Cost Debated As Congress Tackles Patients’ Bill Of Rights

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Advocates of the Senate version of the patients’ bill of rights said last week that health insurers concern over the bills potential cost was overstated. Insurers and their allies in the House, however, continued to support a Republican-backed version of a bill they believe is far less expensive in terms of future legal costs.

The Health Insurance Association of America insists the Senate bill, S. 872, sponsored by Sens. John McCain, R-Ariz., and Edward Kennedy, D-Mass., will cause a million Americans to lose their health coverage and do nothing to improve health care in the U.S. The bill passed the Senate by a vote of 59-36.

The House version of that bill, H.R. 526, which is expected to be debated in mid-July, would expose self-insured employers as well as insurance carriers to unlimited-damage lawsuits in state courts.

“Rather than protecting patients, the McCain-Kennedy patients’ rights bill sacrifices the most basic patient protection, affordable health coverage,” said Donald Young, a physician who is interim president of HIAA.

But an official of the American Medical Association says H.R. 526, sponsored in the House by Rep. Charles Norwood, R-Ga., and John D. Dingell, D-Mich., would have far less impact on insurance costs than carriers and their allies say. Moreover, a continued strong economy would make it unlikely that employers would drop out of health plans in large numbers, says Thomas Reardon, past president of the AMA.

The Congressional Budget Office estimates the cost increase to insurers will be 4.2%. Of that total, only a 0.8% increase would be attributable to liability for lawsuits, he adds.

“On the other hand, health plans didnt complain last year about raising rates 8% to 12%,” Reardon continues. “And the number of uninsured actually went down when they did that. Employers didnt drop their health plans then, so I think its false to say they would now.”

Both versions of the bill would require health care plans to provide basic services, including emergency room coverage without prior approval under a “reasonable layperson” standard, and visits to certain specialists.

A bipartisan House bill, H.R. 2315, favored by President George W. Bush and co-sponsored by Rep. Ernie Fletcher, R-Ky., and Collin Peterson, D-Minn., would place limits on punitive jury awards against health plans.

The Fletcher bill would not change current restrictions imposed by ERISA against patients filing lawsuits against their health plans in state court.

The Senate version would allow for attempts to remedy patient grievances against their health plans outside of court. It would not, however, limit punitive damages.


Reproduced from National Underwriter Life & Health/Financial Services Edition, July 13, 2001. Copyright 2001 by The National Underwriter Company in the serial publication. All rights reserved.Copyright in this article as an independent work may be held by the author.


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