06.29.01

Statement of Senator Maria Cantwell On Senate Passage of Bipartisan Patient Protection Act

WASHINGTON, DC - U.S. Sen. Maria Cantwell (D-WA) joined forces with 58 other senators today to ensure final Senate passage of the Bipartisan Patient Protection Act, a major health-care bill that extends essential, fundamental protections to every American who is covered by any health insurance plan.

"People have a right to expect decisions about their health and treatment to be made by their doctors, based on all necessary medical tests and examinations - not dictated by accountants, who are focused on the health of the insurance company's bottom line instead of the health of patients," said Cantwell, who co-sponsored the bill.

Cantwell said that the federal legislation passed today enhances state protections, rather than undermining them as some people have feared, by "explicitly preserving strong state patient protection laws that substantially comply with the protections in the federal bill." She stressed that, "The standards for certifying state laws that meet or exceed the federal minimum standard ensure that only more protective state laws replace the federal standards."

Among other important achievements, Cantwell said, the new legislation protects a patient's right to hear the full range of treatment options from his or her doctor; prohibits financial incentives for limiting medical care; allows patients to go to the first available emergency room (ER) when they are facing an emergency, regardless of whether that particular ER is in their managed care network; allows patients with life-threatening or serious illnesses, for whom standard treatments are ineffective, to participate in approved clinical trials; and holds insurers and HMOs accountable when their abuses result in injury or death.

(Statement of Senator Maria Cantwell, as prepared)

Senator Maria Cantwell June 29, 2001 Final Passage Bipartisan Patient Protection Act

Mr. President, I rise today to speak in support of the bipartisan McCain-Edwards-Kennedy Bipartisan Patient Protection Act. Managed care reform, particularly the enactment of a comprehensive Patients' Bill of Rights, is one of the most important issues currently before either Body of the United States Congress. After all the debate we have had on the floor in the last two weeks, I believe we are at the cusp of providing true, meaningful protections for every American in every health care plan.

Unfortunately, while over 160 million Americans rely on managed care plans for their health insurance, HMOs can still restrict a doctor's best advice based purely on financial costs. The fact is, we know that the great promise of managed care - lower costs and increased quality - has in all too many cases turned into an acute case of less freedom and greater bureaucracy.

I want to tell my colleagues about the Malone family from Everett, Washington. Their son, Ian, was born with brain damage that makes it very difficult for him to swallow, to even cough and gag properly. He cannot eat or breathe without being carefully watched. He's fed through a tube in his stomach since he can't swallow.

The doctors at Children's Hospital in Seattle -- one of the best pediatric care institutions in the world -- said that Ian could leave the Intensive Care Unit but would need 16 hours of home nursing care a day for Ian. And while initially the Malone's health insurance company paid for this care, it decided to cut it off. Ian's father says that, "The insurance company told us to give Ian up for adoption and let the taxpayers step in and pay for his care. They didn't care. It was all about saving money."

It seems that the week's rhetoric has centered on the idea of business and employers versus patients -- as if these two interests are inherently antithetical, rather than complementary. But they are not. In fact, I believe the Bipartisan Patient Protection Act is a balanced approach to protecting patients and protecting the business of managed care.

My home state of Washington has been a leader in providing health care to all of its citizens and has enacted strong patient protections at the state level. Under Washington State law, patients have the right to accurate and accessible information about their health insurance; the right to a second opinion; timely access to services by qualified medical personnel; the right to appeal decisions to an independent review board; and the ability to sue providers for damages if they are substantially harmed by a provider's decisions.

I believe that States are the laboratories of democracy and I do not take lightly the possibility that any federal legislation would undermine or preempt state law. I spent six years on the Health Care Committee in the State House of Representatives and just this last year Washington passed a comprehensive Patient's Bill of Rights. In issues such as the one before us this week, it is paramount that federal legislation enhance state protections, not undermine them.

And that is what this bill does. The McCain-Edwards-Kennedy compromise explicitly preserves strong state patient protection laws that substantially comply with the protections in the federal bill. This is an extremely important point. The standards for certifying state laws that meet or exceed the federal minimum standard ensure that only more protective state laws replace the federal standards.

But I find it ironic that opponents of a strong, enforceable, Patients' Bill of Rights have traditionally limited the scope of the patient protections in their managed care reform legislation to those individuals in self-insured plans, which are not regulated by the states, and assert that the states are responsible for the rest.

This approach denies federal protections to millions of Americans - teachers, police officers, firefighters and nurses who work for state and local governments; most farmers and independent business owners who purchase their own coverage; most workers in small businesses who are covered by small group insurance policies, and millions more who are covered by a health maintenance organization. We need federal protections so that all Americans are guaranteed basic rights.

In fact, no state has passed all the protections in the bipartisan McCain-Edwards-Kennedy Patients' Bill of Rights. To fail to enact this bill would mean that neighbors, and sometimes workers in the same company, will have different protections under the law. The scope of this legislation simply ensures that all Americans in all health plans have the same basic level of patient protections.

Let me focus for a few minutes on what this bill does:

This bill protects a patient's right to hear the full range of treatment options from their doctors, and it prohibits financial incentives to limiting medical care. This bill allows patients to go to the first available emergency room when they are facing an emergency -- regardless of whether that particular E.R. is in their managed care network. This bill allows women to go directly to their obstetrician or gynecologist without going through a "gatekeeper," and it allows parents to bring their children directly to pediatricians instead of having to go through primary care physicians. This bill allows patients with life-threatening or serious illnesses, for whom standard treatments are ineffective, to participate in approved clinical trials. This bill has laid out stringent, tough, enforceable internal and external review standards, and we have ensured that a truly independent body has the capability and authority to resolve disputes for cases denying access to medical care. This bill promotes informed decision-making by patients, by requiring health plans and insurance companies to provide details about plan benefits, restrictions and exclusions, and other important information about coverage and rights under the legislation. Finally, the Bipartisan Patient Protection Act holds insurers and HMOs accountable for their acts. Twenty years ago, very few Americans were in managed care plans. Since the early 1990s, however, insured workers' enrollment in traditional fee-for-service plans has dropped from about 50 percent to under 25 percent. The broad shift to managed care has been driven, largely, by cost concerns. But in our need to control health care costs, it is imperative that we do not forget what we are supposed to be doing - providing health care.

There will be few issues more important in the 107th Congress than the one we are voting on today. Health care affects people personally, every day of their lives, and we have a real responsibility to ensure that any changes we make put the patient's interests first. That is what this bill does, and I proudly rise in support of the Bipartisan Patient Protection Act.