PATIENTS’ RIGHTS: GOP Leaders Unveil Access Package
House Republican leaders yesterday proposed $43 million in health-related tax breaks and insurance access provisions in an apparent effort to either broker a quid pro quo with Democrats on HMO reform, or to simply offer a poison pill designed to kill the patients' rights effort altogether. "Frankly, all the lawsuits in the world won't do a thing for a worker struggling to buy health insurance for themselves or their family," said House Ways and Means Committee Chair Bill Archer (R-TX) (Scully, Washington Times, 9/29). At a press conference yesterday, House Speaker Dennis Hastert (R-IL) said, "While the Democrats say they're for health care reform, I must point out that none of the managed care proposals they support comes close to providing coverage for the uninsured. ... We're here because one out of every six Americans currently doesn't have the peace of mind that health care protection provides, and it would be irresponsible to go forward with health reform without addressing this critical need" (MacDonald, Hartford Courant, 9/29). The Quality Care for the Uninsured Act includes the health care provisions contained in the $792 billion tax cut recently vetoed by President Clinton, as well as other provisions. It would allow for 100% deductibility for individuals who purchase health insurance outside of an employer plan, whether or not they itemize deductions. It would also allow 100% deductions for the purchase of long-term care insurance and accelerate by two years, to 2001, the phase-in for deductibility of health insurance for the self-employed. Taxpayers will be allowed an additional exemption for family members who care for the elderly at home. The act would also expand Medical Savings Accounts to all individuals and repeal the 750,000 cap on enrollment. It permits "cafeteria" benefit plans to include MSAs and long-term care insurance, and includes medical research incentives (Ways and Means release, 9/28). In addition, the proposal includes pooled purchasing arrangements for small business -- championed by House Small Business Committee Chair Jim Talent (R-MO) -- called HealthMarts and Association Health Plans (Norton, CongressDaily, 9/28).
Get Ready to Rumble
CongressDaily reports that "most Democrats and the Clinton administration will likely oppose the GOP access bill -- not because of its tax provisions, which are relatively popular with both parties -- but because" MSAs and the pooling mechanisms are "anathema to many Democrats" (Rovner, 9/28). They also accused Republicans of having ulterior motives. House Minority Leader Richard Gephardt (D-MO) said, "Nine months into this session of Congress, Republicans have suddenly found religion on the issue of expanding health care coverage for uninsured Americans. This is a cynical, desperate, last-minute attempt to stave off a bipartisan managed care bill on the verge of passage, not a genuine effort to pass legislation to benefit uninsured Americans" (Gephardt release, 9/28). White House spokesperson Joe Lockhart added, "The concern is that we don't try to use the back door of a popular measure -- among Democrats and Republicans -- to do something else" (Norton, CongressDaily, 9/28).
House Majority Leader Dick Armey (R-TX) said "the plan is to have a day where we basically address the access provisions, have another day where we address the (HMO) provisions, then marry them up at the end of the process" (Rovner, CongressDaily, 9/28). But several steps remain until the bills are settled. Rep. Charlie Norwood (R-GA) filed two discharge petitions yesterday to try to ensure a vote on his bill, while Rep. Bill Thomas (R-CA) is still trying to find a "responsible position in the middle" between the Norwood and Boehner bills. "Nervous Republicans are still looking for a place to land," said one lobbyist. Thomas may not write his own bill, but may instead seek to alter the Coburn-Shadegg bill. But if Shadegg agrees, that would likely alienate Coburn, who may then abandon the effort and sign on to Dingell-Norwood (Morrissey, CongressDaily/A.M., 9/29). But for now, Coburn says, he will not abandon his bill (Rovner, CongressDaily, 9/28).