‘Unity Government’ Mindset Slowing Health Legislation in Congress, CQ’s Goldreich Says

A focus on bipartisanship in Congress following the Sept. 11 terrorist attacks is slowing the passage of some health-related bills, Congressional Quarterly senior reporter Samuel Goldreich says in this week's "Congressional Quarterly Audio Report." Goldreich reports that in an effort to "hold together this notion of a national unity government," President Bush and congressional leaders have "basically decreed that nothing will move to the House and Senate floors unless it has unanimous support." This mentality has impeded the passage of legislation to improve COBRA benefits for laid-off airline workers and to expand mental health parity requirements, and may influence the allocation of additional funds for the Medicare+Choice program, Goldreich says. But Goldreich adds that the "era of legislation by acclamation" may end within the next few weeks, predicting that "things will get back to normal" if Congress can meet an Oct. 16 deadline to pass 13 appropriations bills to fund government operations in fiscal year 2002. Though the fiscal year begins Oct. 1, a continuing resolution will keep agencies running through mid-month. Goldreich provides detail on several measures, including the following:

• COBRA Expansion: Democrats are calling for expanded COBRA benefits for airline workers laid off as travel has slowed following the attacks. While House Speaker Dennis Hastert (R-Ill.) and Bush both seem to support such an expansion, Senate Assistant Minority Leader Don Nickles (R-Okla.) and House Majority Whip Tom DeLay (R-Texas) are "resisting the effort," which is projected to cost $3.8 billion next year. Goldreich says Democrats may succeed if they can link the expansion to Bush's plan to partially federalize airline security, but he warns they "risk ... overplaying their hand by demanding similar help for anyone who's lost a job in recent months as part of an economic stimulus bill" under discussion by Bush and congressional leaders.
• Mental Health Parity: Also "stuck in the unity government works" is an expansion of mental health parity requirements for insurers and employers, "headed for certain approval last week" but "yanked" from the schedule by Senate Majority Leader Tom Daschle (D-S.D.) because a few Republicans said it could increase health premiums ("Congressional Quarterly Audio Report," 10/1). The Mental Health Parity Act (S 543), which would expand 1996 legislation currently up for reauthorization, would keep insurers from imposing limits on hospital stays and physician visits for mental health treatment that are greater than those imposed for physical health visits, and require them to charge the same co-payments and deductibles for both mental and physical health services. In comparison, the 1996 law required only that health plans provide equal annual and lifetime benefits for mental health as for other services (Kaiser Daily Health Policy Report, 8/2). Goldreich predicts Daschle may bring the bill up this week, adding that if not, "I'm sure it will come back soon as a test of Democratic strength" once the spirit of bipartisanship fades.
• Medicare: Following a Sept. 25 hearing on problems with the Medicare payment and fraud-fighting systems, Goldreich predicts that a Medicare "regulatory relief" bill could pass in the coming months. Improving Medicare contractor and provider communications and similar details have bipartisan support, he notes. But Goldreich warns that increasing funding to Medicare+Choice insurers -- a suggestion made by CMS Administrator Tom Scully last week following news that program pullouts will impact more than 500,000 people next year -- is "a lot more politically divisive."
• Uninsured: Though a Census Bureau report released last week reported the percentage of uninsured Americans dropped in 2000 for the second year in a row, the recent economic slowdown means that trend will likely reverse. Goldreich notes that states have been asking Congress all year to help the uninsured, adding, "Now that there's a crisis developing, lawmakers might actually listen."