[Weekly Compilation of Presidential Documents Volume 32, Number 34 (Monday, August 26, 1996)]
[Pages 1480-1482]
[Online from the Government Publishing Office, www.gpo.gov]
<R04>
Statement on Signing the Health Insurance Portability and Accountability
Act of 1996
August 21, 1996
I am pleased to sign into law H.R. 3103, the ``Health Insurance
Portability and Accountability Act of 1996.'' For the first time, this
Act will ensure the portability of health benefits when workers change
or lose their jobs and will protect workers against discrimination by
health plans based on their health status.
For too long, tens of millions of Americans have been denied health
insurance coverage because they have preexisting conditions. We have all
heard their stories.
-- A husband and his pregnant wife lose their insurance and
then find they cannot buy new coverage because her pregnancy
is considered a preexisting condition.
-- A young woman starting out in her career cannot accept a
promotion with another company because its health insurance
policy won't cover her diabetes.
-- A small business owner faithfully pays his group health
insurance premiums for years only to learn that his coverage
won't be renewed after one of his employees develops a heart
condition.
Since taking office, I have been fighting for changes that would
stop this kind of unfairness and make health insurance more accessible
for all people, including the most needy. I am pleased that the Congress
has responded to my call. In passing this Act, a modest but important
step has been taken
[[Page 1481]]
to improve Americans' access to health care coverage.
This legislation will set into motion several key reforms. First, it
will eliminate the possibility that individuals can be denied coverage
because they have a preexisting medical condition. Second, it will
require insurance companies to sell coverage to small employer groups
and to individuals who lose group coverage without regard to their
health risk status. Finally, it will require insurers to renew the
policies they sell to groups and individuals.
In addition to the health insurance reforms, this legislation will
help strengthen other aspects of our health care system.
-- It increases the tax deductibility of health insurance
premiums for the self-employed and their dependents from 30
percent to 80 percent by calendar year 2006.
-- It significantly expands Federal authority and resources to
combat fraud and abuse in Federal health programs, such as
Medicare, and in the private sector.
-- It provides for the development of: (1) national standards
for the electronic submission of health insurance claims
that will reduce paperwork, administrative costs, and
burdens for doctors and hospitals; and (2) privacy
protection recommendations for health information generally,
and, in the absence of additional legislation, regulations
for privacy of health care claims information.
-- It establishes consumer protection standards for certain
long-term care insurance policies and provides tax
clarifications to make those policies more affordable and
available.
Like most legislation, this Act includes compromises that are less
than perfect. For example, it includes a provision that will allow a
limited number of individuals covered by catastrophic health insurance
to establish tax-advantaged medical savings accounts, or MSAs. I opposed
an open-ended, unconstrained expansion of MSAs because of my concern
that MSAs may create incentives for healthier people to select
catastrophic health coverage, which experts believe would increase
premiums for those who choose traditional, comprehensive health care
policies. I agreed, however, to work with the Congress in crafting a
compromise that would permit the establishment of a limited number of
MSAs. This limited use of MSAs will be studied carefully for a period of
4 years before deciding whether or not to expand them to the broader
health insurance market, and the Congress will have to consider this
issue and vote again before doing so.
Similarly, while the bill makes some of the positive changes that I
have proposed to strengthen our efforts to combat health care fraud and
abuse, I am concerned that it also contains a provision that could
weaken those efforts. I oppose the requirement that Government officials
provide advisory opinions on whether certain arrangements violate
criminal health fraud statutes. The Attorney General and the Secretary
of Health and Human Services are concerned that advisory opinions of
this nature could create complexities that would burden the efforts to
enforce laws against health care fraud and abuse. Therefore, I am
directing the Departments of Justice and Health and Human Services to
work closely together in implementing this provision to ensure that it
promotes and protects Federal law enforcement activities relating to
health care fraud.
Finally, I want to reiterate my disappointment that the Congress
dropped from this legislation the mental health parity provision that
received such bipartisan support in the Senate. Individuals with mental
illness have long suffered from discrimination in health plans that
impose severe financial burdens on top of the illnesses they already
face. I urge the Congress to act at the earliest opportunity to require
parity in health insurance coverage for mental health services. I look
forward to working with the Congress to address this critical issue.
As I sign this legislation, I am particularly grateful to Senators
Kassebaum and Kennedy and the many other Members of Congress who worked
tirelessly to assure that this bill is a meaningful and important step
toward making health care more accessible and more secure for millions
of Americans. I pledge to continue this effort and hope that
[[Page 1482]]
the Congress will work with me and so that all Americans can have health
care security.
William J. Clinton
The White House,
August 21, 1996.
Note: H.R. 3103, approved August 21, was assigned Public Law No. 104-
191.