The Middle Class Opposes. Legislation that enabled small businesses to affordably provide quality health coverage to their employees would allow more Americans to enjoy a middle-class standard of living. Unfortunately, this bill does not accomplish that goal. Instead, it would downgrade the quality of health coverage millions of Americans currently have, while doing little to reduce costs. The Congressional Budget Office estimates that health insurance premiums for small businesses would decline just 2 to 3 percent as a result of this legislation, while one in four small businesses would actually pay higher premiums. At the same time, the exemptions from state insurance regulations would allow insurance companies to sell “junk insurance policies” that fail to provide adequate coverage of needed medical care. With an estimated 25 million Americans already underinsured, exemptions from state insurance laws that protect at least some Americans would result in a devastating loss of covered care. Preempting state insurance laws would also have other negative impacts on patients and health care providers: for example, it would block states from regulating insurance rates, overseeing how insurance companies handle customer complaints, and requiring prompt payment of claims.