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Copyright 1999 The Houston Chronicle Publishing Company  
The Houston Chronicle

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October 07, 1999, Thursday 3 STAR EDITION


LENGTH: 829 words

HEADLINE: House GOP passes insurance-related tax break


BYLINE: BENNETT ROTH, Houston Chronicle Washington Bureau


WASHINGTON - As the House commenced a heated debate over regulating managed care plans, Republican leaders Wednesday muscled through a series of tax breaks they said were intended to help individuals and businesses afford health insurance.

The package of incentives to increase health insurance access was approved 227-205 on a largely party line vote, with dissenting Democrats claiming the provisions were added solely to sour support for a broader package of HMO reforms.

The action, however, was merely a prelude to a more significant series of votes scheduled for today on managed care alternatives that would make it easier for consumers to appeal their HMO health care decisions and force the plans to provide basic services, such as access to the nearest emergency room.

And in a sign that they have capitulated to the demands of some of their members, GOP leaders have reluctantly thrown their support behind a managed care proposal that allows consumers a limited right to sue their managed care plan. The Senate has already approved a managed care plan that does not include the right to sue.

House Republicans said tax provisions are needed because of the growing number of uninsured Americans, which the Census Bureau reported this week stood at 44 million people. They added that Democrats' clamor for HMO reforms would mean little if consumers could not afford to purchase health insurance.

"Access and affordability is as important as providing patient protection," said Rep. Porter Goss, R-Fla. "A right without insurance is no right at all."

The package includes tax breaks for individuals who pay more than half the cost of their premiums, and for those who are caring for elderly family members at home. It would also make it easier for small businesses and individuals to band together to purchase cheaper health policies.

It would also expand a Medical Savings Account program, now capped at 750,000 taxpayers, which allows individuals to sock away money for medical expenses in tax free accounts.

Democrats, however, said the tax incentives would do little to address the concerns of many of the uninsured who do not make enough money to benefit from such breaks. They added that Medical Savings Accounts benefit only those who are healthy and have the money to save for extra expenses. They claimed that MSAs drain insurance pools of healthy beneficiaries, driving up costs for the sickly who cannot choose other options.

"This bill does nothing except to help the insurance companies and the well-to-do and the healthy," said Rep. John Dingell, D-Mich.

Democrats also objected to the fact that Republicans had not detailed how they would pay for the cost of the tax breaks, which are estimated to be $ 48 billion over 10 years.

They suggested the tax provisions were tacked on to force Democrats to vote against the overall health care legislation.

The Democrats were also angry that the Republicans had not allowed them to bring up amendments that would detail how they would pay for the managed care reform - a financing plan that some Democrats believe must be included in any bill they support.

Before the vote President Clinton accused the Republican leadership of "legislative gamesmanship " and spiking the bill with "poison pills and legislative sleights of hand to practically guarantee the defeat of this bill."

House Minority Leader Richard Gephardt, D-Mo., injected presidential politics into the debate by passing out a letter he sent to GOP front-runner George W. Bush, asking the Texas governor to use his influence to urge Republicans to approve the same kind of tough managed care regulations that he allowed to become law in Texas.

Texas is one of a handful of states that allows consumers the right to sue their managed care plans.

Gephardt noted that Bush should exercise the same influence on GOP lawmakers on the managed care issue as he did recently on the budget when he chided Republicans for trying to delay full payment next year of earned income tax credits to the working poor.

Bush spokesman Scott McClellan suggested that the governor supported legislation that included the right to sue managed care plans.

"He believes people in federal plans ought to have protections similar to those in Texas," said McClellan.

House members today will consider several managed care plans. One sponsored by Reps. Dingell and Charles Norwood, R-Ga., which is backed by most Democrats and some Republicans, provides for the broadest right to sue health plans.

Another health plan sponsored by Rep. Tom Coburn, R-Okla., and supported by House Speaker Dennis Hastert, R-Ill., would give consumers the right to sue but would only allow such suits in federal courts and would place limits on damages.

The managed care legislation has been the target of an aggressive lobbying effort, with business and insurance interests opposing the measure and doctors, consumers groups and trial lawyers supporting it.

LOAD-DATE: October 8, 1999

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