[Congressional Record Volume 141, Number 37 (Tuesday, February 28, 1995)]
[House]
[Page H2310]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]


            THE FEDERAL EMPLOYEE HEALTH BENEFITS ACCESS ACT

  The SPEAKER pro tempore. Under the Speaker's announced policy of 
January 4, 1995, the gentlewoman from Colorado [Mrs. Schroeder] is 
recognized during morning business for 5 minutes.
  Mrs. SCHROEDER. Mr. Speaker, I had been wondering when to introduce 
the bill that I introduced last year. When I got a letter today 
explaining the AMA's position on health care and preexisting conditions 
I decided this was the day.
  You see, the AMA has a dictionary where they are talking about 
menopause as a preexisting condition. But when they were asked why they 
were defining that, they said they were only saying what the insurance 
companies were saying, and the insurance companies are saying that is 
whey they consider menopause a preexisting condition and are denying 
payment.
  If this continues, pretty soon women are going to be a preexisting 
condition, and no woman is going to get health care. But we know that 
this is going on with men, with women, with children, with families, 
and we have a true, true health care crisis.
  This letter is what inspired me today to reintroduce my Federal 
employee health benefits bill that I introduced last year. It is very 
simple. It only says every American should be entitled to the same 
choices that we as Members of Congress have, the President has, and 
over 9 million Federal employees, retirees and their families have.
  That means once a year you get a catalog of a hole series of choices. 
You are in a very large group. There are no preexisting conditions. 
Whether it is menopause or anything else, you can be in that pool, and 
it has been tremendously cost effective. I think that this is one thing 
we could certainly do that would make life a lot better for small 
employers, for self-employed people, and for many Americans.
  One of the things we learned from the health care debate was that 
most Americans are really very poor consumers of health care. And why 
not? They have no choice anyway. Their only choice is what their 
employer can get, if he can get anything, or what they can get, if they 
can get anything. They do not have the catalog and the options we all 
have once a year under open season.
  Now, this does not cost the Federal Government anything. All you do 
is get the catalog, figure out what you want, and then you have to pay 
the premium or you and your employer share the premium, or whatever 
works out, whatever your negotiated position is. But it gets you a wide 
range of choices. It gets you much better prices. It gets a much better 
cost relationship, and I think it is time we do it.
  It is in the spirit of this Congress, which has been putting itself 
under the laws it makes for other people, and it is time we now open 
the door to many of the benefits that we have, that we now know because 
of the last 2 years' historic health care debate that other people do 
not have. This would be a terrific stress reliever for an awful lot of 
American families who are either locked into their job because they 
cannot get health care, or lost their job and cannot get health care, 
or many, many other things.
  So I really hope that this body takes this bill very seriously, and 
that we pass it out of here, and we at least give people choices. That 
makes all the sense in the world.
  Mr. Speaker, I would ask to put this letter from the American Medical 
Association in the Record on preexisting conditions and menopause.
  Mr. Speaker, today I am introducing the Federal Employee Healths 
Benefits Access Act. The purpose of this bill is simple: to give the 
general public access to the same health care benefits as Members of 
Congress.
  We recently passed legislation requiring Congress to comply with the 
same laws that we pass for the rest of the country. Well, it is about 
time we gave everyone the same health care we get.
  The Federal Employee Health Benefits Program provides health care to 
nearly 9 million Federal employees, retirees, and their families. It is 
a proven plan and model for the rest of the country. Enrollees are 
offered coverage at group rates, are not barred from coverage on the 
basis of a preeexisting health condition, and are free to enroll in a 
plan of their choice during an annual open season.
  My bill requires health carriers under the Federal Employee Health 
Benefits [FEHB] Program to offer to the general public the same 
benefits that Federal employees and members of Congress receive. This 
means that small businesses and individuals will have access to the 
same deductibles, maximums, coverage, treatment, and quality care that 
every Member in this Chamber gets. Under the bill, health care plans 
available to the general public would be community rated and would not 
result in an increase cost or less of benefits to Federal employees.
  FEHB access allows Americans to choose the plan that is right for 
them. It does not require a standard package of benefits. Rather, it 
maintains one of the most important features of the current FEHB 
Program--the ability to pick a plan that fits the needs of each 
individual or family.
  The Federal Employee Health Access Act also contains some important 
cost savings provisions.
  First, it requires that insurance carriers use standardized claims 
forms. This will reduce administration waste as well as save time and 
money.
  Second, it requires insurance carriers to provide enrollees with 
information about advanced directives or ``living wills.'' The use of 
living wills gives patients an opportunity to make critical decisions 
about their treatment. It can also save millions of unnecessary medical 
bills.
  And finally, my bill establishes a demonstration project that allows 
enrollees the option to choose arbitration in order to settle 
malpractice disputes. Individuals who choose this option would either 
pay reduced premiums, copayments, or deductibles. Many health insurance 
plans already require participants to use alternative dispute 
resolution for malpractice claims. But, unlike my plan, they are not 
voluntary and they do not pass any of the savings on to enrollees.
  The Federal Employee Health Benefits Access Act is a common sense 
proposal that makes health care available and affordable to every 
American. If it works for Members of Congress, why can't it work for 
the rest of the country?
  I urge my colleagues to cosponsor the Federal Employee Health 
Benefits Access Act.

                                 American Medical Association,

                                   Chicago, IL, February 13, 1995.
     Dr. Carol C. Nadelson, M.D.,
     Editor in Chief, American Psychiatric Press, Inc., 
         Washington, DC.
       Dear Doctor Nadelson: Thank you for your recent letter 
     demonstrating the misuse of an American Medical Association 
     [AMA] statement on menopause. I appreciate having the benefit 
     of this information.
       The statement quoted by the insurance company is not AMA 
     policy, but rather is a definition taken from one of the 
     AMA's many consumer books. The purpose of the AMA's consumer 
     books is to educate the public about common medical 
     conditions, not to serve as rationale for classification of 
     conditions by the insurance industry. While the cited 
     definition is supported by the medical literature, the AMA 
     regrets that its statement is being used by the insurance 
     industry to deny payment for treatments. In addition, I wish 
     to assure you that the AMA supports equal rights for men and 
     women and does not advocate any position that would lead to 
     the discrimination of women in terms of their health care.
       Again, thank you for sharing your concerns with me. I hope 
     this information is helpful.
           Sincerely,
     James S. Todd, M.D.

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