An update from the firm of Leach and English, health care reform lobbyists for The American.
While no comprehensive overhaul of the nation's health care system will occur this year, vigorous lobbying of Congress has created a broad awareness that mental health treatment is both necessary and cost-effective, and—equally important—that managed care poses grave dangers. Our success in educating Congress is reflected in the fact that all of the bills developed in Congressional committees provide mental health benefits better than those in the original Clinton proposal, and most provide for parity with other medical treatments. Congress's increased awareness of managed care abuses has also resulted in improvements on the original bill, such as the Patient Protection Act and provider due process requirements. The battles for "all (qualified) willing provider" access and "point of service" (non-network) treatment were joined despite intense insurance company opposition. By contrast, our bedrock principle of freedom to contract privately met little opposition, and the issue is largely moot with the collapse of any Clinton-like plan.
For the moment the most likely elements of health care legislation are insurance reforms (portability, curbs on preexisting condition exclusions), subsidies for children and pregnant women, and long-term care for the elderly. Despite anticipated Republican gains in November, many view national health care legislation as a real possibility in 1995. Now that the stage has been set, issues debated, and expectations raised, there will be pressure to bring the process to fruition. Many Democrats remain committed to this issue, and Republicans may find it difficult to oppose reform without the time pressure and election-year panic affecting the current Congress.
Dramatic and positive reforms are also likely at the state level. Several states have already legislated some type of managed care regulation or all-willing-provider requirement. Legislation is pending in other states and will undoubtedly be stimulated by the failure of comprehensive national reform. As this is written, however, existing state laws and future initiatives are threatened by federal proposals, such as Senator John Chafee's "mainstream" bill, that sweepingly prohibit or preempt state action in the name of national uniformity. The American has actively opposed any such preemption of state law, and will continue to do so. The American also continues to advocate the basic principles of patient freedom of choice, freedom of contract, protection from managed care abuses, and full coverage of all clinically indicated mental health treatment.