Buoyed by last week's enactment of the health insurance reform bill, congressional Republicans said they would push for other healthcare reforms before the November elections.
Rep. William Thomas (R-Calif.), House Ways and Means health subcommittee chairman, said he had been appointed by House Republican leaders to "identify areas where we have general agreement" on Medicare reforms that could be passed before Congress recesses. Congress is expected to break about a month before the November elections.
Among the possible areas under consideration, according to Thomas, are:
Moving Medicare physician reimbursements to a single conversion factor. The conversion factor is the dollar value that is multiplied by the relative value of each service to yield the physician reimbursement. There are currently separate conversion factors for primary care, surgery and other services. Both the Clinton administration budget and the GOP balanced-budget plan called for a single conversion factor.
Changing the way Medicare managed-care plans are reimbursed. Both budgets would have reduced the disparity that currently exists because Medicare managed-care reimbursements are determined on a county-by-county basis.
Graduate medical education reforms. The Ways and Means health subcommittee held hearings earlier this year on graduate medical education, and Republicans and Democrats alike said they would push for reform.
One area that won't be addressed, Thomas said, is opening Medicare to provider-sponsored networks. That issue was controversial during the budget negotiations last year. Thomas said that, "because of the antitrust changes needed," allowing PSNs to contract directly with Medicare "might run into a roadblock."
Sen. Nancy Kassebaum (R-Kan.), one of the two chief sponsors of the health insurance reform bill signed into law last week, said she also believed more legislation could be passed this year. Kassebaum said Republicans were likely to push a measure to reform the Food and Drug Administration.
The bipartisan mood was precipitated by Clinton's signing of the Health Insurance Portability and Accountability Act last week.
The bill requires insurers to provide health insurance, regardless of health status, to anyone who loses employer coverage because they change or lose a job. Insurers also would be required to offer insurance to small firms regardless of claims history or the health status of workers.
The bill also contains new fraud and abuse provisions, a medical savings account demonstration project and a requirement that the federal government give guidance to providers who want to collaborate.
On hand for the White House signing ceremony were several hundred hospital and managed-care executives, physicians and other healthcare professionals, including Gail L. Warden, immediate past chairman of the American Hospital Association.
The occasion wasn't completely free of partisan sniping.
Reflecting GOP concerns that voters will give Clinton credit for passage of the insurance reform plan, Republican National Committee Chairman Haley Barbour held a press conference prior to the signing ceremony at which he said the president's support for the plan was an election-year ploy.
"The (health insurance reform plan) could have been passed three years ago, were it not for Clinton's wrong-headed scheme to create a government-run healthcare system," he said.