PATIENTS’ RIGHTS: Conferees Begin to Deal
As conferees to the House-Senate managed care conference finally gather this afternoon to begin hammering out a compromise on patients' rights, they are likely to face a rough road since "they have done little to bridge the huge difference between the bills passed by the Senate last July and the House last October," CongressDaily/A.M. reports. The primary stumbling block will be the right to sue health insurers. The bipartisan House measure opens the door to lawsuits by patients who are wrongly denied care, but the GOP-backed Senate version, passed along strict party lines, does not grant the right to sue.
Also, a "second major front in the war has emerged -- the question of which Americans the bill's protections would cover." Under the Senate bill, most patient protections would be afforded only to the 55 million Americans with "self-insured" employer plans that are not regulated by states under the federal Employee Retirement Income Security Act. Senate Republicans argue that resorting to both state and federal regulation of plans "would not only be unwieldy, but unworkable for regulators, health plans and consumers." But supporters of the House measure -- which would grant protection to all Americans with private, employment-based insurance, those with individual coverage and state and local workers -- say citizens should be assured of the same protections and "should not have to rely on whether the state legislature has enacted a particular" mandate.
Pressure, Pressure, Pressure
Meanwhile, interests on all sides are pressuring conferees to act. In a letter to the conference committee, a bipartisan group of 52 female House members Tuesday urged conferees to adopt the House measure because of its flexibility in allowing women to see obstetrician-gynecologists without a primary care referral. "The House provision specifically states that women have direct access to all covered gynecological care and pregnancy-related services ... The Senate provision is limited to 'routine' care and follow- up care," they wrote. President Clinton plans to call for a bipartisan compromise along with Rep. Charles Norwood (R-Ga.), who sponsored the House bill but was not appointed as a conferee, and key leaders of a bipartisan Senate measure that never reached the floor. Perhaps the most pressure, however, comes from the "political reality that the public still wants the issue addressed," CongressDaily/A.M. reports. According to a Kaiser Family Foundation and Harvard School of Public Health poll last month, 74% of respondents "said the problems with managed care have not gotten better over the past few years;" and almost half said legislative action is even "more urgent" than when the debate began (Rovner, 3/2). Conferees have set a March 31 deadline for a compromise ( AP/Las Vegas Sun, 3/2).