As the partisan showdown over managed-care legislation heats up, two of the nation's largest hospital groups are wading into the fray-perhaps not wanting to be left at the dock.
One group, the St. Louis-based Catholic Health Association, said last week that it supported enacting federal legislation this year to protect managed-care enrollees.
The other, the American Hospital Association, which long ago declared its opposition to federal legislation, seems to be wavering a bit.
While still trumpeting a private-sector solution to ensure patients' rights, the AHA has warmed up to a House Republican task force proposal for a managed-care bill.
The AHA has commended it for seeking a balance "between the concerns consumers have about access to quality healthcare and the concerns of those who oppose overly burdensome federal regulation."
But this bend in the AHA's position on such a highly volatile political topic wasn't made widely known.
A statement from AHA President Richard Davidson was crafted July 1, shortly after the House Republicans released the outline of their plan, but it wasn't publicly released.
Richard Wade, the AHA's chief spokesman, said the statement was put together as internal guidance for staff. At the time, the AHA hadn't seen the final legislative language, so it was handicapped by a lack of details.
"We just wanted to have something general in hand if we were asked," Wade said.
The House Republican proposal reforms medical malpractice laws, gives women direct access to OB/GYN specialists and expands the ability of patients to appeal coverage decisions (June 29, p. 2).
"This is the best of all the alternatives that have been presented thus far," said Richard Pollack, AHA executive vice president for government and public affairs. "Politically, it's clear that Congress is going to deal with legislation in this area."
The House Republicans' task force, headed by Rep. J. Dennis Hastert (R-Ill.), finally introduced its reform plan as a bill late last week. At deadline, the AHA said it would be reviewing the bill's language.
But another hospital alliance, San Diego-based Premier, is so far standing firm in its opposition to managed-care legislation. Premier is part of an employer coalition that openly opposes such legislation (May 4, p. 8).
However, Premier's spokeswoman, Laura Yandell, said the group is reviewing all the legislative proposals coming out of Washington.
The latest measure from the House joins the mix of other reform proposals, including a patients' bill of rights sponsored by the Democrats and the notable "Patient Access to Responsible Care Act," sponsored by Rep. Charlie Norwood (R-Ga.), a dentist.
In laying out its position, the St. Louis-based CHA also appears to generally be in line with the Republicans and employer groups. The CHA represents about 1,200 Catholic healthcare providers.
"There's a certain practicality, a bit of a recognition that there is a train leaving town on this legislation," said William Cox, CHA executive vice president.
While the CHA is waiting for more details before it acts on any specific bill, the group has spelled out several of its policy positions, including:
Support for an emergency-care standard that requires health plans to pay for emergency room visits if a "prudent layperson" would think the trip was necessary.
Support for a system of review, appeals and grievances of health plan coverage decisions.
Opposition to requirements that plans provide morally objectionable services, such as abortions.
Opposition to health plan point-of-service requirements, which would allow enrollees to go outside their managed-care networks for care.