107th Congress Adjourns Without Passage of Several Health-Related Bills
The 107th Congress will adjourn today after a session marked by failures on several health-related bills, such as a Medicare prescription drug benefit, the New York Times reports (Hulse, New York Times, 11/21). The 107th Congress convened in January 2001 with Republicans in control of both the House and Senate. However, the Senate switched to Democratic control in May 2001, which "laid the groundwork for gridlock," the AP/Dallas Morning News reports (AP/Dallas Morning News, 11/21). In the two-year session, Congress did "rack up major accomplishments," such as the passage of a 10-year, $1.35 trillion tax cut; an education reform program; legislation in response to the Sept. 11 attacks, such as a bill to establish a Department of Homeland Security; and reforms of the Securities and Exchange Commission (Hook, Los Angeles Times, 11/21). In addition, Congress passed a trade bill (HR 3009) that included a 10-year, $12 billion provision to provide displaced workers with health and other benefits. The bill provides uninsured trade-displaced workers with a refundable tax credit to cover 65% of the cost of their health insurance premiums. The workers can use the tax credits to purchase health insurance through COBRA, the 1986 Consolidated Omnibus Budget Reconciliation Act, or through state-sponsored health insurance purchasing pools and high-risk pools (California Healthline, 8/7).
However, the 107th Congress failed to pass legislation on a number of health-related issues, such as:
- Patients' rights: Both the House and Senate passed patients' rights legislation, but negotiations between the White House, which supported the House bill, and the Senate stalled in August over the issue of caps on damage awards in lawsuits against health plans. The Senate bill would have allowed patients to sue HMOs in state courts -- which often award larger damages than federal courts -- for denial of benefits or quality of care issues and in federal courts for other issues. The legislation would have capped damages awarded in federal courts at $5 million but would have allowed state courts to award as much damages as states allow. The House bill would have only allowed patients to sue health plans in state courts for noneconomic damages up to $1.5 million. The legislation also would have allowed courts to award patients as much as $1.5 million in punitive damages, but only in cases where patients had won complaints against health plans before an outside appeals panel and an HMO still refused to provide care. During negotiations, senators and White House aides considered a compromise that would have placed a $1.5 million cap on damages awarded to patients for most injuries and would have allowed larger awards for "particularly serious" injuries. However, the two sides could not agree on a definition for particularly serious injuries (California Healthline, 8/2).
- Generic treatments: In July, the Senate passed a bill (S 812) designed to increase access to generic treatments, but the House did not approve similar legislation. The bill, introduced to close loopholes in the 1984 Hatch-Waxman Act, would have allowed brand-name pharmaceutical companies to receive only one 30-month patent extension per product. The legislation also would not have allowed brand-name pharmaceutical companies to pay generic drug makers not to market generic versions of their products. In addition, the bill would have allowed generic drug makers to legally challenge "frivolous patents," such as those that involved "superficial changes" in the color or physical design of a treatment (California Healthline, 10/22). Although the House Energy and Commerce Committee held hearings on the bill, the committee never reported the legislation. In response, House Democrats launched a discharge petition to force the bill to the House floor, but the procedural move failed (California Healthline, 9/20).
- Medicare prescription drug benefit: The House passed a GOP-sponsored prescription drug benefit bill this summer, but the Senate failed four times to pass similar legislation (California Healthline, 11/18). Under the House bill, Medicare beneficiaries would have purchased prescription drug coverage directly from private insurance companies for a $250 annual deductible and a $33 monthly premium (California Healthline, 6/28). The Senate considered several prescription drug benefit bills, but none received enough for passage (California Healthline, 8/5). Senate Republicans and Democrats could not agree on the structure of a prescription drug benefit. Democrats preferred a Medicare prescription drug benefit administered by the federal government, but Republicans supported a bill that would have relied on private insurers to provide coverage (California Healthline, 8/1).
- Mental health parity: Sens. Pete Domenici (R-N.M.) and Paul Wellstone (D-Minn.), who died in October, sponsored a bill (S 543) that would have eliminated a loophole in the 1996 mental health parity law, which mandated that health plans that cover mental illnesses could not establish different annual and lifetime benefits for those illnesses than for physical illnesses. Under the legislation, health plans also could not establish higher deductibles or copayments for mental health benefits than for other medical conditions. Although President Bush expressed support for mental health parity legislation earlier this year, the House did not address the legislation (California Healthline, 10/18).