The Senate on Tuesday passed legislation to make health insurance portable from job to job, in a 100-0 vote that masked months of uncertainties, compromises and difficult persuasion.
The legislation sponsored by Sen. Nancy Kassebaum, R-Kan., and Sen. Edward Kennedy, D-Mass., still faces a difficult conference with the House, which passed a different version last month, but election-year anxieties appear to have given the measure irresistible political momentum.
The core of the bill - common to both House and Senate versions - is a provision that would require insurers to cover workers under a new employer’s plan if their last job carried insurance. It would also sharply limit any exclusions for preexisting medical conditions.
If that core becomes law, it would be at once the palest shadow of President Clinton’s failed universal health insurance plan of 1994, and the most sweeping federal health legislation since Medicare and Medicaid were established in 1965.
The obstacles to passage are the elements that go beyond the core: House provisions for personal medical savings accounts and limits on medical malpractice lawsuits, which Clinton and most Democrats oppose, and a Senate requirement that insurers cover mental health as generously as they cover physical health, which business fears as costly.
Advocates of the bill cite a General Accounting Office study to contend that it would free 25 million to 30 million Americans of “job lock,” a reluctance to change jobs because their existing health problems might disqualify them from new coverage.
But the measure is equally important as a forceful step by the federal government into the rules of health insurance.
Kassebaum sought to minimize that potential Tuesday by declaring that the bill was not even a “Trojan Pony.”
But if Washington can set rules on “portability” and pre-existing conditions, then logically it could someday go further by requiring lifetime benefit limits of at least $10 million, requiring equal treatment for mental health, or acting on pricing, benefit packages and guaranteed access to insurance.
xxxx KEY PROVISIONS The bill would require insurers to cover workers under a new employer’s plan if their last job carried insurance. It would also sharply limit exclusions for preexisting medical conditions.