Health Care Reform

Floor Speech

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Mr. MERKLEY. Mr. President, it is a pleasure to talk about health care following upon the remarks of Senator JEANNE SHAHEEN and Senator MARK WARNER, both of whom, as Governors, had the opportunity to know firsthand how important health care reform is to taking our Nation forward. They come from very diverse States, but the observation is the same. Health care reform is essential to putting our Nation back on track, and now is the time.

I wish to direct my comments specifically to the benefits of health care reform to small business. We all know the current system doesn't work for small business employers or their employees. Without numbers behind them, they have no ability to negotiate rates with insurance companies. They are like lambs led to the slaughter. More often than not, they have to take whatever deal is offered. Those deals are not very good. On average, small businesses pay 18 percent more than large firms for the same health insurance policies. Because of this, they are far less likely to provide health insurance. Just 49 percent of firms with 3 to 9 workers and only 78 percent of firms with 10 to 24 workers offer health insurance to their employees, as compared to 99 percent of firms with 200 or more employees in the same year.

When small firms do offer health care, rising premiums force owners to make hard choices between keeping health coverage, expanding their operations, or increasing wages. In the last decade, health care premiums for the average Oregon family more than doubled, while median earnings rose only 23.8 percent. It is no coincidence. Employers are spending more in compensation, but that compensation is going to higher insurance premiums rather than higher wages.

Last month I talked to small business owners in Medford and Portland, OR, who share strikingly similar stories about the problems rising health care costs are causing for them. Dave Wilkerson runs a Medford architectural firm that has 12 full-time employees. He is dedicated to providing a family-friendly work environment, and he provides full medical, dental, and vision coverage to his employees. The company has had to deal with large annual increases in health care premiums and has had to change carriers several times in order to try to keep costs down. Health care costs are the second highest expense for David's firm. Only payroll exceeds them.

This year rising health care costs forced David and his partners to look very closely at either eliminating health care benefits or laying off employees.

Jim Houser and his wife Liz Dally tell a similar story. They operate the Harthorne Auto Clinic in Portland. When they opened their doors 26 years ago, they made a commitment to offer those who worked for them a good benefits package, including comprehensive health care. Jim and Liz are still able to provide health insurance to their employees, but premiums have gone from 9 percent of their payroll to 18 percent in 5 years. As a result, they have had to cut back on benefits. These and otherwise successful small businesses have been hamstrung by health care costs.

Will reform help these small businesses? Yes, it will. It will help them a lot.

First, it will allow them to enter health care exchanges, where they will be part of a much larger pool. With their increased market clout, they will be able to negotiate lower premium costs. These rates will be much more stable than in past years. One sick employee will no longer make an entire group uninsurable.

Second, the exchanges will offer more and better policies from which to choose. Currently, many small businesses struggle to find any insurers that will offer policies. But through health care reform, and as part of the exchange, they will be able to choose from a number of different plans. Because these plans will have to meet certain standards, small businesses will have higher quality policies from which to choose.

Finally, better choices at a lower price will mean small businesses can dedicate more revenue to increasing wages--more money in the pockets of their employees--have more opportunity to invest in new equipment or hire additional employees. This is good for these owners, it is good for our economy, and it is good for the employees.

Health care costs have become a millstone around the neck of our small businesses, dragging down our economy. Health care reform will help small businesses thrive by lowering cost, improving service, and enabling small business owners to focus on making their businesses more successful.

I yield back the floor to my colleague from New Hampshire, and I thank her for conducting and managing this set of conversations from the freshman Senators today.

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