106TH CONGRESS: Look For HMO Reform, But Expect A Fight
The American Association of Health Plans is conceding that some form of managed care reform or patient protection legislation is likely to make it through Congress next year, but is predicting that any bill will likely be relatively weak. Mark Merritt, AAHP vice president for public affairs, said that Republicans may "cave" on the issue after last year's heated Congressional battle. He said the AAHP is basically "in the same situation we were in last year," but that the health insurance industry could find itself in an even tougher spot should nothing pass again in the next Congress. "If you don't have something pass, as this turns into an election-year issue [in 2000], we could take a licking," Merritt said. The mood of the House, he said, may dictate that a strong bill gets passed very quickly, but the Senate may take a more reserved posture. "Everybody acts like Congress is the [entire] House," but the Senate doesn't "care for this stuff," he said. Therefore, any Senate bill may be relatively toothless next to Democrats' demands. Furthermore, he said Congress realizes that "[y]ou can't eviscerate managed care. Too many state governments rely on it. ... [T]here's no alternative to it, except for government-run health care and the old system which is way more expensive." Merritt also noted that AAHP plans another large lobbying and advertising expenditure next year to mitigate any Democratic clamor for wide-ranging reform. "It's just a matter of timing," he said, adding, "We're not sure what the flow is, we don't know what [Speaker-elect Bob] Livingston's (R-LA) up to."
Merritt's comments came at the National Post-Election Conference, co-sponsored by National Journal's Hotline and the University of Virginia's Center for Governmental Studies, at which health care reform was a frequent topic of discussion. In digesting the November elections, many panelists agreed that Republicans must take a more active role in defining the health care debate. GOP pollster Linda DiVall released a post-election survey by her organization, American Viewpoint, which showed that while only 6% of voters identified health care as the issue that mattered most to them, 68% of those voters voted Democrat, and 30% voted Republican. She said Republicans cannot hope solely to define all the issues that matter. Rather, they "must talk about issues that come up whether [they] like those issues or not." John McLaughlin, another Republican pollster, released a survey showing that the share of voters most concerned about "social" issues has remained relatively steady since 1994, while those preoccupied with "economic" issues has actually declined by nine percentage points. He commented that managed care "is going to be an issue as the baby boomers age, and if Republicans and Democrats don't take a position on it, it will hurt them." In analyzing the election's outcome, however, Weekly Standard Editor Fred Barnes said, "I never ran into anybody who cared about the Patients' Bill of Rights. I can think of no race decided by that issue." Merritt agreed that HMO reform had a negligible electoral impact. He said the only people who were terribly concerned about the issue at the ballot box were "hardcore Democratic voters. It's like the minimum wage issue. It doesn't do anything for Republicans, but it's a good Democratic mover. [Among] swing voters, everybody likes it, but nobody really cares" (Jeff Dufour, American Healthline). Click here for coverage of an AAHP survey indicating that HMO-bashers fared poorly overall on Nov. 3.