What: All Issues : Health Care : Access to Affordable Prescription Drugs : Vote on passage of a Democratic substitute to the Republican-backed HR 4281, legislation designed to enable small businesses to join together to form ``associations'' that will leverage their collective buying power to get lower-cost health insurance for their employees
 Who: All Members
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Vote on passage of a Democratic substitute to the Republican-backed HR 4281, legislation designed to enable small businesses to join together to form ``associations'' that will leverage their collective buying power to get lower-cost health insurance for their employees
house Roll Call 172     May 13, 2004
Y = Conservative
N = Progressive
Winning Side:
Conservative

House progressives backed this Democratic substitute offered by Rep. Ron Kind (D-Wis.) to the conservative-backed HR 4281, legislation designed to enable small businesses to join together to form ``associations'' that will leverage their collective buying power to get lower-cost health insurance for their employees. Although progressives said they supported the concept of companies working together collectively to control costs, they objected to H.R. 4281's preempting of state laws on insurance regulation, by its undermining of individual state minimum coverage levels. Most states require that any health plan cover some basic items such as mammograms, contraception, prostate cancer screenings, and many mental health services. However, H.R. 4281 would allow these new "associations"' to avoid having to offer these basic benefits, to the detriment of policyholders, progressives said. The Kind bill, progressives argued, will not preempt state law, maintaining the kind of minimum benefit levels that ensure quality coverage for beneficiaries and their dependents. The Kind substitute also commits actual federal funds -- $50 billion allocated in the budget -- to form these so-called Small Employer Health Benefit plans, creating a "realistic, workable" way for small businesses to use their collective buying power to lower costs and increase coverage, progressives said. Conservatives argued that the Kind bill "has the government" creating these new large insurance pools - something conservatives said would inevitably lead to the federal government imposing certain insurance coverage requirements, something conservatives said they would dare not risk. Conservatives also objected to the $50 billion in "taxpayer funds" that would be needed under the Kind bill to set up and to provide subsidies, while the underlying bill has no federal taxpayer money involved in it, conservatives noted. Kind's substitute failed 193-224, however, meaning state minimum coverage requirements would be undermined under this bill and supplanted with new coverage standards determined by these new small business-run health trade associations.

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