The Pennsylvania Orthopaedic Association (POA) was instrumental in the introduction of HB 1997, a bill that gives physicians and other health care providers collective bargaining rights in negotiating with insurance companies. The bill provides the same protections offered other employees in negotiating with their employers. However, the bill prohibits physician strikes and boycotts against health care insurers. Health care providers would be able to band together to negotiate treatment protocols and reimbursements with insurers. HB 1997 amends current Pennsylvania labor laws by changing the definition of employee to include "medical professionals." At the same time, managed care insurers would be considered "health care financing firms" and would be incorporated under the definition of "employer." Implementation of HB 1997 is contingent on a change in federal law which currently bars health care providers from collective bargaining. At the federal level, HR 1304, the Campbell-Conyers bill, awaits action in the House Judiciary Committeepossibly in early February. The Pennsylvania legislature cannot amend the states collective bargaining law until the federal law has been changed. The POA goal in introducing HB 1997 was to create more dialogue on the need for health care reform. The bill has been referred to the House Labor Relations Committee.
A new provision in Wisconsins 1999-2000 budget requires employers with more than 25 employees to offer point-of-service (POS) plans to employees. Under the plan, enrollees would be responsible for the increased costs of a POS plan. The provision is unique in that it requires employers to offer the service and not insurers; it is already under scrutiny and appears to be in conflict with the Employee Retirement Income Security Act (ERISA). A health care attorney speaking with BNAs Health Policy Monitor indicated that "ERISA generally forbids states from imposing benefit plan mandates on employers." Wisconsin plans to move forward with implementation of the provision.
Michigan legislators approved several bills addressing continuity of care for patients in managed care plans. House Bills 4485, 4486, and 4487 have been sent to the governor for approval. The legislation will only permit enrollees with terminal illnesses or those who are pregnant at the time a provider leaves a plan to continue receiving treatment from the health care provider.
Washington state legislators returned to the capitol on January 10, and one issue back on their agenda was a "Patients Bill of Rights." Gov. Gary Locke has asked that legislators revisit several proposals, including independent grievance procedures, access to plan information and insurer liability. The Washington state House is evenly split between Republicans and Democrats, with each party represented as co-chair on committees. The issue seems to have bipartisan support, and may, in fact, be successful after four unsuccessful attempts in the past.
Florida legislators wont return to Tallahassee until March 7, 2000, but prefiled legislation indicates health care issues will be a hot topic of debate. House Bill 291 and Senate Bill 424, each known as the "Managed Care Organization Accountability Act of 2000," address insurer liability and the duty of managed care organizations to exercise ordinary care or be held responsible for adverse determinations. In addition, a chiropractic scope of practice bill has been prefiled that permits employees direct access to chiropractors for cases involving workers compensation. The two insurer liability bills have already been assigned to the House and Senate Judiciary Committees.
New York Gov. George E. Pataki signed the Health Care Reform Act of 2000 which will make as many as 1 million New Yorkers eligible for state-subsidized health care, includes subsidies for small businesses to provide coverage for their employees and provides more money for teaching hospitals. Major new funding for the program will come from a 55-cent a pack increase in the states cigarette tax. The state also will use its tobacco settlement money to fund health care programs.
New Jersey Gov. Christine Whitman said the states managed care plans do not do enough to prevent illness. She announced that the state would reduce by 5 percent the fees paid to HMOs that insure state employees if the insurers fall below the state average for performance next year.