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HMO, health reform falls victim of rush to end term
Saturday, October 10, 1998 By Jack Torry, Post-Gazette Washington Bureau
WASHINGTON -- Angry Democrats, including Rep. William Coyne, D-Oakland, sharply assailed Senate Republicans yesterday for killing managed care reform this year, a major legislative item for both President Clinton and congressional Democrats.
By a 50-47 vote, the Senate blocked a Democratic request to bring to the floor a bill the House approved in July to reform managed care providers, including health maintenance organizations. Even though Senate Democrats opposed the House plan, they hoped to radically alter it to their tastes through a series of floor amendments.
Sen. Arlen Specter, R-Pa., who is seeking re-election, was one of four Senate Republicans who joined 43 Democrats in a bid to bring the managed care package to the floor. The other Republicans supporting the package are all in close election races -- Al D'Amato of New York, Kit Bond of Missouri and Lauch Faircloth of North Carolina.
Within moments of the final vote, an army of Democratic lawmakers -- including Coyne, Sen. Edward Kennedy, D-Mass., and Reps. John Dingell and David Bonior, both D-Mich. -- marched to the Senate press gallery for an unusual meeting with reporters, at which they vowed to make managed care reform a major issue in next month's off-year congressional elections.
"I'm disappointed that the Senate of the United States would not even take up the issue, as we (hear) more and more stories about situations where people are dissatisfied," Coyne said. "I think that it's very unfortunate that the Senate wouldn't address that issue before they left here."
Bonior, the House minority whip, vowed: "We are going to take this issue to the country in this election. This will be an issue that we will talk about from this day forward until the election because the American people want something done about it."
Appearing at the White House with Clinton and House Minority Leader Dick Gephardt, D-Mo., Senate Minority Leader Tom Daschle, D-S.D., charged that Senate Republicans have killed what Democrats have dubbed as "the patients' bill of rights."
"It's over," Daschle said. "It's dead for this year -- a lost opportunity that we lament this afternoon."
Democrats had little chance of forcing Senate Republicans to consider the bill yesterday. With Congress set to recess either this weekend or early next week, there was little time to debate the scores of amendments that Democrats hoped to bring to the floor.
But Democrats have been eager to use the managed care reform issue against Republicans, believing that voters care more about the quality of their health care than about Clinton's sex scandal with former White House intern Monica Lewinsky.
The Democrats had supported a series of reforms that would let patients sue their HMOs when denied coverage, and force HMOs and managed care providers to guarantee access to emergency room procedures and care by specialists. Republicans argued that such suits would lead to higher insurance premiums for all Americans.
The House bill approved in July excluded lawsuits against managed care providers and, instead, established an independent board to allow patients to appeal decisions by their HMOs. The House bill also included conservative-backed medical savings accounts, which would let consumers buy less-expensive catastrophic insurance policies and pay routine medical costs from tax-exempt accounts.
Clinton threatened to veto any bill with the medical savings accounts, arguing that only the richest and healthiest Americans could take advantage of them, thus leading to higher insurance costs for lower- and middle-income people.
Besides Specter, Sens. Robert Byrd and Jay Rockefeller, both D-W.Va., voted to bring the Democratic bill to the floor. Sens. Rick Santorum, R-Pa., and Mike DeWine, R-Ohio, voted to kill it.
"Right now, I will go down to the floor of the Senate and ask for an up-or-down vote on the Republican proposal and the Democratic proposal," Santorum said. "We've been asking for that for three months. ... But we're not going to allow the demagoguery to take this thing and turn it into a political football for the next three or four weeks and just debating and debating.
"We were willing to give them three amendments. ... What they want to do is spend three or four weeks on the floor, having Ted Kennedy scream and shout about how lousy" the managed care system is today.
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