ENZI	KENNEDY

Construction groups have pushed for years for legislation allowing small firms to join to buy health insurance. Bills passed the House but have repeatedly stalled in the Senate. Industry officials now see signs of hope with a Senate panel’s approval March 15 of a health plan bill. But the measure won no Democratic votes in committee and a floor battle is expected.

The bill, which the Health, Education, Labor and Pensions Committee cleared on an 11-9, party-line vote, would let small companies join in a group health plan and thus cut the cost of coverage. Committee Chairman Mike Enzi (R-Wyo.), the bill’s sponsor, says his panel’s action is “the first major step in 15 years to get affordable health insurance for small business and working families.”

The House has approved narrower legislation several times, most recently last July. That version focuses on health plans for firms that belong to trade associations. But Enzi recognized that insurers and insurance commissioners didn’t like the House approach, particularly a provision that lets organizations set up their own group health plans. He didn’t include a self-insurance option in his bill.

Other critics say Enzi’s plan goes too far. Groups such as the AFL-CIO, American Diabetes Association and United Cerebral Palsy claim the bill would preempt state laws for small-group coverage, and also for individual and large-group insurance. The Senate committee’s top Democrat, Edward M. Kennedy (Mass.), contends that Enzi’s proposal “sets up the barest of bare bones standards for benefits—sweeping aside requirements to cover cancer screening, well-baby care, immunization, access to specialists and many other needed services.”

“It’s going to be a tough fight on the Senate floor,” concedes Steve Hall, American Council of Engineering Companies’ vice president for government affairs. “But it is the one major piece of federal legislation in play right now that will truly help businesses deal with rising health insurance premiums.” The bill has a Democratic co-sponsor, Nebraska’s Ben Nelson, and advocates like Hall hope that others will follow. But gaining enough Democrats to achieve the 60 votes needed to end a filibuster looks like a stretch in an election year.

“It’s certainly an uphill climb,” says Brian Crawford, director of legislative affairs for the Associated Builders & Contractors, which had a small-business health insurance program from 1957 to 2001. But he takes heart that after 12 years of lobbying, health-plan legislation has moved in the Senate. “What the final bill looks like coming out of the Senate is certainly unknown at this point,” Crawford adds. “It’s clearly very fluid.”

Kennedy predicts that floor action on the Enzi measure will become a wide-ranging debate on health-care policy. “This [bill] affects everything,” he says.