Last week, the Senate Committee on Finance held a hearing to mark the first anniversary of the Patient Protection and Affordable Care Act, featuring Health and Human Services Secretary Kathleen Sebelius. There was quite a lot about the hearing that was completely predictable. Committee Democrats spent their time encouraging Secretary Sebelius to elaborate on the ways in which the legislation was a resounding success, even though it has not yet been fully implemented. Committee Republicans spent their time complaining to Secretary Sebelius about the things the law was supposed to have done but hasn’t, even though it has not yet been fully implemented. Possibly the most unbelievable thing about the entire first panel of the hearing is that, during a full two hours of testimony by Secretary Sebelius, no one had much of anything to say about the impact (or lack thereof) of the Affordable Care Act on small businesses.

Recall that health care reform has always essentially been a small business issue. After all, most of the working uninsured consist of nonemployer business owners and owners and employees of small businesses. Small business was the lone voice yelling and screaming about it long before everybody else jumped on the bandwagon. In light of that, it’s a bit galling that none of the relevant parties seemed to have anything to say about small businesses at this hearing. The National Association for the Self-Employed released a press statement lambasting Secretary Sebelius for applauding how the Affordable Care Act is helping small businesses, while failing “to recognize the ballooning costs to our nation’s smallest businesses – the self employed and micro-businesses.” In fact, the touting that the NASE is complaining about was a part of Secretary Sebelius’ prepared testimony. Unless I missed it, she did not actually say anything at all about small businesses during the hearing. And that tells it’s own tale.