HILL HEALTH REFORM DEBATE WILL START IN LATE JANUARY WITH STARK HEARING

The House Ways & Means/Health Subcommittee will kick off this year's debate on health care reform legislation with hearings planned for late January. The hearings will focus on legislation introduced Jan. 5 by Subcommittee Chairman Stark (D-Calif.). The bill, HR 200, is "90%" the same as last session's HR 5502, introduced in June by Stark and House Majority Leader Gephardt (D-Mo.), with provisions added to build a framework for "managed competition" in the health care system, Stark staffers explained. The bill's Medicare provisions include coverage of outpatient prescription drugs, starting with a $500 deductible in the first year. Notwithstanding HR 200's introduction, Stark has not altered his stated intention to support President-elect Clinton's upcoming health care reform plan. Rather, Stark's intention is to build consensus in areas such as administrative simplification, fraud and abuse enforcement, insurance reforms and establishment of a standard benefit package. Those provisions are included in many health care reform plans and also are likely to be a part of the Clinton package. Like last year's Stark/Gephardt bill, HR 200 would phase in a national health budget that would eventually hold growth in health spending to that of the nominal gross domestic product. The bill would provide grants to states totaling $150 mil. to establish health plan purchasing cooperatives, one of the cornerstones of the managed competition approach. HR 200's managed competition provisions would be less regulatory than those in many other bills. Enrollment in HPPCs would be voluntary tax deductibility of health insurance premiums would not be limited to programs handled by the HPPCs. The bill also contains a number of insurance reforms, such as restrictions on excluding pre-existing conditions from coverage.