[Congressional Record Volume 140, Number 29 (Wednesday, March 16, 1994)]
[Senate]
[Page S]
From the Congressional Record Online through the Government Printing Office [www.gpo.gov]


[Congressional Record: March 16, 1994]
From the Congressional Record Online via GPO Access [wais.access.gpo.gov]

 
                         WORKERS' COMPENSATION

  Mr. THURMOND. Mr. President, I rise today because this body stands on 
the threshold of what promises to be a historic debate concerning 
health care. While it is generally recognized that our health care 
system is in need of reform, we are nevertheless a long way from 
consensus as to what to do. The public will be watching Congress 
closely; therefore, we must make sure that whatever changes occur in 
our health care system are for the better. Our constituents expect a 
lot.
  In that regard, Mr. President, I want to take a few minutes to focus 
this body on one critical aspect of health care: Workers' compensation. 
As a member of the Committee on Labor and Human Resources, this topic 
will be of prime importance to me and, I hope, to many of you as health 
care reform proceeds.
  Workers' compensation was created over 80 years ago and is the result 
of a commonsense compact between business and labor. If a worker is 
injured on the job, all of his or her medical expenses are covered, and 
disability payments, in lieu of paychecks, are made until the worker 
returns to the job. In return, the injured worker agrees not to sue his 
or her employer to receive compensation for the injury. Thus, both 
business and labor have the certainty that an injured worker will not 
suffer financially and, equally important, will be given medical care. 
The goal of workers' compensation is simple: Get an injured worker back 
to work and normalcy as soon as possible.

  Mr. President, workers' compensation has always been a State-managed 
system, and various States have operated their systems differently. 
Private insurance companies provide converge in many States, while 
other States operate their own workers' compensation funds. While the 
financial condition of workers' compensation programs has varied and 
continues to vary widely, States have always had the freedom and 
flexibility to experiment with new ideas and approaches to improve the 
system. In the last few years, several States, such as California and 
Florida, have reformed their workers' compensation programs. Currently, 
dozens of workers compensation legislative proposals are pending in 
various State legislatures.
  Of all the various health care proposals now under consideration, 
only the President's plan addresses workers' compensation. The 
remaining proposals--be they Democratic, Republican, or both--do not 
address workers' compensation and, therefore, leave the present system 
unaffected. While I understand the President's desire to include as 
many of our health care delivery systems under the umbrella of reform, 
I am hesitant to support the inclusion of this traditionally State-
controlled system in any Federal legislation. If workers' compensation 
is included, however, there are several key principles against which 
any proposal must be judged.
  First, workers' compensation must remain a State, rather than a 
Federal, system. In that regard, various State reforms should not be 
disturbed. Second, insurers or employers who foot the bill for medical 
care should continue to have significant decisionmaking authority. 
Third, experience rating--which encourages a safe workplace--should be 
maintained; and lastly, workers' compensation, as the exclusive remedy 
for an injury, must be preserved.6
  While there are many things we should not change, let me add how 
health care reform could improve workers compensation. Simply put, 
health care reform must help end the massive cost shifting onto 
workers' compensation that currently occurs. This could be accomplished 
by legislatively prohibiting workers' compensation programs from being 
charged more for medical services than other programs. Combined with 
new access to all types of benefits and delivery systems, this cost-
shifting prohibition could be of significant benefit to workers' 
compensation programs in every State.
  Mr. President, workers' compensation has been the subject of great 
attention not only by those who administer workers compensation 
programs, but also by numerous business and insurance groups who are 
greatly concerned that health reform causes no harm to this program. In 
that regard, I would like unanimous consent to include, after my 
remarks, statements by the International Association of Industrial 
Accident Boards and Commissions, the National Association of 
Manufacturers, the U.S. Chamber of Commerce, the National Federation of 
Independent Business, and the Alliance of American Insurers, which 
address workers compensation.
  Mr. President, as the debate over health care proceeds, I urge my 
colleagues to be mindful of workers' compensation and to judge any 
proposal to change this program by the principles I have just outlined. 
Any changes to workers' compensation at the Federal level must not harm 
this vital program.
  I ask unanimous consent that material pertaining to this subject be 
printed in the Record.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

      International Association of Industrial Accident Boards and 
     Commissions--Resolution Regarding National Health Care Reform

