NAHU
article on Medical Liability Reform Bill
Washington Update
February 11, 2003
Medical Liability
Congressman Jim Greenwood (R-PA) introduced a medical liability
reform bill on February 5. H.R. 5 is similar to the legislation
he sponsored during the 107th Congress, which passed the House
in September 2002. The bill would create a $250,000 cap on non-economic
damages, limit punitive damage awards to two times the economic
damage award or $250,000, and limit attorneys' fees. The House
Judiciary Committee is expected to take action this month with
the intent on bringing the legislation before the full House shortly
thereafter. The Senate Health, Education, Labor and Pensions (HELP)
Committee and the Judiciary Committee are holding a joint hearing
on patient access and medical litigation today, February 11. Texas
Insurance Commissioner Jose Montemayor and Dr. Shelby Wilbourne,
on behalf of the American College of Obstetrics and Gynecology
(ACOG) are among the individuals expected to provide testimony.
AHPs
The Senate Committee on Small Business and Entrepreneurship held
a hearing on February 5 to address health care costs for small
businesses. Committee Chairwoman Olympia Snowe (R-ME) and Senator
Jim Talent (R-MO) are expected to introduce legislation that would
authorize association health plans before the end of this month.
Representative Ernie Fletcher (R-KY) is also expected to introduce
legislation addressing association health plans. It will be similar
to H.R. 1774, which Fletcher sponsored during the 107th Congress.
U.S. Secretary of Labor Elaine Chao, Kansas Insurance Commissioner
Sandy Praeger on behalf of the National Association of Insurance
Commissioners, and Len Nichols on behalf of the Center for Studying
Health System Change were among the panelists that testified at
the hearing. The hearing was fairly balanced between those who
were for and those who were against AHPs, as is usual in this
type of hearing. We'll be in touch with you with further instructions
on grassroots efforts as the issue progresses.
President's Budget Proposal
President Bush released his budget proposal for fiscal year 2004.
The budget proposal includes funding for a refundable tax credit
to purchase health insurance. Individuals with incomes up to $30,000
and families with incomes up to $60,000 would be eligible for
credits up to $1000 for individuals and $500 for each dependent.
The President's proposal also contains provisions that would make
MSAs permanent and expand eligibility to include individuals and
employees of firms of all sizes covered by a high-deductible health
plan, which would permit deductibles as low as $1,000 for an individuals
and $2,000 for families. The current MSA provisions are set to
expire on December 31. President Bush also proposed allowing $500
of unused FSA funds to be distributed at the end of the year as
taxable income that could be distributed into an MSA or contributed
as a deferral to an employer-funded retirement plan.
The budget proposal contains an above-the-line tax deduction
for the purchase of long-term care insurance and an additional
tax exemption for caregivers. The deduction would be available
to individuals for the purchase of qualified long-term care insurance
and to individuals that pay at least 50 percent of the cost of
employer-sponsored coverage.
President Bush proposed some major changes to Medicare in the
proposal. Starting in 2006, beneficiaries would have a choice
of remaining in a traditional fee-for-service program, selecting
an HMO, or enrolling in a private health plan, of a type not currently
available to Medicare beneficiaries. Beneficiaries would have
an optional prescription drug benefit with a $275 annual deductible
and 50% coinsurance on drug costs up to $3,050 per year. Once
a beneficiary reaches an out-of-pocket limit of $5,500 in a calendar
year, Medicare would cover 90% of costs. It is estimated the benefit
will cost $388 billion over 10 years. This proposal differs from
the major proposals under consideration in the 107th Congress.
Which proposal comes out on top remains to be seen, but the budget
allocation of $400 billion will be an initial guideline as to
the breadth of this year's proposals.
Patients' Rights
Representative Charles Norwood (R-GA) has introduced two new proposals
that address patients' rights. The Patient Protection Act would
require individuals with managed care plans to have access to
emergency and pediatric care as well as prescription drugs and
access to an independent review process. Representative Norwood
has also proposed the ERISA Clarification Act, to reiterate the
Supreme Court decision in Rush v. Moran, that upheld at least
one state's external review law from ERISA preemption. Interestingly
enough, neither of the proposals included health plan liability,
the most contentious item from previous years' debates.
Other News
A press conference was held on February 4 rallying support for
new legislation sponsored by Representatives John Conyers (D-MI)
and Jim McDermott (D-WA). The United States Health Insurance Act
would create a single-payer health care system. The proposal would
finance the system through a series of additional individual and
business taxes. It is unlikely that this type of proposal will
get any serious consideration and this year's introduction is
similar to legislation introduced at the beginning of every new
Congress.
Senators Chris Dodd (D-CT) and Ted Kennedy (D-MA) introduced
legislation this week that would expand the Family Medical Leave
Act (FMLA) and allow states to provide up to six weeks of paid
leave. The proposal includes $400 million for a pilot program
that would provide states with the opportunity to try the six
weeks of paid leave. The proposal would also expand the FMLA to
employer groups with 25 or more employees.
The early bird registration deadline for Capitol Conference was
February 7. We are continuing our efforts on making sure this
year's conference will be exciting, informative, and provide NAHU
members with the opportunity to visit with their members of Congress
and their staff. The agenda and registration information is available
online at www.nahu.org.
If you have questions about any of these issues, contact Janice
Kupiec, Manager of State Government Affairs, at jkupiec@nahu.org,
or another member of the Government Relations staff: Janet Stokes
Trautwein, Vice President of Government Affairs, at jtrautwein@nahu.org,
Tom Bruderle, tbruderle@nahu.org, Vice President of Congressional
Affairs, Jessica Waltman, jwaltman@nahu.org, Director of State
Government Affairs, John Greene, jgreene@nahu.org, Manager of
Federal Affairs, Rachel Conant, Manager of Legislative Communications,
rconant@nahu or Melissa Lang, Legislative Assistant, mlang@nahu.org.
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