Congressional Republicans agreed last week to support two health coverage mandates opposed by insurance and business groups.
The first would require insurers to pay for a minimum hospital stay of 48 hours for new mothers who have a normal birth and 96 hours for those who have a Caesarean section.
The second provision would prohibit insurers from instituting stricter dollar limits on mental health coverage than on physical health coverage. The measure does not apply to firms with fewer than 50 employees.
In a nod to business groups that complained the measure would make insurance prohibitively expensive, Republicans agreed to exempt any firm that experienced more than a 1% annual increase in premiums as a result of raising the mental health limits. Because of the 1% cap, the bill's sponsors said the measure would have a minimal effect on insurance costs.
The mental health amendment, which was sponsored by Sens. Pete Domenici (R-N.M.) and Paul Wellstone (D-Minn.), was pared down from an earlier provision stricken from the recently enacted health insurance reform legislation. That version called for an equal package of benefits for mental health services and physical services. According to a study by Price Waterhouse, that would have increased insurance premiums by 8.7%.
While business and managed-care groups agreed that the two bills-approved by House-Senate negotiators-were much improved over earlier versions, they didn't endorse them.
"We are still opposed to them," said Julie Cantor-Weinberg, a spokeswoman for the National Association of Manufacturers. "They are mandates and a horrible precedent. The federal government should not be involved in the benefits area."
Both provisions are attached to a spending measure for the Department of Veterans Affairs. That bill calls for about $17 billion in health spending for veterans for fiscal 1997.
During the early stages of negotiations over the bill, the White House threatened to veto the measure, but recent Clinton administration comments have been softer toward the measure.
One other health-related matter still being bandied about by Congress is a measure designed to prohibit managed-care plans from restricting what physicians tell their patients about coverage or treatment issues.
The so-called "gag clause" provision had been attached to a Treasury Department spending bill. But GOP Senate leaders killed that measure, partly because of their opposition to the gag clause amendment.
Sen. Ron Wyden (D-Ore.) who sponsored the gag clause provision, said he will continue to work to attach it to other bills for the remainder of the legislative session, which is scheduled to end early in October.