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Piece By Piece

Tax cuts here, managed care there: Bits of bills push their way through Congress.

The narrow five-vote margin that Republicans have in the House all but guarantees a political dead end for controversial, partisan bills on such hot-button topics as managed care, regulatory reform and tax cuts.

Forget reform bills that make changes in the way federal agencies weigh costs and benefits of major rules; forget about slightly smaller bills giving small businesses some leeway for first-time paperwork violations. Bits of those bills or separate proposals may find a way around partisan roadblocks, however.

Consider, for instance, the Small Business Review Panel Technical Amendments Act (H.R. 1882/S.1156), which stands a good chance of passing. There's bipartisan support for this bill, a follow-up to the Small Business Regulatory Enforcement Fairness Act of 1996 (SBREFA), whose passage, if not a watershed event, was at least a cool drink. One of SBREFA's provisions mandated that both the Occupational Safety and Health Administration (OSHA) and Environmental Protection Agency (EPA) set up Small Business Advocacy Review Panels prior to conducting small- business regulation. In truth, the 1999 bill is pretty incremental: All it does is add the Internal Revenue Service to the SBREFA provisions and make some improvements in how the agencies' panels operate. The bill's very modest aspirations explain why the House and Senate small-business committees passed mid-summer versions by voice votes.

Another "small" bill is the Small Business ACE Act (Access and Choice for Entrepreneurs/H.R. 1496), pushed by House Small Business Committee Chairman Rep. Jim Talent (R-MO). The bill is one of many packaged into an omnibus managed-care bill by the House Education and the Workforce Committee. It would allow trade groups to set up association health insurance plans (AHPs) for its members. These plans wouldn't be subject to state insurance regulation. Talent believes AHPs would allow entrepreneurs to use bargaining power to extract lower premiums and reduce administrative costs. As they have in the past, Democrats will likely oppose the Talent bill. But even some Senate Republicans are uneasy about the notion of bypassing a state's authority to regulate health plans.

It's hoped, however, that when the House and Senate "conference" their managed care bills (the Senate version does not include AHPs), the ACE bill will be seen as one provision that would lower health-care costs and stand out among other provisions that would increase premium prices.


Stephen Barlas is a business reporter who covers the Washington beat for 15 magazines.

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This article was originally published in the October 1999 print edition of Entrepreneur with the headline: Piece By Piece.

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