July 16, 1998

Good morning. Last year, Senator Kennedy and I introduced one of the first comprehensive patient protection bills in this Congress, H.R. 820, the Health Insurance Bill of Rights. At that time we worked from a report by Families USA called "States to the Rescue." This report showed how a few pioneer states had tried to fill the void in patient protections by passing their own state legislation.

Today, two years later, Families USA is unveiling a follow-up report called "Hit or Miss: State Managed Care Laws."

This report is telling. It shows both great interest and huge gaps in protecting consumers in managed care plans. It points to the need for the federal legislation that would guarantee at a minimum, a basic floor of consumer protections across the nation.

Right now, there is little consistency from state to state. Some states have only one or two protections. Some have none. A few key states, like Vermont, have gone a long way for consumers.

Of a list of 13 key consumer protections -- all of which are in the Patients' Bill of Rights -- 33 states have passed between one and four. That means, in close to two-thirds of the states, consumers have very few protections at all.

Even more telling is the number of consumers who are not affected even when their state does enact a consumer protection law. Approximately one-third of Americans with employer provided health care, or about 51 million people, are in "self-insured" plans that are preempted from patient protections established by state laws. In short 51 million people in this country have virtually no consumer protections. Additionally, of those who have health insurance provided by their employer, 83 percent, or 124 million Americans, are preempted by ERISA from holding their health plan liable for wrongful denials of care.

The report today from Families USA underscores the argument for a national Patients' Bill of Rights.