The Democrats Don’t Like HMOs

Democrats Continue Heavy Push for HMO Reform

By Helen Dewar and Michael Grunwald
Washington Post Staff Writers
Thursday, June 24, 1999; Page A8

Democrats yesterday intensified efforts in both houses of Congress to grab the offensive on legislation to regulate health maintenance organizations — an issue that both parties see as critical for next year’s elections.

Senate Democrats halted action in their chamber for a second day to force Republicans to schedule votes, while House Democrats started circulating a petition to bring their bill to a vote over the objection of GOP leaders.

"We’ll get votes," vowed Senate Minority Leader Thomas A. Daschle (D-S.D.). "It is either that or we’ll sit on the Senate floor looking at each other."

As of late yesterday, Republicans and Democrats were still at odds over procedures to schedule votes in the Senate. And, in the House, the Education and the Workforce Committee postponed action on a GOP managed-care bill because Republicans could not agree on its provisions.

Both parties have bills aimed at providing new protections for patients in managed-care plans, including new processes for review of patient grievances. But they differ in critical details, including the extent of government regulation and whether patients or survivors should be able to sue their health plans. Democrats generally favor more regulation than Republicans and want to expand access to lawsuits, while most Republicans would curtail them.

For their first vote, Senate Democrats want to focus on another key difference: who decides a patient’s treatment. They are pushing for immediate action on a proposal to require that doctors, rather than health plan officials, be empowered to decide what is "medically necessary" for a patient. The Senate Republicans’ bill is silent on that point, although it allows appeals to health professionals when treatment is in dispute. Critics argue that the Democrats’ proposal could drive up costs and threaten the financial viability of HMOs.