Health reform gets lift in House Bill would preserve coverage for workers who change jobs

Seriously ill also covered

But measure may not pass Senate, Clinton

March 29, 1996|By Karen Hosler | Karen Hosler,SUN NATIONAL STAFF

WASHINGTON -- After years of failed efforts to reform health care insurance, the House soundly approved last night a bill to preserve coverage for people who become seriously ill or change or lose jobs.

The 267-151 vote by the Republican-led House represented the most progress Congress has made on the issue in decades.

"This is a giant step toward health security for all working Americans," said Rep. Nancy L. Johnson, a Connecticut Republican who is among the leading advocates in her party for expanding the availability of health care. "We are going to be able to put on the president's desk something that directly affects the lives of millions of Americans."

But the long-term prognosis for the measure is much in doubt. The bill includes some features, such as curbs on medical malpractice lawsuits and tax breaks for medical savings accounts, that are considered unlikely to pass muster with the Senate or President Clinton.

"They have taken a stake and thrown it into the heart of health care reform," Rep. Joseph P. Kennedy II, a Massachusetts Democrat, said of the House Republican leaders, who Democrats say have "gummed up" the measure in order to favor their special interests.

"They are throwing off the track the ability of the American people to get health care in order to enrich the pockets of the doctors and enrich the pockets of the lawyers," he said.

Rep. Benjamin L. Cardin, a Maryland Democrat, complained that another feature of the measure could undermine insurance reform in states like Maryland that have undertaken them on their own.

But Republicans fired back that their bill includes proposals that have been under consideration in Congress for years and enjoy broad support.

In the Maryland delegation, all four Republicans supported the measure, but all three Democrats voted against it.

The Senate is scheduled to vote next month on a narrower bill that has the president's backing. Some Republicans would rather not give Mr. Clinton such an election-year prize, however. Democrats failed last night in an effort to substitute the Senate bill for the broader House measure.

Health reform advocates say the best hope for the enactment of any measure this year depends on whether a bargain can be struck when House and Senate negotiators meet to work out their differences later this spring.

The legislation -- a tiny slice of the health care reform proposal unveiled three years ago by Mr. Clinton and even less ambitious than many Republican counterproposals offered then -- nonetheless addresses what many lawmakers say are some of the most severe problems in the insurance industry.

It seeks to protect people with serious medical conditions by guaranteeing that workers would not be denied coverage merely because someone in their family was sick. Currently, many workers fear a job change because they would lose employer-based coverage and could not qualify for health coverage at the new workplace.

The bill would also make it easier for sick people who leave group coverage to buy an individual policy, despite a pre-existing medical condition.

Furthermore, a business could not be denied a group health insurance policy on the ground that one of its employees or an employee's relative had a serious medical condition, as is the case today.

Sponsors say these "portability" provisions, which are nearly identical to those in the Senate bill, would expand coverage to 25 million people.

But House Republican leaders say they wanted to use the vehicle of a popular health care bill to put into law several other "affordability" improvements.

"We think that the Senate package was lacking," said Rep. Dennis Hastert, an Illinois Republican who helped craft the House bill. "This is an amalgam of ideas that have been tested around here for five or six years."

One of the most highly debated provisions would grant tax breaks for medical savings accounts. Under such plans, individuals or their employers would buy a high-deductible insurance policy to cover catastrophic illnesses or injuries. At the same time, they would put tax-free money in special savings accounts to pay for office visits, prescription drugs and other routine medical costs.

Such an approach, Republicans say, would give workers greater control over their doctor and other health care choices than under most regular insurance plans, particularly managed-care plans, like HMOs. In addition, they say, medical savings accounts would reward people for keeping down health care costs.

"It's an ideal solution for many families that provides affordability, flexibility and portability," said Rep. Jim McCrery, a Louisiana Republican.

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