House Republicans are preparing this week to begin pushing insurance-reform legislation that aims to expand healthcare coverage of workers who change or lose jobs and work for small businesses.
The House GOP leadership's move to pass such legislation comes as similar legislation on the Senate side has picked up steam, despite resistance from some health insurers.
The House Economic and Educational Opportunities Committee is scheduled to begin work on a such a bill sponsored by Rep. Harris Fawell (R-Ill.), chairman of the committee's employer-employee relations subcommittee.
At the same time, House Republicans soon may begin pushing through committee a similar bill, sponsored by Rep. William Thomas (R-Calif.), chairman of the Ways and Means Committee's health panel.
House Speaker Newt Gingrich (R-Ga.) said last week that the two plans would be blended together to form a bill that would be, "essentially parallel" to the Senate plan sponsored by Sens. Nancy Kassebaum (R-Kan.) and Edward Kennedy (D-Mass.).
Both the Senate and House plans would guarantee that anyone who changes jobs or insurers would be covered regardless of pre-existing conditions. That provision is known by insurers as "group-to-group" portability and faces little opposition.
Where the plans differ relates to individuals who lose their employer coverage and seek individual coverage. The Senate plan would force insurers to offer coverage, while the House plan would not. Many insurers oppose the "group-to-individual" provision, arguing it will increase costs by as much as 30% because the individual policies will attract only the least healthy people.
The Health Insurance Association of America projects that costs for individual policies would increase by as much as 30%, but the American Association of Actuaries estimated only a 2% to 5% increases.
Republicans also are considering attaching malpractice and antitrust-reform legislation, both of which have begun percolating in the House Judiciary Committee (See related story, p. 58), to the insurance reform plan. However, provider groups are concerned that adding controversial provisions such as malpractice reform to the bill will make it more difficult to pass.
Observers said the leadership's efforts to move insurance-reform legislation may be part of a strategy to polish the House GOP's healthcare credentials as the November elections approach.
"In the whole question of economic insecurity, health insurance insecurity is a part of it," said James Scott, president of the AmHS/Premier/SunHealth Institute.
"It's good for the election," agreed Rep. John Porter (R-Ill.). "If there's anything that would give us a good deal of credibility with the American people, it would be to pass that legislation. It meets the needs of people who are at risk."