June 12, 1997

Congress panel OKs health plan conscience rule

WASHINGTON - Health plans contracting with Medicare would not have to provide end-of-life or abortion services if they objected on moral grounds, a House committee decided Thursday.

The plans also would not be required to provide palliative care, which lessens pain without curing. The House Commerce Committee approved the ``conscience clause'' as it debated legislation creating a new program to cover up to 5 million uninsured children and cut Medicare and Medicaid spending.

The measure is one of the most significant domestic initiatives to move through Congress this year. It calls for $15 billion in savings in the Medicaid health program for the poor, elderly and disabled while providing $16 billion in grants to states to cover uninsured children.

The bill is needed to implement a five-year balanced budget deal between Congress and the White House. It was expected to be approved later Thursday.

The committee by 33-12 vote approved an amendment making it clear that health plans contracting with Medicare would not have to provide, pay for or cover counseling or referral for services such as end-of-life, abortion or family planning to which they object on moral grounds.

While Medicare primarily covers senior citizens, it also provides care to younger, disabled individuals.

``A health plan doesn't have a conscience,'' California Democratic Rep. Henry Waxman said. Oklahoma Republican Tom Coburn protested that ``killing somebody is not health care.''

During debate, Democrats offered a series of unsuccessful amendments to eliminate or trim a pilot project allowing 500,000 seniors to set up tax-free medical savings accounts rather than participating in the traditional Medicare program.

Democrats worry the healthiest, wealthiest seniors will use the accounts, leaving older, sicker people in the Medicare program and increasing spending by at least $2 billion. They tried to persuade the committee to use the $2 billion instead to subsidize Medicare premiums of low-income seniors or cover co-payments for preventive care.

``Medicare is going to be in a death spiral as (medical savings account expansion) goes on,'' New Jersey Democrat Frank Pallone said.

Republicans argued that the accounts, used in conjunction with high-deductible insurance plans, would make seniors more careful health care shoppers. ``Medical savings accounts are something whose time is coming .... People will use that money more rationally for their health care needs,'' Texas Republican Joe Barton said.