The National Federation of Independent Businesses describes itself as “The Voice of Small Business.” And what they’re saying is that, when it comes to America’s health care system, small businesses are fed up with the status quo. They recently posted their health care reform proposal and, while there’s not a lot that’s changed in their proposal, the desire for changes rings through loud and clear.
The NFIB health care reform proposalis built around 11 principles. Notable among them is that all Americans should have access to quality care and protection against catastrophic costs. And while there’s a role for government in providing a saftey net to enable low income Americans to obtain coverage, they make clear “[t]his does not mean a government-run, single-payer system.”
Instead, the NFIB believes “Americans should receive their health insurance and healthcare through the private sector. Care must be taken to minimize the extent to which governmental safety nets crowd out private insurance and care.” They call for affordable coverage that is portable. “Americans should be able to move throughout the United States and change jobs without losing their health insurance.”
In getting specific concerning their reform proposals they call for allowing small business to create multi-state purchasing pools. These Small-Business Health Plans could be sponsored by a variety of organizations including, not surprisingly, the NFIB. This is one of the more controversial aspects of the NFIB reform package as many believe it would undermine state consumer protection laws, creating an unlevel playing field between the pool and non-pool health plans in any given state.
The NFIB’s other provisions include promotion of Health Savings Accounts, full deductibility of health insurance premiums for individuals and the ability for individuals to purchase coverage across state lines. This latter element reflects a component of Senator John McCain’s health care reform plan and is also controversial. It could defeat consumer protections enacted by states as carriers rush to offer plans under the most lenient state regulatory scheme.
While state health care reform proposals will continue to be debated in capitols across the country, my take is that meaningful change will require Federal action. Which means the proposals of advocates like the NFIB will, and should, be part of the debate. And it means proposals from other advocates will be coming fast and furious as a new administration takes shape.