Lobbyists take aim at new health care standards Patient's bill of rights, similar proposals likened to rejected Clinton plan


WASHINGTON -- 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 swung into action, with briefings for 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 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 exceeds 41 million, will rise.

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, summarized the situation in a confidential memorandum to her supervisor, Michael Fortier, a vice president of the association, 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."

She said that Lott and his aides had indicated 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.

Harned said aides to Republican leaders on both sides of the Capitol had urged the lobbyists to write a definitive paper "trashing all these bills."

Her memo shows the intensity of organized resistance to consumer protections that involve federal regulations or more laws.

The Health Insurance Association of America helped defeat Clinton's health plan in 1994 with a series of television commercials in which "Harry and Louise" lampooned the bureaucratic complexity of the proposal.

The National Federation of Independent Business, which represents 600,000 small business owners, galvanized opposition around the country, saying the president's plan would destroy jobs by imposing new health insurance costs on many employers.

Pub Date: 11/04/97

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