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Spokane, Washington  Est. May 19, 1883

Demos See Winning Strategy In Plans To Regulate Hmos

New York Times

President Clinton is preparing for another election-year battle over health care as he proposes sweeping new federal regulations for insurance companies and health maintenance organizations to protect patients’ rights.

A presidential advisory panel recommended last week a bill of rights for patients. But in urging Congress to translate the rights into law, Clinton went beyond the recommendations of the 34-member panel, which reserved judgment on who should enforce the proposed standards.

In advocating regulation, Democrats believe that they have a winning issue that resonates with voters, many of whom have had frustrating experiences with health maintenance organizations. White House officials said they would welcome a fight over the issue, which they expect will unite Democrats and divide Republicans in the election season next year.

Health insurance has historically been regulated by the states. Democrats see a clear need for federal laws and regulations to set standards for insurers and HMOs. More than a third of congressional Republicans, including some conservatives, support such legislation.

But the House Republicans’ floor leader, Dick Armey of Texas, and the Senate Republican leader, Trent Lott of Mississippi, adamantly oppose a new regulatory regime, saying it would increase the cost of benefits. The higher costs, they say, would force employers to cut back health benefits, increasing the number of uninsured Americans and whetting the public appetite for new government health programs.

On Thursday, Clinton enthusiastically endorsed the proposals, which would give consumers access to additional information about the quality of health plans, the right to appeal a denial of care or reimbursement and an assurance that medical records would be kept confidential. Similar proposals were in Clinton’s ill-fated scheme to redesign the health care system in 1993 and 1994.

Clinton is no longer proposing universal insurance coverage, a standard package of benefits or a requirement for employers to provide such benefits. But the president made clear that the old impulses, the yearnings for health security for all, are just below the surface.

“There is,” he said, “an emerging consensus that while people may not have wanted to bite the whole apple at once in 1994, almost the whole population wants to keep nibbling away at the apple until we actually have solved the problems of cost, accessibility and quality for all responsible American citizens.”

Karen Ignagni, president of the American Association of Health Plans, a lobby for HMOs, spoke for many in the industry when she said, “It’s beginning to feel a lot like 1993.”

Some members of the president’s advisory panel were stunned by the speed of his endorsement, which preempts much of the work that they had planned in the next four months.

The panel would never have achieved consensus if members had known that their recommendations would be the basis for new laws and regulations. Many members prefer using private accreditation agencies to insure compliance with the proposed standards.