       Whereas the President of the United States is committed to 
     providing every American access to quality health care; and.
       Whereas the Administration has proposed to integrate 
     workers' compensation medical coverage into the health care 
     package provided to Americans; and,
       Whereas the International Association of Industrial 
     Accident Boards and Commissions (IAIABC) is an organization 
     of workers' compensation Administrators and Commissioners; 
     and,
       Whereas the primary interest of the IAIABC is to improve 
     the effectiveness and efficiency of workers' compensation 
     systems; and,
       Whereas state workers' compensation laws already provide 
     universal health care for occupational injuries and diseases 
     for all workers covered by workers' compensation laws; and,
       Whereas many states are already involved in health care 
     reform efforts to assure quality health care for injured 
     workers at a fair and reasonable cost to employers; and,
       Whereas state managed care initiatives and other medical 
     cost containment reforms directed toward improving quality 
     care at a reasonable cost should not be preempted by any of 
     the current federal health care proposals; and,
       Whereas due to the long pay out pattern of existing 
     workers' compensation medical liability, under the 
     Administration's health care reform proposal a dual payment 
     system would be created resulting in extreme confusion, 
     indeterminable liabilities and administrative inefficiencies: 
     Therefore be it
       Resolved, That the IAIABC opposes integration or merger of 
     workers' compensation medical care and financing into a 
     national health care system at this time. The IAIABC believes 
     that the proposed system would reduce safety incentives, 
     delay return to work, increase costs and destroy the many 
     innovative existing state programs as well as those presently 
     being put in place, without proof that integration or merger 
     would improve the quality of care to injured workers and 
     control or reduce costs to employers while safeguarding the 
     many beneficial elements of the existing workers' 
     compensation system; and be it further
       Resolved, That the IAIABC continues to support all sincere 
     and legitimate efforts to improve the workers' compensation 
     systems. The IAIABC supports creation of a task force or 
     commission, which includes state Administrators and 
     Commissioners, to study the feasibility and appropriateness 
     of coordinating workers' compensation with a restructured 
     health care system. Such task force or commission should not 
     be charged to mandate a federal system, preempt state laws or 
     preserve the existing state programs but, rather should be a 
     reasoned effort to improve the systems, lower the costs and 
     assure quality health care and indemnity benefits to injured 
     workers.
       Adopted by the Executive Committee of the IAIABC this 15th 
     day of November, 1993, Pittsburgh, Pennsylvania.
                                  ____


    Statement by the National Federation of Independent Business on 
             Workers' Compensation and National Health Care

