[Congressional Record Volume 142, Number 126 (Friday, September 13, 1996)]
[Senate]
[Pages S10564-S10565]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




          HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT

 Mr. FRIST. Mr. President, I rise today to recognize an 
important achievement by this body, as well as to congratulate my 
colleagues on the Health Insurance Portability and Accountability Act 
being signed into law. Last year, I joined Senators Kassebaum and 
Kennedy in introducing this important piece of legislation. It has 
enjoyed broad bipartisan support in both the House of Representatives 
and the U.S. Senate.
  Last summer, the Committee on Labor and Human Resources, of which I 
am a member, reported out this legislation unanimously. This spring, 
the bill passed with overwhelming support in the Senate. Mr. President, 
as you may recall, the vote was 100 to 0.
  I regret that this very popular bill--that the General Accounting 
Office told us would help 25 million Americans--was filibustered for 94 
days by our Democratic colleagues and therefore enactment was 
unnecessarily delayed.
  First, we heard from our friends across the aisle that the bill 
contained poison pills--provisions that would jeopardize support for 
the overall bill.

[[Page S10565]]

 The most fiercely opposed was inclusion of a medical savings account 
provision.
  To back up a bit, I would like to read the language of an amendment 
that I offered, and that passed, during consideration of the bill by 
the Committee on Labor and Human Resources. Specifically, the committee 
added a sense of the committee that the establishment of medical 
savings accounts should be encouraged as part of any health insurance 
reform legislation passed by the Senate through the use of tax 
incentives relating to contributions to, the income growth of, and the 
qualified use of, such accounts.
  Although the Labor Committee does not have jurisdiction over the 
Internal Revenue Code, this amendment articulated our support that MSAs 
should be a part of the final package. Furthermore, the Kassebaum-
Kennedy legislation addressed the issue of medical savings accounts 
within its area of jurisdiction, the Public Health Service Act. The 
bill allows health maintenance organizations [HMO's] to offer 
deductibles in conjunction with a medical savings account. This was a 
necessary change to current law because the current HMO Act prohibits 
managed care plans from offering significant copayments and deductibles 
which would typify a catastrophic plan design. By including this 
language, the committee hoped to level the playing field for all health 
delivery systems in offering a medical savings account product. My own 
MSA legislation, introduced last year, also accomplishes this goal.
  The medical savings account provisions included in the Health 
Insurance Portability and Accountability Act are much more narrow than 
the bill I introduced last year to establish MSA's. However, I believe 
the provision has much to offer the population it is directed toward: 
small employers and the self-employed. This population could greatly 
benefit from expanding their choices of affordable health plan options. 
In addition, it is worth encouraging individuals to become better 
consumers of their health care dollars. The MSA provision included in 
the Health Insurance Portability and Accountability Act attempts to 
accomplish this goal.

  Mr. President, the Journal of the American Medical Association 
recently published a study by the RAND Corp. regarding medical savings 
accounts. RAND currently conducts the largest private program of health 
policy research in the United States. RAND has an exceptional program 
of health care research that has helped advance knowledge about how 
cost, quality, and access to care can be improved. Its research agenda 
has kept pace with the Nation's emerging health policy concerns and has 
helped shape the way policymakers, health professionals, and the public 
think about these issues.
  We should note that the RAND study concludes that MSA's could prove 
attractive to some sick and lower income people as well as to the 
healthy and well-to-do. The report implies that this is an effort worth 
demonstrating--and certainly not poisonous--especially when we focus on 
extending the option to populations that now have difficulty finding 
affordable health care options.
  Above all, the goal of the Health Insurance Portability and 
Accountability Act continues to be the implementation of the very basic 
reforms of portability and limits on pre-existing conditions. The 
Senate has debated both these issues for the past 6 years. The bills 
have even passed the Senate in previous years, but ultimately failed to 
become law. These reforms represent what we all support and are 
important to the many people who experience a sense of job-lock or pre-
existing conditions. The General Accounting Office [GAO] estimates that 
25 million people will benefit from this bill.
  Yet, even once the MSA provision was resolved the group-to-individual 
portability provisions came under attack. We need to remember why 
health insurance reform legislation was pursued by this Congress. The 
goal of this bill has always been to insure that people who play by the 
rules will not be denied access to health insurance. That must be the 
litmus test for the ultimate success of this legislation. The 
conference agreement continues to insure that individuals who change or 
lose their jobs will have access to a choice of health insurance 
policies. The goal of portability remains strong in the bill.
  Mr. President, this Congress has delivered on its promise to enact 
market-based insurance reforms that increase everyone's security that 
they will not lose their health insurance. I congratulate the majority 
leader, Senators Kassebaum and Roth, and the other conferees for 
ultimately refusing to allow politics as usual to stand in the way of 
adopting these national rules.
  Mr. COVERDELL. Madam President, I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The legislative clerk proceeded to call the roll.
  Mr. THURMOND. Mr. President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER (Mr. Grams). Without objection, it is so 
ordered.
  The Senator from South Carolina is recognized.
  Mr. THURMOND. I thank the Chair.
  (The remarks of Mr. Thurmond pertaining to the introduction of S. 
2074 are located in today's Record under ``Statements on Introduced 
Bills and Joint Resolutions.'')
  Mr. THURMOND. Mr. President, I yield the floor.
  Mr. COVERDELL addressed the Chair.
  The PRESIDING OFFICER. The Senator from Georgia.

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