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Life Health > Health Insurance

Who Wrote That Group Health Bill?

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“Laws are like sausages, it is better not to see them being made.”Otto von Bismarck

If you sell group health insurance, you know that Congress is about as important to your business as the carriers you represent and the employers that buy the coverage.

But, if you have not yet spent much time working in agent association legislative affairs efforts, you may not realize that senators and representatives are just the most visible of the many people on Capitol Hill who help shape group health legislation. The lawmakers’ staff members also play a major role in developing and “shaping” group health bills.

“Shaping” refers to the process of staff members using suggestions from many sources to form cohesive bills that (they hope) will be supported by many people.

The overwhelming volume of bills introduced makes it impossible for members to do much drafting. In 2001 and 2002, for example, members of the 107th Congress introduced 5,767 bills in the House and 3,181 bills in the Senate. Members of Congress could not draft that many bills, or even read that many bills.

Although only a member of Congress can introduce a bill, anyone can suggest a bill. Recommendations for bill topics come from members of Congress, congressional staff members, interest groups, state and local initiatives, party leaders, the White House, executive agencies, and individual citizens. Any of those parties may also help draft the bill.

Lawmakers’ personal staff members, who are usually young and idealistic, rarely shape bills, although they may bring suggestions to the lawmakers’ legislative directors. Personal staff members are assigned several topic areas and may develop some expertise on some issues.

The House and Senate Offices of Legislative Counsel initially draft most bills. The OLCs are nonpartisan and are made up of attorneys and other staff members. The attorneys do the drafting of bills and are experts on certain policy issues. The OLC does not actually shape the bill, but rather puts the content into proper form.

Once a bill has been introduced, it is assigned to a committee. The committee staff then shapes the bill. Committee staff members, usually more experienced than personal staff, bring a greater degree of expertise on issues. OLC attorneys work with the committees and they are assigned to specific committees based on their policy expertise.

Special interests also play an important role in shaping bills. They have much expertise about the policy issue and provide ideas and information. They may affect the bill through efforts at public persuasion, such as advertisements and political pressure, and they also may affect the bill through meetings with staff. Lobbyists cannot afford to lie or mislead, so the information they provide is usually honest, though it may be biased. A good lobbyist will provide information and arguments supporting both their position and the opposite side. Lobbyists on both sides of an issue will talk to the staff about a bill.

In most sessions of Congress, fewer than 25% of the bills introduced are passed. Benefit bills are particularly difficult to pass. In order for a bill to become law, it is essential that the affected industry be mostly united.

Classic cases demonstrating the importance of industry support occurred in 1994 and in 2003.

In 1994, the health insurance industry opposed the Clinton health reform plan. Through intense lobbying and the famous “Harry and Louise” ads, the reform proposal was defeated in Congress.

In 2003, the health insurance industry, the prescription drug industry and the AARP, Washington, all supported the final draft of the prescription drug bill, and it passed both houses of Congress.

Joseph Luchok is an Arlington, Va., communications consultant. He can be contacted by e-mail at [email protected]

Reproduced from National Underwriter Edition, April 19, 2004. Copyright 2004 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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