       Title X of the Administration's Health Security Act 
     requires each health plan to provide enrollees, or arrange 
     for the provision of, workers' compensation services--defined 
     as medical benefits, rehabilitation, long-term care, and 
     other services commonly used for treatment of work-related 
     injuries and illnesses. This concept has come to be known as 
     a coordination between workers' compensation and national 
     health care, as opposed to a full merger approach which would 
     entail actually separating the medical component of workers' 
     compensation from the disability (or wage loss component and 
     transferring it to a new national health system. Under the 
     coordinated approach the current workers' compensation 
     medical and disability would be maintained, but insurers 
     would contract with approved health plans for the treatment 
     of workers' compensation medical claims.
       Many in the Administration seem to favor the idea of 
     separating the medical portion of workers' compensation from 
     the disability component. Under this kind of proposal, 
     medical would become part of the new national health care 
     structure and disability would remain under the purview of 
     existing workers' compensation carriers. Indeed, Title X 
     contains a provision to create a Commission on Integration of 
     Health Benefits to study the feasibility and appropriateness 
     of transferring financial responsibility for all medical 
     benefits, including workers' compensation and automobile 
     insurance, to the health plans. In anticipation of such a 
     proposal, NFIB recently polled its members on this concept 
     (Mandate 501, June 1993). The following question was posed: 
     ``Should the Medical Portion of Workers' Compensation be 
     Moved Into a New Standard Health Plan?'' Appropriate 
     background information was provided to the membership, 
     including pro and con arguments. The results were 19 percent 
     voting in the affirmative, 63 percent voting in the negative, 
     with 18 percent undecided.
       Considering the fact that workers' compensation is 
     mandatory for most employers and that the costs for this 
     insurance are rising faster than general health insurance, 
     one might think that employers would opt for any kind of 
     change that offered some hope of reducing costs. Indeed, the 
     Administration has put forth its proposed merger of health 
     insurance and workers' compensation medical as a cost 
     containment measure. Clearly, NFIB members did not view it as 
     such. Since workers' compensation medical expenditures are 
     less than 2 percent of all health care expenditures, it is 
     hard to conceive of the merger approach as a major cost 
     containment mechanism. Under either the merger approach or 
     the coordinated approach, any cost savings are likely to 
     occur as a result of getting workers' compensation medical 
     claimants into a managed care environment. This can be 
     achieved without dismembering the current workers' 
     compensation program. A recent study by the Workers 
     Compensation Research Institute (WCRI) of Cambridge, 
     Massachusetts on the cost implications of the coordinated 
     approach under Title X presents some disturbing findings. 
     The WCRI report concluded that:
       ``On balance, the Clinton plan is likely to increase costs 
     for workers' compensation--the effects of features that 
     increase costs are likely to outweigh effects of features 
     that reduce them. The possible exception is the corporate 
     alliances which could provide a vehicle for large employers 
     to counter some of the cost-increasing incentives created by 
     the Clinton plan.''
       The WCRI study identified seven components of Title X which 
     could be cost-drivers with respect to workers' compensation--
     driving costs either up or down. Among those factors which 
     would tend to increase costs:
       Mixing fee-for-service and capitated payment would create 
     an incentive to shift costs from general health care to 
     workers' compensation.
       Disconnecting responsibility for managing medical treatment 
     from the responsibility for paying indemnity benefits may 
     increase these wage-loss payments.
       Allowing employees to choose specialized workers' 
     compensation providers may offer incentives for doctor 
     shopping and excessive service provision by providers, as 
     well as delay return to work efforts.
       WCRI identified other components of the Clinton plan that 
     would create incentive to promote cost savings. These 
     include:
       Medical fee schedule, depending on the level that the rates 
     are set, could drive costs down.
       Managed care treatment of workers' compensation medical 
     claims could lead to lower medical costs and possibly lower 
     indemnity costs.
       The development of promised medical treatment protocols for 
     work-related injuries and illnesses could lead to lower 
     costs, depending on the enforcement mechanisms in place.
       Selective contracting with the most cost-effective health 
     care plans by corporate alliances could offset the effects of 
     the fee-for-service/capitation mix and the medical-
     indemnity disconnect, but only for large corporations.
       The Administration has repeatedly touted Title X as a way 
     of bringing down the costs of workers' compensation, and has 
     argued that business should support the adoption of the 
     Health Care Security Act, in part, because of this promised 
     cost savings. The WCRI findings gives us great cause for 
     concern over the Administration's claims.
       There are also several technical problems in merging 
     workers' compensation and health insurance. These revolve 
     around the difference between health and comp in such areas 
     as experience rating, scope of coverage, extent of coverage, 
     benefit levels, cost sharing, and so forth. In addition, 
     splitting the system into two parts means that employers/
     insurers would essentially lose control over the disability 
     case management aspect of workers' comp. Eliminating the 
     rehabilitation and return to work supervision of employees 
     could seriously inhibit the ability to control costs on the 
     disability side. Administration officials have come to 
     recognize that these problems are significant and are 
     beginning to give serious thought to how they might be 
     resolved.
       Since most employers are required to carry workers' 
     compensation, they have some understanding of the program, 
     and they understand that workers' compensation reform is 
     absolutely essential. It will be difficult, however, to 
     convince them that a merger of the health and comp systems 
     represents the road to reform if the technical problems 
     outlined above cannot be resolved.
       NFIB appreciates efforts by the Administration and others 
     to mitigate the workers' compensation burden on small 
     business. In testimony delivered before the House Small 
     Business Committee in September of last year, NFIB stated its 
     belief however, that a full integration policy, untested in 
     the United States, is unworkable and may not effectively slow 
     down cost increases. In that same testimony, we noted that a 
     ``coordination'' policy, that allows cost-saving managed care 
     programs to be applied to workers' comp cases would be far 
     preferable and, we believed, more palatable to both employers 
     and insurers. Now, however, considering the findings of the 
     Workers Compensation Research Institute with respect to the 
     workers' compensation cost impacts of Title X of the Clinton 
     legislation, NFIB believes that it is time to simply drop 
     Title X altogether from the Health Security Act. No other 
     health plan before the Congress deals with the workers' 
     compensation issue. We believe it is time to get on with the 
     business of fashioning a health care reform bill. Once we 
     have some idea of what the health care reform will look like, 
     then we can determine how workers' compensation may, or may 
     not, fit into a new national health care plan.
                                  ____


