House begins health care debate
October 6, 1999
Web posted at: 10:58 p.m. EDT (0258 GMT)
WASHINGTON (CNN) -- House Republicans passed a package of health care tax breaks Wednesday in a prelude to an expected debate on Thursday of the so-called patients' bill of rights.
The GOP wanted to debate their tax-break bill first, hoping to shift attention to the estimated 44 million Americans who lack insurance and away from the White House-backed bill to strengthen patients dealings' with their insurance companies.
"We have to deal with access, affordability and choice in order to get quality," said Rep. John Shadegg (R-Arizona).
Democrats opposed the tax break bill saying that the plan would consume a portion of the Social Security surplus. The vote was 227-205, largely along party lines.
"This bill does nothing except to help the insurance companies and the well-to-do and the healthy," said Rep. John Dingell (D-Michigan).
Republicans have promised that they will not to invade the Social Security trust funds for other programs and they immediately refuted the accusation.
"There's nothing in this bill that invades the Social Security trust fund," retorted Rep. Bill Archer (R-Texas), adding that fact was certified by the Congressional Budget Office.
Meanwhile, the White House's Office of Management and Budget
accused the GOP of ulterior motives, saying the bill was
"explicitly designed to interfere with the passage of a
freestanding" patients' bill of rights.
The tax bill includes:
Tax breaks for individuals buying health coverage and long-term care insurance on their own.
A provision opposed by many Democrats that would allow more medical savings accounts, which let people opt out of the current health insurance market and buy high-risk plans on their own.
Plans to give small businesses the option to buy health insurance under federal rather than state regulation -- exempting them from state mandates that bigger self-insured companies now avoid.
The House now will move to the HMO issue, beginning with the bill offered by Dingell and Rep. Charlie Norwood (R-Georgia), supported by the White House and backed by some 20 Republicans. It was expected to pass until the House leadership offered its rules of debate that Democrats say endanger the bill.
The legislation is expected to cost several billion dollars over several years, and the rules do not allow for amendments to pay for the cost. Democrats say the rules proposed by the leadership will endanger the bill because they can't offer amendments on how to pay for the bill, which is cause for concern for conservative Democrats.
Minority Leader Dick Gephardt (D-Missouri) said the rules would cost a "sizeable number" of Democratic votes and put the entire legislation in jeopardy.
President BIll Clinton said the GOP leadership knows the bill will command a majority and acted to stop the bill through legislative tactics.
"Once again it appears that the will of the American people will be thwarted," Clinton said. "In the dead of the night last night, the House leaders concocted a process filled with enough poison pills and legislative sleights of hand to practically guarantee the defeat of this bill. It's a travesty."
But Republicans said they let the Democrats know the rules of debate. "The Democrats have moved the goal post again," said Rep. Porter Goss (R-Florida).
The GOP also accused Democrats of secretly maneuvering for the bill's defeat so they could continue to exploit the health care issue politically. "This last minute pay-for problem is a smokescreen for the fact that they want to play politics," said John Feehery, a spokesman for House Speaker Dennis Hastert of Illinois.
The legislation is opposed by the House leadership and would boost protections for people under managed care, including giving patients the right to sue health maintenance organizations (HMOs) in state courts.
The bill is backed by Democrats and appears to have enough support from the Republican majority to pass over the objections of GOP leaders.
But Clinton, speaking in the Rose Garden, said Republicans area blocking a bipartisan majority from passing the bill.
"The American people deserve more than partisan posturing and legislative gamesmanship on an issue this vital," he said.
Gephardt also tried to lure GOP presidential front-runner George Bush into the debate, urging him to push congressional Republicans to embrace regulations similar to those in a Texas state law.
In a letter to the Texas governor, Gephardt credited Bush's statements last week criticizing congressional Republican budget strategy with convincing some Republicans to back away from a plan to delay payments to lower-income Americans who benefit from the Earned Income Tax Credit.
Bush's comments led to internal GOP finger-pointing, as congressional Republicans criticized Bush for meddling in their affairs and giving Democrats fodder in the budget fight. Bush also criticized his party in a speech on Tuesday for being too harsh on social issues.
Gephardt's playful letter was sent in hopes of luring Bush into this week's debate over health care reform and other issues as well. "I hope this is just the first step you will take to provide guidance and to try to steer House Republicans towards the mainstream on a number of other critical issues we are considering this year," Gephardt wrote.
That bill would give patients a host of new rights in dealing with their health insurance companies. It would:
Make it easier to go to an emergency room or see a specialist
Give patients the chance to take their complaints to independent panels.
Allow patients who are still not satisfied the right to sue an HMO in court.
Three alternative GOP bills could be offered. The leading alternative gives patients the right to sue, but only in federal courts -- where damage awards are typically smaller -- and only under limited circumstances.
Hastert and other Republican leaders plan to back this legislation, reasoning it was preferable to the Dingell-Norwood version.
Still, even if the broader patients' rights bill passes the House, it must be reconciled with a much more limited version already approved by the Senate.
The Senate version lacked Democratic support and Clinton threatened to veto it, saying it would not do enough to make sure managed care plans give patients the care they need.