FP Report -- November 1999
House-Senate panels to dictate shape of high-priority health bills
House-Senate conference committees will forge agreements within the next few months affecting three areas of high priority to FPs and the Academy: managed care reform, Title VII funding, and the Agency for Health Care Policy and Research.
After the House-Senate panels juggle the differences between bills from the two chambers, Congress will vote on the final bills.
Managed care reform. The House voted 275-151 on Oct. 7 to pass a bill the Academy supports, the Bipartisan Consensus Managed Care Improvement Act. The bill would apply patient protections to all health plans, unlike the limited Senate bill the AAFP has criticized.
In a procedural move, the House tacked onto its bill some provisions from a recently vetoed tax bill. They include deductions for caretakers of elderly family members, an expansion of medical savings accounts, and tax breaks for self-employed and uninsured employees to help them buy private health insurance.
"As for the tax provisions passed to help the uninsured, they may help some, but they are not enough," said AAFP Board Chair Lanny Copeland, M.D., of Albany, Ga. "Right now, 44 million Americans have no health insurance. One out of six of our citizens has to choose between putting food on the table and seeing a doctor for preventive health care. This is unacceptable."
If the conference committee on the reform bills retains the tax measures or approves legislation much like the Senate bill, and if Congress adopts the committee's bill, President Bill Clinton reportedly may veto it.
Title VII. The House called for Title VII funding for family medicine training programs similar to the 1999 level of $51 million. The Senate, however, called for an across-the-board Title VII cut of 25 percent.
"The Academy is lobbying the conference committee to maintain the current funding," said Jeffrey Human, director of AAFP's Washington office. "We hope there'll be no compromise, no decrease, and the committee will follow the House's recommendation."
AHCPR funding. Both Senate and House bills call for something the Academy has long sought: more funding for AHCPR (soon to be renamed the Agency for Health Research and Quality).
Similarly, both the Senate and House gave legislative approval to the agency's already existing Center for Primary Care Research. The legislation defines primary care research and spells out what kind of research the center should conduct. The Academy helped draft the legislation.
FP Report is published by the AAFP News Department. Copyright © 1999 by American Academy of Family Physicians.
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