Hearing of the Senate Health, Education, Labor and Pensions Committee: Regulating Health Insurance
HEARING OF THE SENATE HEALTH, EDUCATION, LABOR AND PENSIONS COMMITTEE
REGULATING HEALTH INSURANCE
CHAIRED BY: SENATOR JAMES JEFFORDS (R-VT)
430 DIRKSEN SENATE OFFICE BUILDING
WASHINGTON, DC
10:00 AM.
MARCH 11, 1999, THURSDAY
BREAK IN TRANSCRIPT
SEN. MICHAEL B. ENZI (R-WY): Thank you. And I would ask unanimous consent to include a statement in the record.
BREAK IN TRANSCRIPT
SEN. MICHAEL ENZI (R-SY): Thank you, Mr. Chairman, and I appreciate the information that the witnesses have provided.
Mr. Thomas, did the commission formally endorse the legislative approach to implementing a bill of rights?
BREAK IN TRANSCRIPT
SEN. ENZI: Part of your testimony, you talked about disabilities and direct access for people with disabilities or other conditions requiring repeated visits to a specialists and that was a part of the advisory commission's recommendation. But it did also recommend reasonable authorizations as required under an approved treatment plan. Why did the commission think it was important to allow plans to work with the treating physician to outline a prospective course of treatment and access?
BREAK IN TRANSCRIPT
SEN. ENZI: Thank you.
Mr. Scanlon, in surveys that you did on the states, did they give the impression that they could comment on either the efficacy or the cost of their health care protections?
BREAK IN TRANSCRIPT
SEN. ENZI: Do you have any idea how many-you mentioned that a lot of them are new. Do you know how many bills
there are currently pending before state legislatures?
BREAK IN TRANSCRIPT
SEN. ENZI: Thank you.
Ms. Sebelius, obviously the states are working on this problem as well. If the federal government regulates employee plans under ERISA and the states regulate fully ensured plans, does this set up an overlapping regulatory structure? Do you see conflicts?
BREAK IN TRANSCRIPT
SEN. ENZI: Thank you.
I noted that the states were given that right in 1944, and that was a very important year for me. -- (laughter) -- And I'm aware of some of the things that Wyoming's been doing in these areas because I used to be on the labor committee, which handles health in Wyoming as well. And we passed an any willing provider statute, which forces managed care companies to contract with any interested doctor in the plan service area. Now I realize I didn't that would have a devastating affect in, perhaps, Massachusetts, but it works well in Wyoming. And so we're interested in persevering some of these states rights in making sure that the plans don't take away from that.
And I'd yield back the small balance of time that I have.
BREAK IN TRANSCRIPT
SEN. ENZI: Thank you, Mr. Chairman.
BREAK IN TRANSCRIPT
SEN. ENZI: Thank you, Mr. Chairman.
Ms. Ignagni, I noticed your chart that showed the patchwork system of regulation and of course I couldn't see it very well, even though I'm fairly close to it. So I hope we'll get copies of that. But it occurred to me that there --
SEN. ENZI: Oh okay.
It also occurred to me that there are a lot of different kinds of plans and each of those adds some confusion too. And I don't think you were suggesting that we ought to reduce the number of plans that there are, the number of types of plans. Also would federal legislation that creates a national and then allows states to enact even stronger requirements result in a more streamlined system of regulation than the current patchwork? Would that clear up some of those things?
BREAK IN TRANSCRIPT
SEN. ENZI: Thank you.
MS. IGNAGNI: You're welcome.
SEN. ENZI: Uh, Mr. Pollack, in listening to your comments, it sounded like you're anticipating that all consumers do have insurance at the present time. And I'm reminded frequently that it is a voluntary system of medical insurance that we have at the moment. In fact, in my last job I was an accountant and one of my clients was recognizing that they were spending almost $400 a month per employee on health insurance. And the employees didn't even know it, kind of. I mean it was there-but it really-so they thought that maybe since they were having some complaints on the amount of coverage that there was that they would see if the employees wanted to spend the $400 their own way or continue the plan. And it was a terrible mistake to ask that because most of them wanted to take the $400 and not put it into insurance. It was quite a shock to the company to find out that more than half of the employees really wished they had $400 instead of insurance.
Do you think that all the consumers would benefit from a far reaching Patient's Bill of Rights including, those who would not have any insurance at all, recognizing that there might be some companies that would drop the coverage?
BREAK IN TRANSCRIPT
SEN. ENZI: But you're suggesting that it takes the federal government to make that decision?
BREAK IN TRANSCRIPT
SEN. ENZI: Your comments remind me of a letter that I got from one of my constituents. It said, watch out for some of the things they are talking about under Patient's Bill of Rights. Some people-see if I can give them proper credit on this-but some people don't think that the ship that's being steered is the right ship. So, they don't care if it wrecks at all.
BREAK IN TRANSCRIPT
SEN. ENZI: Thank you. My time has expired.
BREAK IN TRANSCRIPT
SEN. ENZI: I won't impose.
BREAK IN TRANSCRIPT
SEN. ENZI: And, Mr. Chairman, they will get some questions.
BREAK IN TRANSCRIPT