Monday, August 31, 2009 8:30 AM

'Status Quo Is Unacceptable' For NFIB

National Federation of Independent Business
This association speaks for the interests of small and independent business owners. The group has 350,000 members.

What They Want
The NFIB has four top goals for health care reform legislation: lowering costs while increasing access, reforming the individual and small group insurance markets, providing greater choice for insurance options and making insurance plans portable.

The group's focus is different from other business groups like the Business Roundtable, because small business owners are characteristically different from large corporations in their insurance-buying habits. NFIB reports that small businesses pay 18 percent more in premiums than large companies for the same health insurance benefits and premiums for small businesses have risen by 113 percent since 1999.

"We feel [the individual and small group] marketplaces are currently broken," said Amanda Austin, NFIB's director of federal public policy, citing the need to eliminate denials of coverage based on pre-existing conditions.

To increase choice in those markets, the NFIB would like to open up the system so insurance consumers can shop across state lines.

"We would like employers to be able to choose the plan that fits them," Austin said. Small business owners "need to be in the driver's seat and not the back seat."

The NFIB also feels health care reform should provide a way for people to keep their insurance plan if they leave a job that provided coverage. Because of the way the employer-based insurance system works now, individuals are often reluctant to become self-employed or move to a small business because they'll lose coverage, Austin contended.

"People are staying in jobs versus becoming the next big idea because of reasons like health care," she said.

The group's overall stance -- that reform needs to happen promptly -- is far different from the last time health care reform was on the table. In the 1990s, the NFIB actively worked against Clinton's reform plan.

"It is necessary we have reform," Austin said of this year's reform debate. "Status quo is unacceptable in our eyes."

Deal Breakers
The NFIB opposes two provisions that have been part of the health care debate: an employer mandate and a public option.

"We have long been opposed, for very specific reasons, to an employer mandate," Austin said. "We fundamentally believe an employer mandate is a job killer."

An employer mandate is currently part of the bill proposed by three House committees. Though the employer mandate in that bill exempts businesses with payrolls under $250,000 per year, the NFIB is against any mandate because it would still affect the bottom line for small businesses above the exemption level -- plus, the group says, the government could lower that level at any time.

"An employer mandate would be very difficult for this organization to swallow," Austin said. "We think it's going to hurt jobs and put perverse incentives in the system that we don't need in this economy."

Because of the potential impact on the private insurance market, the NFIB also opposes a public insurance option that would be based on Medicare rates or a similar model. The group is open to discussion on co-ops or other alternatives, Austin said.

"We think [a public option] could cause a significant crowd-out in the market," Austin said. "It's going to continue to erode the system, and people are not going to be able to keep what they have."

How Much They've Spent
The NFIB spent $1.6 million on all lobbying activities in the first half of 2009, according to lobbying disclosure forms. The forms do not break down spending by activity, and as a small business organization, the NFIB lobbies for non-health care related issues. But health care reform has been a top priority for the group for years, Austin said, and this year activities surrounding health care have been a "major resource allocation".

During the 2010 election cycle, the NFIB, through its Save America's Free Enterprise Trust PAC, has donated $5,500 to federal candidates, all Republicans, according to Federal Election Commission records. The group contributed $851,587 to federal candidates and committees during the 2008 election cycle. Of the donations to candidates, 83 percent went to Republicans, according to the Center for Responsive Politics.

The NFIB has helped fund the new "Harry and Louise" television ads urging reform during the 2008 campaign.

The NFIB is also part of two coalitions that have been working for reform, Divided We Fail and the Small Business Coalition for Affordable Healthcare.

Key Players
Donald "Dan" Danner, NFIB's president and CEO, took the helm of the group just seven months ago, but he has worked at the NFIB in executive positions since 1993, previously as vice president for the group's Education Foundation, vice president of federal public policy and executive vice president.

"We do think that small business has a key role in this debate. And for them, cost is still the top issue," Danner told President Obama at the White House health care reform summit in March. "We very much look forward to finding a solution together that works for America's job creators."

Though Danner does not have a background specifically in health care issues, he has a long history working in government and for groups lobbying the government. His past positions have included chief of staff to former Commerce Secretary William Verity, deputy director for Reagan's White House Office of Public Liaison, lobbying executive at steel manufacturing company Armco Inc., and vice president of federal relations for George Mason University.

Danner is a registered lobbyist. On health care issues, Austin leads the NFIB's team of 10 registered lobbyists.

"I've been beating down the doors of Capitol Hill since I started here," Austin said. "We have met with both sides [House and Senate] more times than I can count."

In addition to participating in the White House health care summit in March, representatives from NFIB have met with the White House health care czar, Nancy-Ann DeParle, on numerous occasions.

The group has also met with other health care stakeholders as part of the Health Reform Dialogue discussions and has called on its members to demand reform in their states as part of a grassroots campaign launched last year.

Links
NFIB Health Care Page
Danner at White House Health Care Summit
NFIB Fixed For American Campaign
"Health Care Reform Faces Its 'Super Bowl Moment,'" National Journal, June 13