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HEALTH CARE LIABILITY FOR EMPLOYERS

THE ISSUE IS. Health care patient protection, or patients' "bill of rights," proposals that could expose employers to lawsuits and substantially raise costs to consumers.

IT'S IMPORTANT BECAUSE. The majority of insured working Americans today receive their health care coverage through their employers. Health care costs have significantly risen in the last decade, and many employers have turned to managed care plans as a way to control costs and to have flexibility in providing health benefits to their employees. Approximately 60 percent of Americans (or 160 million people) are now enrolled in these managed care plans.

In recent years, consumers have raised concerns about the quality of care provided by managed care plans, particularly health maintenance organizations (HMOs). Some specific concerns include the denial or delay of certain treatments to save money and the lack of access to specialists. While public complaints regarding managed care have focused more on anecdotes rather than statistics, the outcry has been loud enough to spur legislative activity on both the state and federal government levels.

Most states have passed some form of managed care legislation over the past several years. Most significant was likely the 1997 Texas law permitting medical malpractice lawsuits to be brought in state courts against HMOs for medical decisions resulting in injury or death. This state law contrasts with the federal 1974 Employee Retirement Income Security Act (ERISA), which preempts state laws relating to employee benefit plans and prevents employees from bringing malpractice suits in state courts in connection with employer-provided health plans.

Numerous insurers and business organizations have expressed concern that additional regulation will likely increase health care costs and increase the number of uninsured Americans.

NAMIC POSITION. Because the vast majority of people in the United States who have health benefits have obtained it through their employers, NAMIC opposes legislation that would substantially increase employer costs in providing health insurance to their employees.

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Every two years, NAMIC presents their coveted Benjamin Franklin Public Policy Award© to lawmakers who have supported a stronger insurance market at least 75 percent of the time. This is demonstrated based on their support of NAMIC's position on certain roll call votes taken, or being a principal player/sponsor on legislation affected the property/casualty insurance industry, during the previous Congress.