Congressional Corner from Representative James Barcia: Supporting `The Medicare HMO Improvement Act of 1999`

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Congressional Corner from Representative James Barcia: Supporting `The Medicare HMO Improvement Act of 1999`

By Representative James Barcia (D-MI)

Recently I was contacted by almost 5,000 senior citizens in Michigan's Fifth Congressional District to ask that I co-sponsor H.R. 141, the "Medicare HMO Improvement Act of 1999," introduced by my colleague, Congressman Sam Gejdenson. Many of my constituents related painful stories of how their Medicare Health Maintenance Organizations (HMOs) had abruptly canceled their health care policies because the company decided it was not making enough money. As a result, many seniors who desperately needed health insurance didn't have it, simply because a company decided profits weren't lucrative enough. This is wrong, and should be addressed by Congress.

After careful studying Congressman Gejdenson's bill, I decided it was the best proposal to address Medicare HMO's often brutal treatment of our nation's seniors. I agreed to co-sponsor the legislation and have actively encouraged my colleagues to co-sponsor the bill as well.

H.R. 141 protects seniors by preventing HMOs from enrolling them on a short term basis. It would extend the contract period between the Department of Health & Human Services (HHS) and Medicare HMOs from one year to three. In cases where termination would cause a serious risk, it allows the Secretary of HHS to legally enforce coverage by a Medicare HMO for one year after the effective date.

H.R. 141 would also force Medicare HMOs out of the business of "cherry picking," by requiring the Secretary of HHS to terminate the HMO contract with the entire portion of the metropolitan area (MSA) in a state if the HMO had previously decided to terminate specific contracts that the HMO decided had not met profit goals. And finally, this legislation ensures that when an HMO terminates coverage, it would still have to maintain continuity of care for three months after termination. This would guarantee seniors' peace of mind by allowing them to continue to see their primary care doctor during this time period, rather than immediately having to locate a new physician who would not be familiar with their medical history.

I'm sure that you will agree with me that "The Medicare HMO Improvement Act of 1999" is honorable legislation and is good for all our nation's seniors. While I will continue to speak with my colleagues in the House about this bill, I urge you to contact your representative in Congress, and let them know of your support for H.R. 141

This article first appeared in Volume 5, Issue 1 of "The Social Security and Medicare Advisor" newsletter (November/1999). To receive future editions of "The Advisor" in its special, free e-mail version, please click here.