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Who Represents Small Business in Health Care Reform?

There’s a YouTube video making the rounds that takes aim at two progressive groups lobbying for health care reform, the Small Business Majority and the Main Street Alliance.

The video, produced by a group that calls itself the Small Business Coalition for Affordable Health Care, basically says the Small Business Majority and Main Street Alliance wrongly claim to represent mainstream small business perspectives on health care reform.

The coalition says it represents 162 small business membership organizations. They’re mostly trade associations and other industry groups, as well as some well-known small business groups like the National Association for the Self-Employed and the National Federation of Independent Business. (The NFIB seems to be running the show, as the contacts on the coalition’s site are NFIB staff.)

But there are also some groups listed as members that don’t seem to have any clear connection with small business, however, and some with direct stakes in health care reform that certainly don’t seem to align with small business interests. For example:

Eli Lilly (the 10th largest pharmaceutical company in the world)

The Federation of American Hospitals

The Self-Insurance Institute of America

Financial Executives International (79% of members are CFOs of companies with $50 million or more in revenue)

And Ogilvy (“one of the largest marketing communications networks in the world”)

The NFIB was instrumental in killing health reform in 1994, but has pledged to work toward a solution this year. I have messages into the group asking how some of the unusual coalition members above represent the interest of small business owners in the health care debate. I’ll update with their response when we get it. [See update below.]

It’s clear that no one group speaks for all 27 million small businesses in America on any issue, especially one as contentious as health care reform. It’s also clear that political and business interests on both the left and the right like to claim that whatever policy they favor is best for small business owners.

This is just posturing that avoids the actual issues that matter to business owners: how to control rising health care costs, whether there should be a public insurance option, and how any mandates to provide coverage will affect small employers. Any process to pass health care reform is going to be messy. Let’s at least have a discussion on the merits.


The NFIB’s Stephanie Cathcart emails the following in response to my questions:

1. NFIB helped to put together the coalition around 7 or 8 years ago (some remember it loosely existing as long ago as ’95 working on the Fawell AHP bill). It was originally formed around the AHP initiative but now advocates on larger healthcare reform initiatives, with the mission of seeking affordable healthcare for small businesses. NFIB has equal membership as anyone else in the coalition.

2. The coalition is funded by equal membership dues (I think it’s only $500/year).

3. Eli Lilly is actually not a member anymore and I’m not sure why Ogilvy is on there (but thanks for catching). We just changed our hosting company and re-built our entire web site so some things are carried over from the old site (that we are still updating). [Americans for Tax Reform] and Federation of American Hospitals are still members and, along with our more than 160 member groups, support the goal of increasing small business access to quality, affordable healthcare (there’s probably some cross membership in there, I would guess).

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