On July 6th, President Clinton and Governor Mel Carnahan of Missouri highlighted a legal analysis documenting how the Senate "Patients' Bill of Rights" passed last week would undermine state-based accountability provisions already available under current law. This review concludes that enactment of the Senate bill would be "far worse than were Congress to enact no measure at all."
In addition to highlighting this new analysis, the President detailed other serious shortcomings of the Senate bill, which passed just last week without attracting a single Democratic vote. Specifically, he pointed out that this legislation would fail to provide full protections to more than 135 million Americans; allow health plans to subject patients accessing emergency care to financial penalties; fail to guarantee real access to specialists; and establish a wholly inadequate enforcement mechanism that prevents plans from being accountable when they make harmful decisions. He stressed that the Congress is one vote away from achieving a majority vote for the bipartisan Norwood-Dingell legislation, which has been endorsed by over 200 health care provider and consumer advocacy groups. Finally, the President praised Governor Carnahan for his leadership in passing a strong state version of the Patients' Bill of Rights at the state level without having a negative impact on premiums or the number of uninsured.
Here are some of the details of what the Senate bill would do:
-- Leave more than 135 million Americans without the guarantee of full protections. Protections in the Senate bill, most of which are limited to self-insured health plans, would apply to only 2 percent of HMOs nationwide -- fewer than 1 in 10 people in managed care.
-- Allow health plans to subject patients accessing emergency care to high financial penalties. The amendment allows plans to penalize patients who did not receive prior authorization before going to the emergency room by requiring them to pay higher levels of cost sharing. Patients should not pay a high financial penalty because they did not have time to stop during their emergency and call their plan.
-- Fail to guarantee true access to necessary health care specialists. A plan could meet the requirements of the Senate bill by providing "access" to a specialist who was hundreds miles away from the patient or did not have an available appointment for months.
-- Fail to provide access to important clinical trials. The Senate bill limits access to clinical trials for patients with cancer. Patients with Parkinson's, Alzheimer's, multiple sclerosis, and other diseases would not be guaranteed access to appropriate clinical trials and potentially lifesaving treatments.
