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Proposed Health Care Standards Fought Republican Leaders Mobilize Medical, Business Lobbies

TUESDAY, NOV. 4, 1997

Business and insurance lobbyists who helped kill President Clinton’s health plan in 1994 are mobilizing a new campaign to block more modest proposals that would set federal standards for the quality of care.

Republican leaders of Congress are urging the lobbyists to step up their activities against an array of health care bills backed by consumer advocates as a way to protect patients in a turbulent medical market.

The lobbyists, from groups like the Health Insurance Association of America and the National Federation of Independent Business, have briefed congressional aides and plans for a grass-roots campaign to fight the legislation. They see the proposals as an effort to accomplish, in an incremental way, some of the goals that Clinton pursued with his plan for national health insurance.

A presidential advisory commission is drafting a bill of rights for patients. Legislative proposals are proliferating on Capitol Hill, and lawmakers of both parties say they may prove irresistible in an election year. Some bills are narrowly focused and would, for example, require insurance companies to cover 48-hour hospital stays for women undergoing mastectomies. Others are more comprehensive and would prescribe detailed standards for the operation of health plans, which have constrained costs, in part by limiting patients’ choices.

Insurers, employers and Republican leaders contend that the proposed new regulations will raise the cost of health benefits. As a result, they say, employers will cut back coverage, and the number of uninsured people, which now exceeds 41 million, will rise further.

The Senate Republican leader, Trent Lott of Mississippi, and his deputy, Don Nickles of Oklahoma, organized a briefing for aides to Republican members of Congress on Friday.

Lott and Nickles announced the session in letters that said ominously, “Clinton Care Returns: the Trojan Horse Strategy.”

The letters, to Republicans on Capitol Hill, said: “A flurry of health care legislation has been introduced in both the House and the Senate this Congress which propose sweeping new federal mandates and control over the private health care market. While many have described these proposals as ‘quality’ bills, it is clear that these initiatives are a Trojan horse for implementing the once-defeated Clinton health plan.”

Melody Harned, federal affairs counsel at the Health Insurance Association of America, summmarized the situation in a confidential memorandum on Oct. 22.

“The message we are getting from House and Senate leadership is that we are in a war and need to start fighting like we’re in a war,” Harned wrote. “Republican leadership is now engaged on this issue and is issuing strong directives to all players in the insurance and employer community to get activated.”

Harned said that Lott’s officeindicated that “Senate Republicans need a lot of help from their friends on the outside” if they are to withstand the pressure for federal regulation of health insurance and managed care.

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