David Kirkpatrick

July 2, 2009

Small business and health care reform

Here’s two stories on Main Street and the health care debate.

First up is entrepreneurship and opposition to public plan health care:

The so-called “public option,” backed by President Obama and many Congressional Democrats, would set up a government-backed health insurance plan that would compete with private plans. Though details remain fuzzy, the proposal already has critics on both sides of the aisle decrying “government-run health care.” The American Medical Association and private insurers oppose any public option.

Also resisting is the National Federation of Independent Businesses, the nation’s largest and most influential small business group. A fierce critic of the Clinton administration’s health care reform efforts a decade ago, the NFIB now considers universal health care to be one of its top legislative priorities. But it wants to see that care and coverage come from the private sector.

“Our members, who are entrepreneurs and risk takers, really do fundamentally at the end of the day want lower costs and competition, but they are going to be very skeptical of something that has a lot of government involvement,” says Michelle Dimarob, the federation’s legislative policy manager. The NFIB is instead pushing for a reform plan that would provide universal coverage and cut costs by increasing competition among private insurers, likely through the creation of government-mediated insurance pools.

And batting second is a NYT blog post underscoring a range of small biz attitudes toward the debate:

Oddly, the public plan is also one of the battle lines for organizations that claim to represent small business. The National Federation of Independent Business and the U.S. Chamber of Commerce staunchly oppose a public plan; the Small Business Majority appears (pdf) to support it; while the National Small Business Association insists that if there is a public plan, it should be constrained by the same rules as private insurance.

 The legislators who will decide the issue are the handful of moderates in both parties. The conventional wisdom is that the House will pass the public plan, and its fate will rest in the hands of maybe 10 senators. But it may prove a battle in the House, too: The conservative Democratic Blue Dog Coalition supports only a drastically curtailed (pdf) government option, and its 49 members could tip the balance. So the question is, how will these moderates vote in the end?