      [From the NAM Board of Directors, Naples, FL, Feb. 5, 1994]

    NAM Resolution on Health Care Reform as It Relates to Workers' 
                              Compensation

       The members of the National Association of Manufacturers 
     (NAM) have previously expressed concern with the rising costs 
     of health care and the high numbers of uninsured Americans. 
     We are also concerned about the cost impact that changes to 
     the health care system would have on the workers' 
     compensation system. After careful study of the President's 
     reform proposal as it affects workers' compensation (Title 
     X), we have come to the conclusion that this complex issue 
     deserves separate attention from that of the health care 
     system.
       Title X would jeopardize successful workers' compensation 
     reform efforts at the state level, particularly as they 
     relate to cost control mechanisms. The proposal would, among 
     other things, eliminate employer choice of provider and 
     diminish employer input and control of case management. Of 
     greatest concern is the Federal Commission called for in 
     Title X which apparently is intended to federalize the entire 
     workers' compensation system. The members of the NAM believe 
     that any federalization of these programs would be a serious 
     error. At the state level, the benefits can best be tailored 
     to fit local socio-economic conditions and such situations as 
     may arise as the result of the introduction of new industries 
     and technologies. Therefore, workers' compensation should 
     continue to be regulated and administered by the states 
     without intervention by the federal government.
       For the reasons listed above, the workers' compensation 
     provisions of Title X should be removed from the 
     Administration's Health Security Act. If a Federal health 
     care reform plan is enacted, specific statutory language must 
     be included to prohibit cost-shifting to workers' 
     compensation.


                               background

       Outlined below in greater detail are our concerns.
       Choice of physician: The value of allowing the free 
     selection of physician is debatable. We have seen no evidence 
     to support that this is preferable in workers' compensation 
     cases. Most employees do not have the training, knowledge or 
     information necessary to make these decisions, particularly 
     in instances requiring specialists and rehabilitation. The 
     proposal allowing states to certify specialists available to 
     injured workers outside their basic Alliance Health Plan 
     would facilitate doctor shopping and create additional 
     disputes over medical treatment. Currently, roughly half the 
     states are split between employee and employer choice of 
     physician. Under Title X, the employer would have no control 
     and in some cases no input in that decision.
       We believe that there is value to employer input into the 
     choice of physician and that the employee is better served if 
     he/she makes this decision with the advice of the employer. 
     If the system allows the employee to switch doctors, this is 
     likely to result in the unnecessary lengthening of the 
     disability period and/or the impairment rating, which will 
     increase costs.
       The bill as substantially written reduces the ability of 
     the employer to control treatment. This, coupled with the 
     free choice of physician by the employee, could result in 
     treatment by inappropriate provider or providers lacking 
     appropriate training for the injury involved. In any case, it 
     does nothing to enhance or maintain the quality of treatment 
     available to the injured workers.
       Case management: Case management is critical to the 
     successful treatment of serious injuries. To speed recovery 
     and allow a timely return to work for injured workers, the 
     case manager needs a thorough understanding of the specific 
     jobs and workplace. This is most effectively accomplished by 
     employer or carrier case managers. Case managers working for 
     the alliances or AHP's (as structured under the Health 
     Security Act) will be subject to internal financial pressures 
     which are not conducive to the goal of high-quality, cost-
     effective care aimed at a prompt return to productivity. 
     Additionally, dual case managers create further opportunity 
     for additional strife within the system.
       Cost Shifting: We are fearful that there are incentives in 
     this bill for employees to shift cases to workers' 
     compensation in order to receive first dollar coverage. While 
     Title X does contain language calling for the development of 
     treatment protocols and fee schedules to address all medical 
     services, until these are fully operational, health plans may 
     still employ differential pricing to the detriment of 
     workers' compensation.
       Proposed Workers' Compensation Commission: The NAM 
     questions whether federal commissions produce value 
     commensurate with their costs. In this case, we do not feel 
     the commission should be charged with completing a study for 
     further integration of the workers' compensation system into 
     the general health care program before the reform program 
     goes into effect. If the commission is required, it should 
     not issue any recommendation until it has had time to 
     evaluate the effectiveness of the reforms. In addition, we 
     are concerned that the commission may expand its scope into 
     issues concerning coverage and benefits, areas which fall 
     under the jurisdiction of the states. The NAM believes these 
     issues should remain with the states.
                                  ____


