Senate weighs limited health insurance reform House poised to load on suffocating amendments

March 08, 1996|By Karen Hosler | Karen Hosler,SUN NATIONAL STAFF

WASHINGTON -- A broad bipartisan drive is building in Congress to enact this year health insurance reforms that would allow workers to retain coverage when they get sick, or change or lose jobs.

The effort faces the same partisan politics and special interest concerns that killed President Clinton's health care reform proposal nearly two years ago. But this time, leaders of the movement say, they believe that political momentum may be on their side.

"We're getting stronger every day," proclaimed Sen. Nancy Landon Kassebaum, a Kansas Republican and chief sponsor of the proposal. She has signed up half the Senate -- 22 Republicans and 28 Democrats -- as co-sponsors.

The threat to the bill appears to lie in the House, where Republican leaders are planning to attach so many amendments to the basic proposal that advocates fear it could collapse from the weight. GOP leaders were scheduled to unveil their package this morning.

"We're just adding items for which we believe there is a broad consensus, like medical malpractice reform," said Tony Blankley, press secretary for House Speaker Newt Gingrich. "You don't have that many chances to get health legislation through."

That's just the point, says Rep. Marge Roukema, a New Jersey Republican who is chief sponsor of the Kassebaum proposal in the House. "They're reaching too far. The Republicans in the Senate have already learned this; the House should, too."

Unlike the massive overhaul of America's health system that Mr. Clinton proposed, the Kassebaum bill tries to correct only one element of the health insurance market to help about 25 million Americans.

The measure prohibits insurers from denying coverage for more than 12 months because of pre-existing conditions, and it makes insurance portable by requiring insurers to renew policies for workers and companies that have bought insurance for at least 18 months.

"It eliminates the worst abuses and the worst profiteering of the current system," said Sen. Edward M. Kennedy.

The measure falls far short of what the Massachusetts Democrat would prefer; he favors a government-sponsored program of universal health care. But Mr. Kennedy has joined the effort because he believes it is the most Congress can now do.

The bill was blocked for months by conservative Republican senators who had placed "holds" on the measure. They were persuaded to drop the "holds" only after Mr. Clinton called

attention to them in his State of the Union address this year.

The Kassebaum-Kennedy bill has drawn enthusiastic backing from the medical community, the business community and much of the insurance industry. It was passed unanimously by the Labor and Human Resources committee Ms. Kassebaum chairs.

Stiff resistance is coming from other quarters, however.

Small insurance companies -- represented by the Health Insurance Association of America, which ran the "Harry and Louise" television ad campaign against the Clinton bill -- are vigorously opposed to guaranteeing that workers who lose their jobs can buy private insurance regardless of HIAA argues that only the sickest people with few other options are likely to take on the full cost of private insurance, and that their medical expenses will be so high, insurance costs will rise even higher.

Premiums for these people could rise as much as 200 percent, said Richard P. Coorsh, a spokesman for HIAA, which fears that states would limit such rate increases, forcing insurers to pass the costs on to all their customers.

Mrs. Kassebaum called that complaint "a red herring." But House leaders took it seriously enough in their proposal to limit the type of policies that must be made available to workers who can no longer get group coverage.

A bigger problem for legislation, though, is likely to be all the other elements House leaders are adding to it.

Medical malpractice reform, for example, which would set federal limits on the amount of damages victims could win, is strongly opposed by trial lawyers and consumer advocates.

Other features of the House leadership bill would lift anti-trust laws to let doctors and hospitals set up their own health care plans, exempt small businesses from state regulations so they can set up insurance purchasing pools, offer tax breaks for individuals who create Medical Savings Accounts, and grant 50 percent tax breaks for businesses that self-insure.

Rep. Benjamin L. Cardin, a Baltimore Democrat who has worked closely with his GOP colleagues on health care issues, believes the package is being deliberately overloaded to kill it.

"I think there are Republicans who just don't want to give Clinton the chance to sign a health care bill," he said.

Bill Frist, a Tennessee Republican who is the only doctor in the Senate, said he wasn't sure about the motives of the House GOP leadership in packaging their bill, but he is certain of the results.

"I've been involved in this since Day One, and I know all you can have is a narrow bill -- pre-existing conditions, portability, that's it," he said. "If you add anything else on -- and I support most of the things they're considering -- there's no way we're going to get it through this Congress."

Pub Date: 3/08/96

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