HMO POLITICS: Reform Remains Big Issue In The States
Rhode Island Democratic attorney general candidate William Guglietta yesterday pledged he would give voters a health care advocate if they elected him. Appearing "[w]ith one of the state's most prominent politicians, U.S. Rep. Patrick J. Kennedy" (D), Guglietta put forth the proposal to even the playing field with his two Democratic rivals, who have both pledged managed care oversight. Specifically, Guglietta would establish a "Healthcare Unit" in the AG's office "to make sure that [HMOs] and other medical services don't deny people treatment because of rules set by the insurance industry." He said, "We have to make sure that bureaucrats are not making the decisions, but that doctors and patients are making the decisions." The Providence Journal-Bulletin reports that Guglietta would have the new health care unit "lobby" the General Assembly to pass a law regulating mergers in the insurance industry. "I want to make sure that our citizens' benefits and premiums are protected in these transactions," he said. Kennedy, stumping for Guglietta, added, "Bill Guglietta has got it absolutely right: there is no issue more important in the state right now than the well-being of our state's citizens and the quality delivery of our health care system" (Saltzman, 8/25).
AG In MN, Too
The race for Attorney General in Minnesota focuses on managed care as well, reports City Business of Minneapolis/St. Paul. All candidates -- three Democrats and two Republicans -- are offering competing HMO reform plans. Republican Charlie Weaver would "push for more funding for the health care assistance office [and] want to see clear guidelines published to explain to consumers how they can navigate the appeal process." Democrat Ember Reichgott Junge "wants to see the recently created health care protection office move from the Department of Health to the Attorney General's office," and would set up a consumer advocate to assist patients with appeals. Democrat David Lillehaug said he may set up independent panels to make sure treatment decisions are properly made. But Democrat Mike Hatch "would be the health plans' biggest nightmare." Hatch would like to see a "nonbinding forum" debate health plan decisions and was particularly vocal on the idea of suing HMOs. Hatch was known for being especially tough on the insurance industry when he was commissioner of the state Department of Commerce. "They obviously don't think I'm the guy they want," he said (Manning, 8/24).
Mass. May Get A Bill After All
The Massachusetts Legislature adjourned July 31 without reaching a consensus on a sweeping HMO reform bill. But according to one Democratic member, the issue may have life this year after all. In the Assembly's regular session, the House and Senate passed their versions of HMO reform legislation. Harriette Chandler (D), co-chair of the Legislature's joint health care committee, thinks that the bills may be reconciled during the ongoing informal legislative session. "I think we really are people of good will in this and we will work to see it happen," she said. The primary difference between the two bills is that the Senate gives patients the right to appeal a denial of care through an independent reviewer, while the House only requires HMOs to follow their own appeals criteria. State Sen. Mark Montigny (D), the other co-chair of the health committee, said such an important bill should not be dealt with in an informal session. Rather, "the Legislature should return to a regular session this year to complete work on the HMO bill" (Griffith, Boston Business Journal, 8/24).
Mandate Warning In Kansas
Kansas Insurance Commissioner Kathleen Sebelius told a state legislative panel Monday that legislators should exercise caution in dictating mandates to HMOs. For example, "requiring managed care plans to cover certain treatments could make things worse by causing more employers to go into self-insured plans with fewer benefits, or drop their plans," she told the Special Committee on Financial Institutions and Insurance. She added that while managed care has stabilized costs to employers, employees' costs have increased by $5.5 billion in the state since 1991. Overall, however, she said her biggest fear is federal mandates. "If I could wave a magic wand, I would eliminate federal involvement and return it to the states," she said (Rothschild, Wichita Eagle, 8/25).