PATIENTS’ RIGHTS: Rep. Boehner Introduces Reform Package
With Democrats "stepping up the pressure" for congressional action on managed care reform, Reps. John Boehner (R-OH) and Bill Goodling (R-PA) yesterday introduced a package of eight bills designed to enhance the rights of patients and increase access for the uninsured (Mitchell, New York Times, 6/10). The Health Care Quality & Access Act of 1999 follows nearly four months of hearings in the House Education and the Workforce subcommittee on employer-employee relations, chaired by Boehner. He called it a "balanced approach to managed care reform that both Democrats and Republicans can support," adding, "This legislation wil make health care more accountable to patients while addressing the needs of our nation's 43 million uninsured. It's the right way to do health care reform." The bill would establish a binding external appeals process, accelerate health plans' internal review systems, allow patients direct access to pediatricians or OB/GYNs, mandate "plain English" in health plan materials, prohibit gag rules, guarantee emergency room care and establish an independent Patient Protection Commission. Noting that the bill does not allow an expanded right to sue health plans for coverage decisions, Boehner said such a provision "would bankrupt many union plans and 'wipe out the health care coverage of thousands of workers, retirees and family members.'" And under a proposal by Rep. Jim Talent (R-MO), the bill would establish Association Health Plans, allowing small employers to pool their resources and purchase quality health plans (Boehner release, 6/9). Talent called the bill "the best thing for health care since penicillin" (Kenen, AP/Nando Times, 6/9).
Will It Fly?
CongressDaily/A.M. reports that with progress having slowed to a crawl in the House Commerce and Ways and Means committees, the Education and the Workforce bills "could emerge as leading contenders for floor action." According to one health lobbyist, Boehner "is the one guy who has an orderly process and knows how he wants to do this." That apparently involves moving quickly, as the full committee is expected to vote on the act next week. Boehner said he briefed both Commerce Committee Chair Tom Bliley (R-VA) and Ways and Means health subcommittee Chair Bill Thomas (R-CA), "and neither objected." Thomas said it makes sense "to let the ERISA subcommittee deal with ERISA." A spokesperson for House Speaker Dennis Hastert (R-IL) said he will meet today with the relevant committee chairs on health "to see where we are and to reiterate his desire to have a bill passed before we leave for the August recess" (Rovner/Morrissey/Earle, 6/10). The New York Times reports that the "crucial question is whether Republican moderates will be content with the signs that their party is now ready to engage in the issue or whether some will join forces with the Democrats." The Democratic Patients' Bill of Rights recently won its first GOP co-sponsor, Rep. Michael Forbes (NY). He said, "The nation urgently needs HMO reform, and the best bill out there currently happens to be the patients' bill of rights. I believe in it to my core" (6/10). And an aide to Republican Rep. Charlie Norwood (GA), who supports the right to sue health plans, said "already there's stuff in [the Boehner bills] he's not happy with." CongressDaily/A.M. reports that Democrats may oppose a provision that would require a "prudent emergency room professional" to authorize involved emergency care. Most Democrats also oppose Association Health Plans (6/10). The Health Insurance Association of America immediately criticized the bill as being a ticket to higher costs and more uninsured (release, 6/9). Rep. John Dingell (D-MI) questioned whether Boehner introduced the act as a series of bills in order "to clear the way for only the least controversial bills to pass" (New York Times, 6/10).
Where Calhoun and Clay Once Roamed
Senate Minority Leader Tom Daschle (D-SD) and Majority Whip Don Nickles (R-OK) met Tuesday to discuss the coming floor action on the patients' rights bill approved by the Senate Health, Education, Labor and Pensions Committee. Daschle said he would like to offer 20 amendments to the bill, but negotiations were at a "standstill." He said if the bill does not "see floor action by the end of the month," he will offer the package as an amendment to other legislation (CongressDaily/A.M., 6/10).