SENATOR JAMES JEFFORDS, COMMITTEE CHAIRMAN

James Jeffords - Chairman

Home State: Vermont

TESTIMONY

Good morning and welcome to the Committee on Health, Education, Labor, and Pensions hearing on the Bipartisan Patient Protection Act of 2001. Today we will hear testimony regarding a very contentious component of this legislation: the right to hold health plans and insurers liable for patient claims.

We have several panelists today who will share their insights into the implications of this piece of legislation. We intend to listen and respond to their comments, and we hope to learn as much as possible from their participation in these proceedings.

As responsible lawmakers, we on the HELP committee clearly recognize the urgency of protecting the health and well-being of all Americans. To that end, we are obligated to create legislation that both allows patients to access the care they deserve, and provides for a reasonable system through which they may voice their grievances.

We would neglect our duties as advocates for our citizens' well-being, however, were we merely to address the receipt of health care. A complex and dynamic system unlike any other, modern health care involves input from physicians, health care professionals, economists, and businessmen alike. Just as patients risk their safety and well-being when trusting their care to doctors and administrators, these people similarly face risks in accepting that trust, and administering care. These peoples' contributions to the health process must be considered, lest we fail to effectively construct and enforce patient protection legislation.

This morning we hear testimony from Secretary of the Department of Health and Human Services, Tommy, G. Thompson. Secretary Thompson heads the department that will eventually enforce the regulations outlined in this legislation. Also, as a former Governor, I look forward to hearing what Secretary Thompson's commentary regarding provisions in this bill requiring accordance of state and federal law. His testimony is therefore crucial and much anticipated. Thank you for coming today Secretary Thompson, and welcome.

Robert Pollack, Executive Director of Families USA, also joins us this morning. Mr. Pollack represents millions of American consumers committed to accessing quality, affordable health care. Mr. Pollack, your presence reminds us of the constituents whom we are devoted to serve, and without whom we would not sit here today. We welcome you and look forward to your testimony.

Representing the Health Insurance Association of America this morning is Mr. Chip Khan. Mr. Khan speaks on behalf of health insurance companies that collectively insure more than 100 million Americans. Today's proceedings intend to bring about federal law that would significantly regulate his industry. He certainly will provide us with necessary insight into the ease of compliance with this legislation, and the costs insurers expect to bear with its passage. Welcome, Mr. Khan, we are pleased to have you with us today.

We will also hear from Mr. Jack Faris, President of the National Federation of Independent Business. The Senate commends employers who provide health care for their employees, especially in these times of continually increasing health care costs. We all realize that Ms. Holmes' attitude towards this legislation affects the access to health care of millions of Amercian workers. We welcome you Ms. Holmes, and eagerly await your testimony.

Much is at stake as we begin our deliberations today.

Senate bill 283 makes provisions for patients to hold their health care providers liable for grievances related to injury and contract disputes. Many patient protections bills have been drafted in recent years; we have heard and debated the merits and downsides of many of these bills in this very Senate chamber. It is with this experience and personal knowledge of patient protection legislation that I approach today's hearing with some skepticism and trepidation.

We must not forget that we are building upon federal regulations made into law last summer with the incorporation of the Nickles Amendment (S. Amdt. 3694) into appropriations bill H.R. 4577.

The Nickles Amendment, also known as the "Patients' Bill of Rights Plus Act," is a substantive bill that encourages internal and external appeals processes of patient claims. Under the Act, the Secretary may assess civil monetary penalties against administrators of health plans and issuers that fail to comply with external medical review decisions, or cause harm to an individual in deciding to delay care. Federal recourse, therefore, now exists for those who wish to make claims against plans and insurers that do not comply with the law. The Secretary is responsible for monitoring whether health plans and insurers comply with the law, providing further assurance that the concerns of patients around the country are looked out for. I worked with Senator Nickles to pass the "Patients' Bill of Rights Plus Act," and I believe that it forms a solid foundation for the provision of thorough patient protection. At the same time the Act prevents cost increases and encroachment upon already existing legislation.

Much of the support earned by the Nickles Amendment was contingent upon allowing states to retain their laws and measures for addressing claims against health plans. It is my belief that the passage of more comprehensive patient protections should not jeopardize States' regulations. Indeed, redress should only be allowable in federal courts. Provisions allowing lawsuits at state and federal levels greatly increase the risk of greater health management costs, which are inevitably passed onto the consumer.

Recent events, such as the Supreme Court case concerning HMO liability, remind us of the increasing importance of providing our constituents with legislation that protects their rights without jeopardizing the affordability of their coverage. It is my hope that today's proceedings may progressively move us toward that goal.

We will begin with the testimony of Secretary Thompson. Thank you again for joining us again today Secretary. Please proceed.

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