A bill to give small businesses a cheaper option when providing health insurance stalled in the Senate on Thursday.
Under the proposal endorsed by President Bush, businesses could buy insurance through regional or national trade associations. The insurance would be free of many state mandates. That could make it a cheaper alternative for businesses and for workers who have no insurance and would want to buy even scaled-back coverage.
By a vote of 55-43, Democrats blocked a motion that would have limited debate. They provided several arguments for their action; for example, Republicans' refusal to allow votes on amendments, such as extending Monday's Medicare enrollment deadline, that they considered a priority.
Democrats also said the bill stripped away a state's ability to determine which health care screenings and treatments insurers must cover. They said states have worked for such protections for years, and it would not be right for lawmakers in Washington to take them away.
Democrats said commonly required screenings for cancer, such as mammograms and colorectal exams, save lives and money. State should have the freedom to require them, they said.
Sen. Patrick Leahy, D-Vt., said the bill would pre-empt requirements in his state that insurers cover treatment for alcoholism, contraceptives, diabetes supplies and home health care.
"It kind of makes you wonder what's going to be left to be covered," Leahy said.
Enzi defends bill
Sen. Mike Enzi, R-Wyo, led the effort to pass the health plans. He said employers would not cut benefits for workers who already have insurance, but they might be able to afford to provide coverage for more of those without.
"What they're trying to nail you on is that this bill eliminates mandates. Well it doesn't really, because every association is going to make sure your employees have the things that they need for their health care," Enzi said when talking to small-business owners on Thursday.
The real savings from the health plans, Enzi said, would come from allowing companies to band together when buying insurance, which lowers administrative costs and gives them more clout when negotiating rates.
Democrats said the proposal would have harmed about as many people as it would help. They said some sicker workers would be charged more because of flexibility provided for in the bill, and they would be priced out of the market. Republicans said that, overall, about 1 million more people would have obtained health insurance if the legislation were approved.
There are an estimated 45 million uninsured people in the United States.
Consumer groups, attorneys general opposed
Numerous consumer groups, such as the American Cancer Society, opposed the bill, as did 41 attorneys general and some insurance trade groups.
"We must tear down the barriers to cancer screening and treatment not raise them, as this legislation would," said Daniel E. Smith of the cancer group.
Major supporters included the National Federation of Independent Businesses.
"We urge the senators to reject this delay, return this vital legislation to the Senate floor and allow small business health plans an up-or-down vote," said the group's president, Todd Stottlemyer.
Democrats this week also blocked Republicans attempts to cap the amount of damages juries can award in medical malpractice cases.
As a result, "Health Week" in the Senate ended the way it began, with Republicans falling well short of the 60 votes needed to advance a pet initiative.