AAHP Poll Finds HMO Reform Not a ‘Silver Bullet’ Election Issue

Just 18% of voters surveyed in an American Association of Health Plans poll listed health care as their top issue in this year's presidential election, and only 2% cited managed care reform as a pivotal concern, while 45% listed education or the economy as the most important issue. In addition, the survey showed that among 13 election concerns, the candidates' stances on HMO reform ranked ninth, with 64% of participants listing the issue as the "single most important factor" or a "major factor" in deciding their vote for president. On the issue of patients' rights, 65% of voters prefer an independent appeals process over suing their health plans to recover damages, and 64% support managed care legislation with an appeals process but without a right to sue provision, according to the AAHP poll. "The American voters may be divided on some things, but they are united in their desire that Congress create an avenue for resolving disputes that does not place these decisions in the hands of trial lawyers," AAHP President and CEO Karen Ignagni said. The survey, conducted by Ayres, McHenry and Associates Inc. between Nov. 8 and 9, included telephone responses from 1,000 Americans who voted on Nov. 7 (AAHP release, 11/16).

Discussing the results of the election at a press conference yesterday, Ignagni admitted that the vote "didn't produce a mandate," with Congress tightly divided and the presidential race still undecided. Citing results from the poll, she argued, however, that Americans strongly favor tackling patients' rights issues in an "effective way," rather than pursuing right-to-sue measures. "The survey is a beacon of what people think, and to those who have said liability or nothing ... that position looks very extreme," she said. Whit Ayres, president of Ayres, McHenry and Associates Inc., said that "what people want is their problem solved," claiming that Americans would prefer an independent review from a group of physicians over "going off and suing somebody" to resolve coverage disputes. He added, however, that managed care reform remains "far from the most compelling concern. It's far from the top of the list. It's not a silver bullet issue." In addition, Ignagni pointed out that in congressional races, candidates who ran primarily on managed care reform -- such as former Rep. Scotty Baesler (D) in Kentucky's 6th District -- lost their bids because the issue had no "traction" with voters. Turning to patients' rights legislation pending in Congress, Ignagni argued that the House-passed Norwood-Dingell bill would not serve the "public interest." She urged Americans to hold politicians' "feet to the fire" to "match the rhetoric with the reality" about the legislation, saying, "Dingell-Norwood ... would ... blow up the entire health care system." Still, she predicted that "reason and balance" would prevail in Congress, citing the Republicans' narrow majority as a "bipartisan opportunity" to pass a reasonable patients' rights bill.

Addressing the stalled
Medicare "giveback" legislation, which would return $30 billion to Medicare providers and HMOs over five years, Ignagni cited an "overwhelming need and a compelling rationale to move forward" with the "crucial" bill. She pointed out that a wide variety of health care groups have joined forces, urging Congress to pass the legislation. In a Nov. 13 letter to House and Senate leaders, Ignagni and nine other health industry leaders wrote, "[W]e urge you to swiftly enact a ... relief package ... none of our organizations agree with every aspect of the package. Still, we believe that this legislation provides substantial relief."

Predicting that the bill will likely pass regardless of the outcome of the presidential election, Ignagni said, "Democrats and Republicans are going to want to respond to the real needs of their constituents. And they're not going to do it for [HMOs]. They're not going to do it for hospitals. They're not going to do it for ... providers ... and that's the way it should be." She concluded that the bill, which emerged as the "overwhelming issue" before the election, remains an "important priority" for both Democratic and GOP lawmakers.

In other news, Ignagni was asked by a reporter at the same press conference "Have you in fact decided to enter discussions with HIAA on a merger ... and if so, what is the timetable?" Ignagni declined to comment and referred questions on the issue to the group's board of directors (Josh Kotzman, California Healthline, 11/16).