[Congressional Record Volume 140, Number 115 (Tuesday, August 16, 1994)]
[Senate]
[Page S]
From the Congressional Record Online through the Government Printing Office [www.gpo.gov]


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

 
                AFFORDABLE HEALTH CARE NOW ACT--S. 1533

 Mr. LOTT. Mr. President, I would like to take this opportunity 
to introduce a refined version of the Affordable Health Care Now Act. I 
ask unanimous consent to include an analysis of the changes made in S. 
1533.
  The material follows:

                           Changes in S. 1533

       Language providing clarification and additional standards 
     governing purchasing groups.
       Eliminate pre-existing condition exclusion if employee 
     elects coverage when first eligible.
       Update insurance reform language, moving away from rating 
     band approach to community rating and using basically the 
     consensus standards developed by the insurance industry, 
     large and small. Include language allowing discounts for 
     wellness programs, etc.
       Require small employers of 50 or fewer employees who self-
     insure to have re-insurance (stop-loss) policies. Allow small 
     self-insuring employers to be included in state-established 
     risk adjustment programs.
       Require insurance companies currently serving the 
     individual market to serve all individuals.
       Include ``patient protection'' standards for managed-care 
     plans.
       Increase funding for rural care programs.
       Eliminate the Federal retirement age increase section of 
     the bill.
       Standards for long-term care.
       Allow Medicare recipients a greater choice of health plans.
       Establish marketing standards setting forth information 
     insurance companies must make available regarding their 
     plans.
       Adjustments in anti-trust reform language.
       Eliminate the following tax breaks for long-term care: Tax-
     free exchanges of life insurance for LTC policies. Use of IRA 
     and 401(k) funds for LTC insurance. Permit exclusion for 
     accelerated death benefits.
       Limit SSI and Medicaid for resident aliens.
       Repeal duplicative vaccine program.
       Limit SSI for drug abusers.
       Extend current law setting Medicare Part B premiums to 
     cover about 25% of average benefits (sunsets in 1999).
       Extend current law requirements for Medicare secondary 
     payers (sunsets of 1996).
       Establish a program of assistance for low-income 
     individuals, to be operated through the states. Priority will 
     be given to children from families below 185% of poverty, 
     pregnant women below 150% of poverty, and other individuals 
     below 150% of poverty, in that order. Federal assistance 
     would amount to approximately $90 billion over 10 years and 
     would be financed by the offsets in the bill plus a 25% 
     reduction in disproportionate share payments.
                                  ____


                     Affordable Health Care Now Act


           improved access to affordable health care coverage

       I. All employers must offer, but are not required to pay 
     for, insurance to their employees.
       II. Small group insurance reform:
       A. Insurers must offer small employers standard and 
     catastrophic plans with an actuarial value range as 
     determined by the National Association of Insurance 
     Commissioners. They may also offer a Medisave Plan.
       B. Small ground is defined as employers with between 2-50 
     employees.
       C. Risk pools would be established to spread insurer risks.
       III. Employee Insurance Security:
       A. Employees cannot be excluded from insurance coverage 
     because of preexisting conditions.
       B. Employees are assured of continued insurance coverage 
     when changing jobs.
       IV. Promoting More Affordable Insurance Coverage:
       A. Increase tax deductions for the self-employed to 100% 
     and provide deductions for employees who purchase their own 
     insurance.
       B. Exempt all group health plans from state benefit 
     mandates.
       C. Prohibit state restrictions on managed care.
       D. Establish standards and incentives for multi-employer 
     insurance purchasing groups.
       E. Eliminate current IRS regulatory barriers which prevent 
     employer groups from being able to offer tax-exempt health 
     insurance.
       V. Family Medical Savings Accounts (Medisave).
       VI. Reforming Medicaid:
       A. Permit states to utilize private insurance for Medicaid 
     beneficiaries.
       B. Permit uninsured people to buy-in to the Medicaid 
     program, with graduated subsidies up to 200% of poverty.
       VII. Expansion of Community Health Center Program.
       VIII. Expanded Rural Health Care Services.
       IX. Long-term Care.


                      health care cost containment

       I. Malpractice Reform.
       II. Administrative Reform:
       A. Streamlined Paperwork.
       B. Electronic Billing.
       C. Merge Medicare Parts A and B.
       III. Anti-trust Reforms.
       IV. Anti-fraud provisions.
       V. State Medicaid flexibility.
                                  ____


     The Affordable Health Care Now Act, S. 1533, Real Reform, the 
                            Commonsense Way


           improves access to affordable health care coverage

       Insurance Security:
       Employees are assured access to affordable health insurance 
     through their employer.
       Employees cannot be excluded from insurance coverage 
     because of pre-existing conditions.
       Employees are assured of continued insurance coverage when 
     changing jobs.
       Bridges the gap for low-income workers and early retirees 
     by allowing States to establish group insurance plans 
     available for purchase, with subsidies for the low income.
       Promoting More Affordable Insurance:
       Encourages and makes it possible for employers to obtain 
     affordable health coverage through group purchasing 
     arrangements.
       Requires insurers who sell in the small group market to 
     offer health plans, including a Standard Plan, Catastrophic 
     plan, and a Medisave plan, to all companies who employ 2 to 
     50 employees. These plans must meet a minimum coverage level 
     as determined by the National Association of Insurance 
     Commissioners.
       Limits the insurance premium rate variations charged to 
     small businesses and will limit the annual increases in 
     insurance premium rates.
       Encourages group purchasing arrangements by easing 
     paperwork and other regulatory burdens and by eliminating the 
     current IRS regulatory barriers which prevent employer groups 
     (the American Farm Bureau, for example) from being able to 
     offer health insurance.
       Tax Fairness:
       Increases the tax deduction for self-employed individuals 
     to 100 percent from 25 percent.
       Provides 100 percent tax deductibility of the cost of 
     health insurance premiums for all individuals who purchase 
     their own insurance.
       Medical Savings Accounts (Medisave):
       Allows tax-free deposits to Medisave Accounts to reimburse 
     medical expenses and pay for a long-term catastrophic, 
     Medigap and Medicare premiums.
       Reforming Medicaid:
       Permits states to use private insurance for Medicaid 
     beneficiaries.
       Permits families with incomes up to 200 percent of poverty 
     to buy-in to the Medicaid program.
       Expands the Community Health Center Program as the 
     disadvantaged Americans will have access to vital preventive 
     and primary care.
       Expands Rural Health Care Services:
       Improves emergency medical services in rural America.
       Establishes Rural Emergency Access Care Hospitals.
       Expands Long Term Care Options.
       Provides the same tax benefit for long term care insurance 
     as for other insurance plans.
       Allows Americans, the option of using IRA's, 401(k) plans, 
     and life insurance--tax free--to purchase long term care 
     insurance.
       Allows states to offer seniors asset protection plans.


                 PUTS THE BRAKES OF SKYROCKETING COSTS

       Reforms the Malpractice and Product Liability System to 
     limit frivolous lawsuits, adequately compensate victims, and 
     reduce defensive medicine costs.
       Requires Administrative Reforms to establish a single, 
     standard claim form and encourage the development electronic 
     billing.
       Increases enforcement of current laws and closes loop-holes 
     to prevent medical fraud and abuse.
       Creates personal Medical Savings Accounts, integrated into 
     the insurance system, that allow you and your doctor to 
     determine the most appropriate course of treatment.
       Allows States to establish managed care plans for Medicaid 
     beneficiaries.
       Reforms antitrust laws to allow sharing of facilities and 
     equipment by providers, thus reducing overhead.

                          ____________________