      [U.S. Chamber of Commerce position on workers' compensation 
                              legislation]

       Statement on Workers' Compensation and Health Care Reform

       As the country reviews proposals that will fundamentally 
     alter the U.S. health care system and its impact on the 
     states' workers' compensation systems, the U.S. Chamber of 
     Commerce seeks to play a constructive role in helping to form 
     a national consensus on this issue. Accordingly, the Chamber 
     offers the following guidelines as a basis upon which we will 
     assess the viability of any plan. There are two underlying 
     principles, recognized in the first three guidelines below, 
     that are central to the policy of the Chamber. First, we 
     remain steadfastly opposed to the federalization of state 
     workers' compensation systems. Second, the medical component 
     of workers' compensation must be able to effectively benefit 
     from any medical cost saving mechanisms instituted under a 
     reformed health care system.
       Workers' compensation must remain within the exclusive 
     domain of state laws. A reform effort should not operate to 
     expand any existing federal mandates or create any new ones, 
     or to otherwise affect benefit levels established by the 
     states.
       Direct and total integration of the medical component of 
     workers' compensation into nonoccupational health care reform 
     is unacceptable. An employer's current ability to engage in 
     overall disability management to ensure maximum 
     rehabilitation in the earliest time frame with an eye toward 
     controlling indemnity costs is essential to a workable, cost-
     effective workers' compensation system. The Chamber will 
     strongly and actively oppose any provision aimed at total 
     integration.
       The health care portion of workers' compensation must be 
     allowed to take advantage of any medical cost savings that 
     national health care reform would produce. Non-discrimination 
     in the pricing of medical care between occupational and non-
     occupational injuries or diseases should be established. 
     Health care reform should not leave workers' compensation 
     more vulnerable to cost shifting.
       The current safety incentives, including experience rating 
     based on both medical and indemnity costs, should be 
     maintained. Employers with good safety programs should 
     continue to benefit from their efforts and should not be 
     required to subsidize unsafe employers.
       The current development and implementation of managed care 
     and effective cost containment in workers' compensation 
     should be permitted to continue.
       The exclusive remedy principle of workers' compensation 
     should be retained. This principle embodies the practice of 
     employees giving up their right to sue the employer for a 
     work-related injury or illness in exchange for reasonable and 
     necessary medical care and cash benefits replacing a portion 
     of lost income on a no-fault basis. Relaxing or eliminating 
     this practice would needlessly expose employers to expensive 
     and damaging tort litigation and would undermine support for 
     no-fault benefits for workers.
       The ability of employers to select medical care providers, 
     where such ability exists under state workers' compensation 
     jurisdictions, should be preserved.
       Employers' right to direct return-to-work efforts, 
     including rehabilitation and associated medical care, should 
     be allowed to continue. Sole control by providers is 
     unacceptable.
       The determination of work-relatedness and other medical-
     legal issues should continue to be governed by state workers' 
     compensation statutes.
       The right to self-insure in accordance with state workers' 
     compensation laws should be preserved. Self-insurance permits 
     employers to elect to bear their own risk if they are 
     financially qualified to guarantee delivery of required 
     benefits.
       The role of federal workers' compensation programs (e.g., 
     Longshore Act, Federal Employees Compensation Act, Black Lung 
     program, etc.) within a reformed system must be considered. 
     The effect of allowing any of these programs to opt out of 
     the reformed system should be explored.
       Workers' compensation premiums should remain fully tax 
     deductible and benefit payments should remain excludable.
       The current paperwork requirements should not be increased.
       State law should continue to govern the definition of 
     coverage (and obligation to cover). Specifically, coverage 
     should be based on date of injury, not date of medical 
     service.
       Any reform effort should not impede states' efforts to 
     effectively deal with fraud.
                                  ____


        [From the Alliance of American Insurers, Washington, DC]

Alliance of American Insurers Position Paper--Workers Compensation and 
                   Title X of the Health Security Act

