ROANOKE TIMES
Copyright (c) 1996, Roanoke Times
DATE: Thursday, August 22, 1996 TAG: 9608220043
SECTION: NATIONAL/INTERNATIONAL PAGE: A-1 EDITION: METRO
DATELINE: WASHINGTON
SOURCE: Los Angeles Times
NOTE: Lede
President Clinton signed a major health care bill Wednesday that will ensure that millions of Americans with conditions ranging from pregnancy to heart disease and cancer can change jobs without fear of losing insurance coverage.
The legislation ``seals the cracks that swallow as many as 25 million Americans who can't get insurance or fear they will lose it,'' Clinton said.
The bill, which had been approved virtually without dissent by the Republican-controlled Congress, guarantees that small companies and self-employed individuals cannot be rejected for coverage by insurers.
The law takes effect July 1, 1997, but because most corporate health plans operate on calendar years, most Americans won't feel the impact until Jan. 1, 1998.
The biggest health care measure passed in a decade was modest by comparison to Clinton's original health plan, which would have required all businesses to provide health insurance for their workers and would have established a system of federal control and oversight.
The biggest beneficiaries of the new law will be insured families in which members have a health problem. Without the legislation, a worker or family members might be required to wait six months or a year before insurance on a new job will cover bills associated with a health condition that existed before the employee joined the company, including a pregnancy.
This ``pre-existing exclusion'' can be imposed whenever someone switches jobs. But the new law says that a worker now will be entitled to immediate coverage in a new job.
The guarantee of continuous coverage will not apply if a worker is without health insurance for more than 63 days between jobs.
The ``Health Insurance Portability and Accountability Act'' was steered through Congress under the leadership of Sen. Nancy Kassebaum, R-Kansas, and Edward Kennedy, D-Mass.
Republican presidential candidate Bob Dole said the legislation ``includes many of the important health insurance reforms I've promoted for years and should end once and for all the Clinton prescription of big-government health care.''
The law also forbids insurers from refusing coverage for small companies - those with two to 50 workers - because an employee has a serious health problem. However, the law says nothing about the price of such coverage, however. That is left to the states, which must find their own systems to make coverage affordable.
Nor does the law address the problem of the growing number of Americans who lack any health insurance. About 17 percent of the U.S. population under the age of 65 is uninsured.
The measure offers new benefits for the self-employed, raising the federal tax deduction for their health insurance premiums from 30 percent of costs to 80 percent by the year 2002.
It also gives the self-employed and companies with fewer than 50 workers the ability to buy Medical Savings Accounts.
These accounts allow participants to set aside money tax-free to pay for current or future medical expenses. The insurance policies come with a high deductible, which is expected to restrain health care spending by discouraging marginal visits to doctors.
Advocates argue that people with the new medical accounts will exercise restraint because they will decide each time they fall ill whether to dip into their tax-free account to pay to see a doctor or skip the visit and let the account build up.
The government will limit the number of people participating in such accounts to 775,000, awarded on a first-come basis, as part of a four-year experiment to determine whether the accounts help hold down costs.
The law also creates a program to combat fraud and abuse. The Medicare system, which provides health care for those over 65 and the disabled, will receive particular attention. Experts estimate that 10 percent of the about $180 billion a year spent on Medicare is consumed by fraud and waste.
LENGTH: Medium: 81 lines ILLUSTRATION: PHOTO: AP. President Clinton speaks with Kristin Hopper, 6, ofby CNBFalls Church, Va., after signing the health care bill Wednesday.
color.