Congress pushed toward adjournment last week with consideration of several health-related measures, including the surprising revival of an immigration reform plan that hospital groups say could significantly increase uncompensated-care costs.
Meanwhile, President Clinton held a White House ceremony to sign legislation that requires health insurers to cover at least 48 hours of hospital care for new mothers and newborns, beginning in 1998. Mothers who undergo a Caesarean section are guaranteed 96 hours of hospital coverage.
The legislation also requires insurers to provide the same annual and lifetime spending limits for treating mental illnesses as they do for treating physical ailments.
Both measures were attached to a bill funding the Department of Veterans Affairs for fiscal 1997, which starts this week. Under the legislation, the VA healthcare system's budget will be $17 billion, up $387 million from fiscal 1996.
Meanwhile, Congress last week was working on several other measures that could affect healthcare providers. Among them:
The House passed immigration reform legislation that would prevent legal immigrants currently in the country from becoming eligible for Medicaid for five years if the income of the immigrant's sponsor exceeds poverty thresholds. Last month, Clinton signed into law a welfare reform bill that effectively bars future illegal immigrants from Medicaid for up to 10 years.
Hospital groups say the bill will increase uncompensated-care costs because hospitals still will be required to care for the immigrants.
The Senate was scheduled to debate the measure late last week. Democrats have opposed the immigration provision, and Republicans until last week had seemed ready to drop the measure. Minority Leader Thomas Daschle (D-S.D.) said the White House opposed the measure and threatened a veto if the bill were passed with the provision attached.
A ban on managed-care "gag clauses" restricting what physicians can tell patients about medical issues and treatment options. At deadline, Senate Republican leaders, who opposed the provision, were working with Democratic sponsors to find a compromise. Among the issues still outstanding was a GOP plan to create a physician data bank that consumers could review to find quality and accreditation information about a physician.
Legislation that would permit some Medicare-eligible military retirees to join Defense Department healthcare plans that would be reimbursed partly by Medicare.
Currently, Medicare-eligible retirees cannot join the military's Tricare managed-care plans. The Congressional Budget Office has devised a formula under which demonstration projects testing such an idea will not cost the Medicare Hospital Insurance Trust Fund any more money. That formula calls for Tricare plans to be reimbursed at 93% of the annual per-person fee-for-service cost of caring for Medicare beneficiaries, which is 2 percentage points less than nonmilitary Medicare HMOs receive. HCFA would contribute 50% of that fee-for-service cost to an escrow account, while the Defense Department would contribute 43%.
Supporters of the two latter measures were hoping congressional leaders would attach them to fiscal 1997 spending legislation that would cover numerous federal departments and agencies, including HHS.