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Congress ponders legislation dealing with pre-existing conditions.


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One of the main obstacles discussed during the Clinton Health Care Reform effort was the elimination of pre-existing conditions as a criteria for being insured. Nothing has been settled, and now Congress is addressing the issue in a manner which may re-kindle the flames of this discussion.


Keep an eye on the national level. Federal legislation that would curb pre- existing condition exclusions in health care policies, cleared a huge hurtle in the US Senate and is confronting a new and ominous obstacle in an expanded health care bill, HR 995. This bill the House Economic and Educational Opportunities Committees recently (mid-March '96).

HR 995 would preempt state authority to set benefit requirements on group plans sold by commercial insurers and HMOs, and would exempt fully insured plans and HMOs from state mandated benefit laws. Reportedly, this would make health insurance more affordable for small companies. Employers large enough to self-insure their benefit programs are exempted from state benefit laws by the Employee Retirement Income Security Act, while small employers purchasing polices from insurers are not. Business, particularly smaller businesses, strongly supports the state benefit mandate preemption which, they claim, forces employers to buy services they might not purchase otherwise, like chiropractic care.

Whether or not HR 995 has a chance of passing is not known. If it did pass and was signed into law, current efforts to pass a new insurance equality law might be called into question. Keep your eyes open and your ear to the ground for further information concerning this bill.


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