JEFFERSON CITY - With federal health care legislation lingering in Washington, there have been multiple bills pre-filed for the 2010 Missouri legislative session dealing with health care.

Among them is a bill that would allow small businesses to join the same health insurance pool as state and local government workers -- the Missouri Consolidated Health Care Plan.

Missouri Consolidated provides health care to more than 107,000 state and local government employees. The idea to add various group to the plan has been proposed in years past, but bill sponsor Rep. Sam Komo, D-House Springs, said with the national health care bill in limbo, there's no point in waiting around.

"Until the president has something on his desk, we don't know if we're going to have a bill or what would be in that bill," Komo said. "We can't sit on our hands waiting for what they do."

Komo said the goal of his bill is to provide an affordable solution for small businesses, such as those owned by his father, that want to provide insurance to their employees but can't afford it.

"My dad would love to insure his employees, but he can't afford going into the open market with his 10 employees and get a fair shake," Komo said.

Under the legislation, any business with under 50 people could join Missouri Consolidated. It's unclear how many people would qualify to join the program under the bill.

But other representatives said that while the measure may sounds like a good idea, it will be costly to the state.

"The people of Missouri pay quite a bit for health care given to state workers, so its a burden on the taxpayer," said Rep. Rob Schaaf, R-St. Joseph, a doctor and committee chair of the Healthcare Transformation Committee. "Anything to have taxpayers further subsidize subsets of businesses might overburden them."

Rep. Doug Ervin, R-Holt, said there is no reason for taxpayers to be subsidizing health care for businesses when they can buy private insurance for the same amount without a state contribution.

"People file these bills out of ignorance. They don't know what it actually costs. They say I'm only paying $46 while the state's paying $451," Ervin said.

The numbers Ervin cited are those for an individual plan. For a family, the cost is $311 for the employee and $1,236 to the state.

"You can get a plan on the private market for that cost, without the contribution from the state," Ervin said. 

There are also questions about how adding more people into Missouri Consolidated's bargaining pool will affect prices.

"Next year, rates are going to go up, people are going to drop it, and the only people who are going to stay with it are the sick ones," said Ervin who also said that only those who cannot get health insurance elsewhere will stay in the insurance pool. "So the pool is going to get smaller and smaller, and the pool is going to get sicker and sicker," Ervin said.

Others see that as an unlikely scenario.

"Oftentimes you have an adverse pool because only sick people come in, but with small businesses you have a large pool and combined with the state that has healthy workers, I don't think it would be a negative," said Rep. Mary Still, D-Columbia. "You avoid the adverse selection process that normally crops up."

Still, Komo said now is the time to act. "Somehow we've got to do something for these small businesses. With the economy, it was important before, but especially now that people are struggling to keep their employees on, giving them insurance is another struggle."

Sen. Joan Bray, D-St. Louis County, sponsored a nearly identical measure in the Senate.