Business, said her members fear a federal health package will come with large tax increases.

Landrieu said the impact of health care proposals on small business is the key issue for her because small businesses employ more than half of America's workers, and their health premiums have increased on average by 74 percent since 2001 -- four times faster than inflation.

In Louisiana, only 36 percent of small-businesses owners surveyed said they provide their employees with insurance, according to the Small Business Majority, a group that generally supports health care overhaul legislation. Most nonproviders cited cost as the major factor.

Small Business Administration Administrator Karen Mills said the insurance exchanges, in which small businesses would pull together to purchase insurance, could be the tool they need to lower premiums, now about 18 percent higher than those paid by larger companies.

"This has left small-business owners in an untenable situation, having to choose between their employees, who are often like family to them, and the bottom line," Mills said.

Tax credits favored

Landrieu supports the idea of tax credits included in the Finance Committee bill to help small businesses buy insurance for employees.

But she said the Senate needs to make them more generous and find a way to pay for the improvements without going for the so-called "public option," which would make a public health insurance plan available alongside private plans, a change Landrieu opposes.

With Senate and House Democratic leaders trying to mold a single bill in each body out of the five passed by various committees, proponents and opponents of health legislation crowded into elevators and congressional offices Tuesday to lobby for their preferences.

For and against

Lenetra Jefferson and Paula Arceneaux, both leaders of New Orleans faith-based groups supporting health care overhaul, said people showing up at town hall meetings to oppose President Barack Obama's proposals probably haven't experienced trying to get health bills paid by reluctant insurance carriers or faced the loss of coverage because of a pre-existing condition or after developing an illness -- actions barred under the reform bills.

"We really need affordable health care for all Americans," said Jefferson, a nursing instructor at Dillard University who while displaced from New Orleans after Hurricane Katrina received a $4,000 biopsy bill she thought insurance would almost fully cover.

The opposition side included representatives from the Coalition to Protect Patient Rights. Among its members in Washington on Tuesday were Mike Mitternight, owner of Factory Service Agency in Metairie, an appliance repair company, and Mike Ellis, a clinical professor at Louisiana State University and Tulane medical schools.

Mitternight said he provides health coverage to his nine employees, but he opposes any sort of government mandate on business because it would take the cost decisions away from him and his fellow business owners.

Ellis said he supports reform of insurance companies and subsidies to help people afford coverage, but he worries the current reform bills would substitute decisions by insurance bureaucrats for "non-reviewable" rulings by government bureaucrats.