Seeking to take control of the debate on managed-care reform, House Republicans rolled out eight bills last week targeting different facets of the issue.
The most ambitious measure in the scattershot legislative approach was introduced by Rep. John Boehner (R-Ohio), chairman of the House Education and Workforce employer-employee relations subcommittee.
Boehner's bill would subject managed-care plans to independent external reviews, through which legally binding decisions would be made about whether the disputed services should be covered. Plans could be sued only if they refused to comply with those decisions.
Of the seven other bills targeting specific areas of managed-care reform, four would allow enrollees to:
* Have direct access to OB/GYNs and bypass "gatekeeper" internists.
* Obtain information about covered and uncovered services, written in layman's terms.
* Choose a pediatrician as a child's primary-care doctor.
* Obtain access to emergency room care without prior authorization.
Three measures would:
* Eliminate gag rules, which prohibit physicians from discussing treatments that aren't covered by plans.
* Provide for the formation of a patient-protection commission to develop and revise guidelines for health plans.
* Create association health plans, which would allow small employers to pool their resources and purchase health insurance for their employees.
All eight bills apply to only federally regulated health plans formed under the Employee Retirement Income Security Act of 1974, or ERISA.
John Stone, a spokesman for Georgia Republican Rep. Charlie Norwood, said the eight bills developed by the subcommittee marked an improvement over the GOP-written bill that passed the House this year. Norwood has drafted a competing patient-protection package for the House Commerce Committee.
Meanwhile, House Democrats said they will begin circulating a petition that could force the House to vote on another managed-care reform package, authored by Rep. John Dingell (D-Mich.), senior Democrat on the House Commerce Committee.
The petition would require the signatures of 218 members-39 more than the number of sponsors of the bill-to force the House vote.
Republicans, who have a slim majority in the House, vowed to fight the petition and Dingell's bill.
In the Senate, Finance Committee Chairman William Roth Jr. (R-Del.) said he and ranking Democrat Sen. Daniel Patrick Moynihan (D-N.Y.) could not agree on their own managed-care bill. Roth said he would try working with other committee members on a proposal.
Senate Minority Leader Tom Daschle (D-S.D.) said if the Republican leadership doesn't agree to a debate on patient-protection legislation, he will try to attach reforms to other Senate bills.
-With Jonathan Gardner