Provisions to encourage medical savings accounts and limit providers' malpractice liability may undo historic health insurance legislation passed by the House last week.Republican leaders hailed the bill as a needed step toward healthcare reform. House Ways and Means Committee Chairman Bill Archer (R-Texas) said the plan "strikes a balance between doing too much and doing too little."But Democrats said the special-inter est provisions in the bill would lead to its demise, ultimately quashing any chance of healthcare reform legislation this year."Loaded down like a Christmas tree, this will suffer the same fate as a Christmas tree-dumped on the fr ont lawn," said Rep. John Dingell (D-Mich.).By a 267-151 vote, the House passed Republican-sponsored insurance legislation designed to expand health coverage by increasing workers' ability to retain their insurance when they change jobs or lose their employer-sponsored coverage. It would do so by requiring insurers to offer coverage to employers and limiting the ability of group health plans to exclude people who have pre-existing conditions. The bill also would require states to develop ways for workers covered by group plans to convert to individual policies.On the Senate side, the movement to expand the original insurance reform bill gained steam when conservative Senate Republica ns said they would seek to amend the stripped-down Senate health-insurance measure introduced by Sens. Nancy Kassebaum (R-Kan.) and Edward Kennedy (D-Mass.) to include contentious provisions to encourage medical savings accounts an d limit malpractice awards. Another measure that may be offered is one sponsored by Sen. James Jeffords (R-Vt.) that would raise the lifetime insurance benefit cap to a minimum of $10 million.But Clinton administration officials la st week threatened a presidential veto if Congress passes a plan that includes medical savings accounts.George Stephanopoulos, White House senior adviser to the president, told a conference sponsored by the Federation of American H ealth Systems that medical savings accounts would "weaken the overall (healthcare) system" by allowing the healthiest people to opt out of the insurance pool.Arguing that malpractice-law reform is necessary to reduce healthcare c ost inflation and make health coverage more affordable, Republican leaders also included a measure that would cap awards for noneconomic damages at $250,000 and limit providers' liability for noneconomic damages only to their share of the blame.Another controversial provision included in the GOP plan would expand the availability of medical savings account plans for non-Medicare beneficiaries by making contributions to such accounts tax deductible up to $2,0 00 for an individual and $4,000 for families.Several provisions sought by physician groups didn't make it into the insurance reform package, however. The American Medical Association sought unsuccessfully to include antitrust refor ms that would make it easier for physicians to discuss fees without violating antitrust laws and to exempt physician-owned laboratories from federal regulations governing clinical labs.
THE WEEK IN HEALTHCARE;INSURANCE REFORM IMPERILED BY ADD-ONS
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