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.
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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.