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HMO reform, tax cuts top agenda as Congress goes back to workJuly 11, 1999 WASHINGTON (AllPolitics, July 11) -- As Congress returns to work this week from its Fourth of July recess, HMO reform and sweeping tax cuts top the agenda -- and appear likely to trigger partisan fights between Republicans and the White House.
Clinton administration officials made it clear Sunday that they will oppose two Republican tax cut measures, one in the House and another in the Senate, that call for about $800 billion in tax relief over 10 years. Meanwhile, some Republicans made it clear that they won't go along with a Democratic "patients' bill of rights" proposal that lets patients sue their HMOs in some instances when coverage for medical procedures is denied, limited or delayed. Republicans say that will drive up the cost of medical insurance premiums and thereby increase the number of Americans without coverage. "Lawsuits should always be the last result, not the first action," said Sen. Majority Leader Trent Lott (R-Mississippi). "That's what Republicans believe in." As Clinton sits down with leaders of both parties Monday for a budget summit, the GOP has two competing tax cut plans on the table. House Republicans have proposed an $850 billion plan that would cut income tax rates across the board by 10 percent over the next decade, reduce capital gains taxes and allow parents to set up tax-deferred accounts to pay for their children's education at private schools. Senate Republicans have put forward a $792 billion, 10-year plan that would cut the lowest tax rate from 15 percent to 14 percent and eliminate the so-called "marriage penalty" paid by many two-income families. It does not include capital gains cuts or the education accounts, both of which are opposed by congressional Democrats and the White House. The GOP tax cut plans, which White House Chief of Staff John Podesta on Sunday termed a "dangerous binge," are more than three times as large as the $250 billion cut the White House is proposing. "The president has made it very clear that he will not sign any budget measure that doesn't put Social Security and Medicare first, that doesn't take those steps forward (and) certainly any measures that would put at risk the progress we've made in paying down the debt," said Treasury Secretary Lawrence Summers. Clinton himself, in an interview with the New York Times published Sunday, said GOP tax cut plans would bring back the deficit. "If you pay for their tax cut and their defense proposal, it would restore the deficit," he said. "It would be, I think, very dumb to restore the deficit if we can avoid it."
Republicans counter that their tax cuts will not threaten Social Security and Medicare and that they are as determined as the Democrats to shore up those programs. And they argue that if the federal government is collecting more tax money than it needs, some of the largesse should go back to the people who provided it in the first place. "If we're in that kind of surplus, we should allow people to keep more of their money," said Sen. Don Nickles (R-Oklahoma) on "Fox News Sunday." "Some people are paying way too much in taxes." Saying that Republicans and Clinton agree on the need to save Social Security and Medicare and pay down the national debt, Lott called on the president to negotiate seriously, rather than using the issue for partisan purposes. "I keep getting mixed signals from the president. I don't know if he wants to get some things done with cooperation or whether he is going to go the partisan route, the political route," Lott said on NBC's "Meet the Press." "We should lock up Social Security, we should have Medicare reform, including (covering the cost of) prescription drugs, and we should return the overpayment in terms of tax relief for working American families," he said.
On the issue of HMO reform, both Democrats and Republicans have put forward competing "patients' bill of rights" proposals that will come up for debate this week. Both sides agree that HMOs should be required to pay for emergency care and that patients should be able to get appointments with specialists, such as pediatricians or gynecologists, without waiting for referrals. However, Democrats want the bill to cover anyone in a managed care plan, while Republicans argue that it only needs to cover those in plans funded by their employers, which are not covered under new state HMO reform measures. And the major dispute is over a provision in the Democratic plan that would allow patients to sue their HMOs. Republicans are proposing a mechanism that would provide outside reviews of decisions to deny coverage without getting courts involved. Insurance and business groups have launched an ad campaign to convince consumers that the Democratic bill, sponsored by Sen. Edward Kennedy of Massachusetts, would drive up premiums and add to the ranks of the 43 million uninsured in America.
But Kennedy said Sunday that the premium increase for the average worker "will be the cost of one Big Mac a month," and he said people would be willing to pay that small amount to avoid what he called "second-class medicine." "I think most American workers want to make sure that when they have actually purchased health insurance, they're going to get the insurance they have purchased," Kennedy said on ABC's "This Week." "We're talking about patients' interests vs. insurance companies' profits." Both Kennedy and Senate Minority Leader Tom Daschle (D-South Dakota) indicated Sunday that they are not willing to compromise with the Republicans on the lawsuit provision in order to get a more limited HMO reform bill passed. "We're not going to give. We fought very hard to get to this point," Daschle said. "A meaningful patients' bill of rights is one of the most important things the American people want us to do." Correspondents David Ensor, Eileen O'Connor and The Associated Press contributed to this report, written by Richard Shumate. |
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