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July 21, 2000

WEEKLY UPDATE for July 21, 2000

***LEGISLATIVE UPDATE
Patient Protections- the Battle Moves from Congress to the Press!
Labor-HHS Appropriations Bill May Include Patient Protections
***WELCOME NEW MEMBERS OF THE 911 LEGISLATIVE NETWORK!

***LEGISLATIVE UPDATE

The House and Senate were preoccupied this week with political positioning in anticipation of the party conventions in August. Congressional leaders would like to have as many appropriations bills completed before they leave at the end of this week for the month-long August recess. Republicans were equally interested in passing tax relief measures, including a bill to eliminate the marriage penalty. This bill, like the one that would eliminate federal estate taxes, is headed for a presidential veto.

Patient Protections-the Battle moves from Congress to the Press!

In Congress...
The Republican House and Senate conferees met on Thursday night in an attempt to break the recent stalemate — no movement was reported! Rep. Charlie Norwood (R-GA) conferred with Democrats and the AMA in an attempt to reach a compromise that a few additional vulnerable Republicans in the Senate might embrace. Speaker Hastert (R-IL), Rep. Bill Thomas (R-CA), and several other conferees are working to develop legislation that will move some of the 68 Republican who voted for the Norwood-Dingell bill toward a version of Sen. Don Nickles' (R-OK) amendment.

Rep. Thomas would like to "deliver the AMA back to the Republican fold" and he believes a modified Nickles bill, acceptable to the AMA, can pass both houses. Rep. Thomas told ACEP this week that "he wants the issue off the table so that we can get down to the serious business of Medicare reform and a prescription drug benefit." Many House Republicans share Rep. Thomas' sentiment, fearing intense criticism from Democrats and constituents alike if they fail to produce a bill the President can sign. ACEP has worked with Hill staff to recommend changes to the emergency services provisions in the Nickles bill. Check the following URL for suggested changes to Senate Amendment 3694 to HR 4577: http://www.acep.org/library/index.cfm/ID/2056 For an explanation regarding these changes see: http://www.acep.org/library/index.cfm/ID/2057

In the Press...
On July 19, a group of 22 health insurers and two trade associations working in concert as the "Coalition for Affordable Quality Healthcare" released a proposal of voluntary health reforms. These same health insurers have spent tens of millions of dollars on lobbying campaigns to defeat patient protection legislation. Some of the proposed initiatives are: a "prudent layperson-like" statement (that does not meet ACEP's criteria); direct access to OB/GYNs and pediatricians; a review process for denials of care; and efforts to streamline the administrative burden for physicians and other providers. The Coalition claims that this is just the beginning of their efforts at voluntary reform. Their web site is accessible at http://www.caqh.org/.

ACEP, other medical specialty societies, and the American Medical Association claim the insurance industry's efforts were politically motivated to prevent passage of an effective patients' bill of rights containing enforcement measures allowing patients' to sue their insurers. Larry Levitt, chief health care analyst for the Kaiser Family Foundation, declared that the effort "signals a real shift" in health plans' operations. While the LA Times reported that the initiative was prompted by health insurers "growing realization that their marketplace will slip away from them if something is not done to quell outrage and dissatisfaction among consumers, doctors and hospitals."

House Labor-HHS Appropriations Bill May Include Patient Protections

On June 29th, the Senate passed their Labor-HHS Appropriations bill that, by a 51-47 vote, included an amendment offered by Sen. Don Nickles (R-OK). This amendment of patient protections does not reflect ACEP's preferred language on emergency services that was included in the Norwood-Dingell bill (HR 2990). (See the Weekly Update from June 30 for details on the Nickles' Amendment.) On July 19, the House passed their version of the Labor-HHS Appropriations bill.

Now the House-Senate Conference is scheduled to meet next Tuesday, July 25. Conferees must settle differences between discretionary funding levels, the Senate is at $106 billion and the House offered $99 billion. Major disagreements remain on how the money is distributed in the bill. In addition, these bills contain funding for poison control centers: $20 million in the Senate version versus $6.6 million in the House bill. There is also funding for trauma center planning: $3 million in the Senate version versus zero funding in the House bill. Hill staff told ACEP that conferees would likely settle on a total of $13.6 million for poison control centers.

Yesterday Ranking Member of the Appropriations Labor, HHS Subcommittee, Rep. Dave Obey (D-WI) claimed he was willing to use the Nickles' Amendment as a negotiating vehicle to resolve differences in patient protection legislation. While Rep. Obey said that he would rather have the differences worked out in the stalled House-Senate Patient Protection Conference Committee, he was not willing to give up the last opportunity to negotiate a patients' bill of rights this year.

Senate Labor-HHS Conferees

Senators Robert Byrd (D-WV), Thad Cochran (R-MS), Larry Craig (R-ID), Pete Domenici (R-NM), Dianne Feinstein (D-CA), Slade Gorton (R-WA), Judd Gregg (R-NH), Tom Harkin (D-IA), Fritz Hollings (D-SC), Kay Hutchison (R-TX), Daniel Inouye (D-HI), Herb Kohl (D-WI), Jon Kyl (R-AZ), Patty Murray (D-WA), Jack Reed (D-RI), Arlen Specter (R-PA) and Ted Stevens (R-AK)

House Labor-HHS Conferees

Reps. John Porter (R-IL), David Obey (D-WI), Bill Young (R-FL), Henry Bonilla (R-TX), Ernest Istook (R-OK), Dan Miller (R-FL), Jay Dickey (R-AR), Roger Wicker (R-MS), Ann Northrup (R-KY), Duke Cunningham (R-CA), Steny Hoyer (D-MD), Nancy Pelosi (D-CA), Nita Lowery (D-NY), Rosa DeLauro (D-CT), Jesse Jackson (D-IL)

WELCOME NEW MEMBERS OF THE 911 LEGISLATIVE NETWORK!

Robert Colligan, MD (Rep. Billy Tauzin R-LA)
Steven Conrad, MD, PhD, FACEP (Rep. Jim McCrery R-LA)
William Curran, MD (Rep. William Jefferson D-LA)
David DuBois, MD, MS, FACEP (Rep. Howard Coble R-NC)
Kevin Jordan, MD, FACEP (Rep. William Jefferson D-LA)
Leslie Kram-Greco, DO, FACEP (Rep. Chris John D-LA)
Charles Sea, MD, FACEP (Rep. David Vitter R-LA)
Michael Sucher, MD, FACEP (Rep. Matt Salmon R-AZ)
Chris Trevino, MD (Rep. Billy Tauzin R-LA)
Paul Windham, MD (Rep. Gary Condit D-CA)