       The Alliance of American Insurers is committed to achieving 
     medical cost containment within the state-based workers 
     compensation system. We are equally committed to opposing any 
     plan that would sacrifice the high quality medical care and 
     rehabilitation which victims of occupational accidents now 
     receive through workers compensation programs.
       A key workers compensation element which must be preserved 
     in any reformed system is the ability of the employer and 
     insurer to manage recovery from disabling work-related 
     injuries. Effective medical treatment can reduce disability, 
     but disability management speeds the worker's return to 
     employment and often can reduce the amount of medical care 
     which must be provided. The Alliance believes that any 
     workers compensation reform proposal should embody the 
     following principles:
       1. Workers compensation providers should be allowed access 
     to all health care delivery systems in use;
       2. Unfair discrimination resulting in cost shifting should 
     be eliminated;
       3. States should continue to regulate workers compensation;
       4. Insurers/employers who are responsible for medical care 
     and disability payments should have substantial control over 
     decisions related to that care;
       5. Experience rating should be maintained; and,
       6. The exclusive remedy doctrine should be preserved.
       Title X of the Health Security Act clearly would undermine 
     the first, second, third, and fourth principles listed above. 
     Title X also would create an unworkable system of regulation 
     and administration, including health alliances engaged in 
     price-setting (fee schedules), and unnamed state agencies 
     controlling access to expert workers compensation medical 
     care. Furthermore, if the medical care component of workers 
     compensation were to be merged into the proposed health 
     insurance system (and this is virtually a pre-ordained result 
     flowing from Subtitle C), the fifth goal would be lost and 
     the sixth would be at risk.
       The Clinton Administration's ``coordinated'' approach to 
     workers compensation outlined in Title X is flawed because it 
     would require, rather than allow, medical treatment for 
     occupational injuries to be delivered through the employee's 
     health insurance plan, leaving employers with no meaningful 
     input into the choice of medical provider. Title X would 
     shift case management of an injury away from the employer/
     insurer--who has expertise in the management and treatment of 
     occupational injuries--to the health insurance plan, 
     where expertise would have to be developed. The 
     requirement that each health plan provide a workers 
     compensation case manager simply duplicates services 
     presently provided by the payers for that care and moves 
     this management function to the health plan, which bears 
     no financial risk for medical care or disability.
       In addition, Title X arguably would prevent the employer 
     and the state workers compensation agency from questioning 
     whether appropriate medical treatment is being received by an 
     injured employee. This would establish a prohibition that 
     presently does not exist even in states where the employee 
     has the right to initial selection of a physician.
       Shifting medical management of an occupational injury from 
     the employer/insurer to the health insurance plan is likely 
     to increase the length of disability (lost productivity) and 
     drive up disability costs. The parties paying for disability, 
     who have a financial stake in an employee's swift return to 
     work, would be restricted in directing treatment toward that 
     optimal outcome. In contrast, a health plan, its providers, 
     and its case manager would have no financial incentive to 
     speed recovery and return to work. This would work to the 
     detriment of both workers and employers.
       Unfortunately, Title X's pre-emption of state workers 
     compensation laws dealing with medical treatment would wipe 
     out much of the improvement already achieved in several 
     states through reform. This is especially true with respect 
     to the application of managed care to occupational injury and 
     disease.
       Title X also would create a commission appointed from 
     within the Departments of Labor and Health and Human Services 
     to ``study the feasibility and appropriateness of 
     transferring financial responsibility for all medical 
     benefits (including those currently covered under workers 
     compensation) to health plans.'' From statements made by 
     Administration officials, it is clear that this commission is 
     expected to recommend total integration of the workers 
     compensation health benefits financing system into the 
     national health insurance system. Such integration would 
     seriously and adversely affect employer safety incentives by 
     moving workers compensation from an experienced-rated to a 
     community-rated system. The public at large would then have 
     to bear the cost of an employer's unsafe workplace.
       This would be a giant step in the wrong direction. 
     Integration would create the wrong financial incentives for 
     health plans to provide the intense and special treatment 
     intended to quickly return an injured employee to work. Also, 
     integration would likely erode the exclusive remedy doctrine, 
     thus flooding the courts with litigation, increasing delivery 
     costs to employers and delaying payment of compensation to 
     injured workers.
       Overall, Title X would impose an entirely new, unworkable 
     operating structure on state workers compensation systems. 
     Title X also would increase workers compensation costs. In 
     addition, Title X fails to address many state-specific 
     workers compensation problems. For all of the reasons cited 
     above, the Alliance of American Insurers and our 214 member 
     companies believe that Title X would be bad public policy for 
     both employers and American workers.

  Several Senators addressed the Chair.
  The PRESIDING OFFICER (Mr. Graham). The Senator from Connecticut is 
recognized.

                          ____________________