Since 1986, health care costs have been the number one issue for small businesses according to the National Federation of Independent Business (NFIB) (Our personal top issues at the time were soft foods and walking upright). NFIB president Todd Stottlemeyer has called health care one of the biggest barriers to entrepreneurship in this country, and nearly 80 percent of small business owners say they have trouble finding affordable health care.

Not surprisingly, lawmakers have often tried to address the burden of health care for small business and a story in Reuters yesterday focuses on two current pieces of legislation in Congress which look to provide relief:

1. The Cooperative for Healthcare Options to Improve Coverage for Employees (CHOICE) Act introduced in July by House Small Business Committee Chairwoman Nydia M. Velazquez (D-NY) and Rep. Joe Pitts (R-PA) and;
2. The Small Business Health Options Program Act (SHOP) Act introduced in the Senate in April 2 by Sens. Dick Durbin (D-IL), Olympia Snowe (R-ME), Blanche Lincoln (D-AR) and Norm Coleman (R-MN).

Our colleague, Elizabeth Carpenter provided an excellent summary of the SHOP act when it was released. While the CHOICE act takes a different approach toward the goal of trying to capture the benefits of risk pooling seen by large firms for small businesses, the bills' common elements are summarized in the Reuters article by New America's health policy program director, Len Nichols:

Both (bills) encourage a new marketplace that would have a common set of rules to enable the health insurance market for small business to work better than it does today by increasing efficiencies and economies of scale. They represent the bipartisan agreement we need for small business and all Americans to secure quality, affordable health coverage.

With a presidential election and an already packed congressional agenda, it may be unlikely that we'll see small business health reform this Congress. But the authors of each bill should be applauded for providing more forums for a bipartisan discussion of health reform. Should some of these small-group insurance market reforms come to pass, they could help lay the groundwork for broader comprehensive reform.

Small businesses have waited 22 years for reforms, and as Stottlemeyer notes: "If we want [small businesses] to be able to continue to power our economic success, we must deal with this healthcare crisis now."