CONGRESS: HEALTH AMENDMENTS SURVIVE CONFERENCE REPORT
"Congress continued its progress on health care reform"This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
yesterday, extending minimum hospital maternity stays to newborns
and mothers and mental health parity guarantees to the mentally
ill, USA TODAY reports (Wolf, 9/20). The proposals were attached
by a House-Senate conference committee to the funding bill for
the Departments of Veterans Affairs and Housing and Urban
Development (VA-HUD) (see AHL 9/19). The VA-HUD appropriations
bill also included coverage of health benefits for children with
spina bifida whose parents were exposed to Agent Orange
(Dewar/Havemann, WASHINGTON POST, 9/20). The maternity-stay and
mental health provisions would take effect January 1, 1998, while
the spina bifida coverage would begin October 1, 1997
(AP/Baltimore SUN, 9/20). Both chambers of Congress must still
pass the final version of the $84 billion spending bill
(Rodrigue, DALLAS MORNING NEWS, 9/20). MILWAUKEE JOURNAL
SENTINEL reports that "the legislation is expected to be passed
by both houses next week and signed into law by President
Clinton" (Manning, 9/20).
GOT YOU COVERED: The maternity-stay amendment would
guarantee minimum hospital stays of 48 hours for uncomplicated
vaginal deliveries and 96 hours for C-sections. The mental
health parity amendment would bar insurers from setting different
lifetime limits for mental health coverage than for physical
health coverage. However, the "provision would be waived if a
group health plan's premiums rise by more than one percent due to
mental health coverage." Medicare, Medicaid and businesses with
50 or fewer employees would be exempt from the mental health
parity requirements (DALLAS MORNING NEWS, 9/20).
GOOD VIBRATIONS: NEW YORK TIMES notes that "consumer
groups, doctors and advocates for the mentally ill rejoiced" at
yesterday's agreement. Dr. Ralph Hale, executive director of the
American College of Obstetricians and Gynecologists, said, "We
are very pleased that Congress has seen fit to pass this bill.
... If health maintenance organizations had done this
voluntarily, we would not have to have new laws" (Pear, 9/20).
The American Academy of Pediatrics praised the bill for putting
"the discharge decisions squarely in the hands of physicians and
their patients," but called Congress "short-sided" for removing
provisions calling for follow-up care for mothers who are
voluntarily released prior to the 48 hour minimum (AAP release,
9/19). Sen. Pete Dominici (R-NM), co-sponsor of the mental
health provision, said, "This is a historic step, a breakthrough,
for the severely mentally ill. Congress is going to take one
step to get rid of the terrible stigma and discrimination that's
based on mystique, mystery and Dark Age concepts" (Pear, 9/20).
The other chief sponsor of the amendment, Sen. Paul Wellstone (D-
MN), called the agreement a "huge victory" and said, "It is a
crucial and affordable step toward ending the stigma and the most
egregious form of discrimination against Americans suffering from
mental illness" (Thomas/Howatt, Minneapolis STAR TRIBUNE, 9/20).
NO GO: "Mandates, no matter how well-intentioned they may
be, collectively raise costs," said Richard Coorsh, a
spokesperson for the Health Insurance Association of America.
"And consumers ought to be aware that they ultimately bear these
costs," he said (DALLAS MORNING NEWS, 9/20). National
Association of Manufacturers Senior Vice President Paul Huard
said, "This is a lousy policy, and it sets an awful precedent.
The government is not qualified to specify the design of health
plans, and we don't like government-mandated benefits whether
they come in tiny increments or in one huge chunk, as in
President Clinton's original health plan." Karen Ignagni,
president of the American Association of Health Plans, called the
maternity-stay provision "a well-intentioned but ultimately
misguided attempt to mandate standards of medical practice" (NEW
YORK TIMES, 9/20).
RISING TIDE: WASHINGTON POST reports that in just over a
year's time, maternity-stays "went from living room conversation
to a new dimension in health care policy." Madeleine Stoner, a
professor of social work at the University of Southern
California, said the maternity-stay measure "represents pent-up
public anger at insurance companies." She said, "I think this is
the sign of increased regulation over the health insurance
industry. It's the tip of the iceberg" (Vobejda, 9/20).
SUCCESS/LIMITS OF INCREMENTS: USA TODAY reports that the
health policy "improvements give Congress a record of achievement
on health care that eluded lawmakers in 1993-94, when President
Clinton failed to win sweeping changes in the nation's health
delivery system." USA TODAY adds, however, that the amendments
"do little for the estimated 43 million Americans without health
insurance." Ron Pollack of Families USA said, "Even though these
are very modest, incremental steps, they likely pave the way for
somewhat more significant steps in the years ahead" (9/20). NEW
YORK TIMES reports that the GOP "acknowledged that they were
imposing new mandates on employers." However, they said "they
were being more selective and judicious" than the president had
been with his health care reform proposal (9/20).
RIDE THE MAGIC OMNI-BUS: With exception of the VA-HUD
appropriations bill, the Senate "will abandon efforts to pass
further individual FY '97 appropriations measures and instead
will concentrate on writing an omnibus spending bill," CONGRESS
DAILY reports. House Appropriations Committee Chair Bob
Livingston (LA) said he expects the omnibus budget bill to
contain "a little over $6 billion" of the $6.5 billion in
increased domestic spending that the Clinton administration has
requested (9/19). AP/RICHMOND TIMES-DISPATCH reports that the
Republicans' conciliatory tones are "an effort to knock down any
suggestion that the GOP would force a federal shutdown to win
their budget priorities" (9/20).