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Show If the entitlement status of the program is preserved, however, and sufficient federal oversight is provided, Democrats will likely compromise on this but will target a higher cap. Insurance reform for the private sector may be proposed by both parties during this Congress. Basic reforms, such as guaranteed issue and renewability and removal of pre-existing condition exclusions, are likely to surface and be enacted in some form. The Health Insurance Association of America supports some small steps in this regard, and these are likely to occur but not to the extent supported by consumer groups. Democrats will probably go along with some of these modest changes, but reluctantly, since they realize these reforms might worsen the private insurance market situation by increasing the level of risk of those purchasing insurance, leading to rising premiums, further market segmentation, dropping of coverage by younger healthier individuals, and so on to the insurance "death spiral." Some legislation providing federal standards for health plans is likely to be enacted this year. The real question is whether it will be in the context of broadening the ERISA umbrella or constraining it. In general, Republicans in Congress would be more likely to support the federal oversight of health plans along with strengthening and expanding ERISA, as proposed by Congressman Harris Fawell (R-Illinois). There is no unanimity on this issue among Democrats. Congressman Jim McDermott (D-Washington) has introduced a revised version of his single payer plan, and Senator Paul Wellstone CD-Minnesota) has not ruled out pursuing this avenue himself this session. It is unlikely, however, that such a plan will see the light of day in this Congress. Similarly, it is unlikely that any comprehensive health care reform will be enacted this session. The second year of the session will be dominated by presidential politics. President Clinton will avoid comprehensive health care reform, as he is wise to do. Similarly, assuming the Republican candidate is a member of Congress, s/he will likely be extremely conservative or will have to cater to conservative groups to defeat the incumbent president. Balancing the budget, decreasing the deficit, controlling crime, promoting family values, and clamping down on immigrants will all dominate the domestic political debates making health care an unlikely topic for consideration prior to the 1996 election. The challenges will be even greater when the 105th Congress convenes in January 1997, and perhaps that will be the Congress to address health care reform in depth. Health Care Legislation Enacted in the 1995 Legislative General Session Catherine J. Dupont. Associate General Counsel,. Legislative Research and General Counsel, Utah State Legislature. The Utah Legislature considered several dozen bills related to health care issues during the 1995 legislative session. The purpose of this article is to provide selected highlights of some of the health care legislation enacted in the 1995 General Session and to summarize the issues that are scheduled for consideration during the interim study process prior to the 1996 General Session. House Bill 305. Health System Improvement Act (B. Harward). H.B. 305 was the bill recommended to the Legislature by Governor Leavitt's Health Policy Commission. The following is a brief summary of the bill: I. Insurance Reform. Beginning January 1, 1996 small employer insurance carriers must accept all eligible employees of a small employer for insurance coverage. This includes people who have traditionally been "uninsurable." Beginning May 1, 1997, insurance carriers must begin to accept "uninsurable" individuals as well. The requirement to accept uninsurables is limited by an enrollment cap. Once an insurer has met the enrollment cap, the insurer is no longer required to accept uninsurables. The insurance commissioner will develop an industry-wide definition for "uninsurable." Uninsurables must be offered at least the basic benefit package which will be developed by the insurance commissioner. Rating restrictions, renewability requirements, and pre-existing condition restrictions of small group reform apply to policies issued to people under open enrollment. Beginning January 1, 1996, conversion policies are subject to the rating and renewability requirements that apply to small groups. The premium rates may not exceed by more than 35 percent of the index rate for individuals with similar case characteristics. II. Medical Care Savings Accounts. Establishes guidelines for the creation and administration of medical care savings accounts. Provides state income tax deductions for money contributed to a medical care savings account. III. Rural Health Care. Appropriates $300,000 to be split between the Department of Health and the University of Utah Health Science Center to fund Area Health Education Centers which will provide community-based health professions education programming for specific geographic areas. Authorizes the De- 134 Communications |