President signs Health Care Insurance Reform bill

Public Law 104-191 Prohibits Discrimination Against Motorcyclists

WASHINGTON, D.C...On the afternoon of Wednesday, August 21, 1996, President Bill Clinton signed into law the "Health Insurance Portability and Accountability Act of 1996." Public Law 104-191 contains language that will, after June 30, 1997, prohibit employer provided health care plans from denying benefits to motorcyclists.

Ensuring motorcyclists were protected from the growing problem of health care discrimination was the number one legislative priority of the MRF and the American Motorcyclist Association in 1996, the second session of the 104th Congress. This accomplishment, combined with the repeal of the federal penalties on States without helmet laws during the first session of the 104th Congress in 1995, makes the 104th Congress the most successful Congress ever for motorcyclists.

Success first came, after motorcyclists laid the groundwork from January through March, on the night of March 28, when the House of Representatives passed H.R.3103, the Health Coverage Availability and Affordability Act of 1996 on a vote of 267 ayes to 151 nays. Sections 103 and 191 of H.R.3103, and the accompanying Ways and Means Committee Report, included provisions to prevent employer provided health care plans from discriminating against motorcyclists.

Then, during Senate floor debate on the legislation, Senator Moseley-Braun (D-IL) entered into a colloquy with bill sponsor Senator Nancy Kassebaum (R-KS) to ensure that the bill's intent, among other things, was to end discrimination against motorcyclists. On April 23, the Senate passed its version of H.R.3103 on an unanimous vote of 100 ayes to zero nays.

After several months of heated debate, mainly over medical savings accounts, late in the night of July 31, 1996, the conference committee on H.R.3103, the "Health Insurance Portability and Accountability Act of 1996," reached agreement on a final bill and issued the conference report on the legislation. Included in the conference report was language to prohibit health insurance discrimination against motorcyclists in employer provided health care benefit plans. The House of Representatives passed the conference report on August 1, on a vote of 421 ayes to 2 nays. Then, on August 2, the Senate passed the conference report on a vote of 98 ayes to zero nays.

The prohibition of discrimination against motorcyclists is contained in several parts of the legislation and conference committee report. The first two are in the legislative language itself, which is of a broad and general nature. The third is in the accompanying report language which is a more detailed description of the conference committee's intent of the legislative language.

Section 101 of Title I of H.R.3103, amends the Employee Retirement Income Security Act of 1974 (ERISA) by adding a new Part 7, titled Group Health Plan Portability Access, and Renewability Requirements. Section 102 of Title I of H.R.3103 amends the Public Health Service Act (PHSA) by adding a new Title XXVII, named Assuring Portability, Availability, and Renewability of Health Insurance Coverage. The key legislative language in these two sections, the new Section 702 of the ERISA and the new Section 2702 of the PHSA, are identical and read as follows:



"(1) IN GENERAL.-- Subject to paragraph (2), a group health plan, and a health insurance issuer offering group health insurance coverage in connection with a group health plan, may not establish rules for eligibility (including continued eligibility) of any individual to enroll under the terms of the plan based on any of the health status-related factors in relation to the individual or a dependent of the individual:

"(A) Health status.

"(B) Medical condition (including both physical and mental illness).

"(C) Claims experience.

"(D) Receipt of health care.

"(E) Medical history.

"(F) Genetic information.

"(G) Evidence of insurability (including conditions arising out of acts of domestic violence).

"(H) Disability.

The conference committee report language that clarifies these sections reads as follows:

"The inclusion of evidence of insurability in the definition of health status is intended to ensure, among other things, that individuals are not excluded from health care coverage due to their participation in activities such as motorcycling, snowmobiling, all-terrain vehicle riding, horseback riding, skiing and other similar activities."

Under the provisions of H.R.3103, these new requirements of ERISA and PHSA shall become effective for "plan years" beginning after June 30, 1997.

"Inclusion of these provisions in this new federal law brings much needed relief to motorcyclists and their families from arbitrary discrimination in health care," stated Wayne Curtin, vice president of government relations for the Motorcycle Riders Foundation. Curtin continued by saying, "This legislative success is the result of years of hard work by many motorcyclist members of the MRF, the American Motorcyclist Association and the state motorcyclists' rights organizations."

Curtin praised "the members of ABATE of Illinois, ABATE of Wisconsin, ABATE of Ohio, Concerned Motorcyclists of Ohio, ABATE of Minnesota and AMA and ABATE members from Kansas who came to Washington early this year with providing the grass roots push that ensured this victory." In addition, Curtin cited, "Rob Dingman, the AMA's Washington Representative, with providing leadership that was key to success on ending discrimination against motorcyclists in employer provided health care plans."

Robert Rasor, the AMA's vice president of government relations, who has been dealing with the issue of health care discrimination for over eight years, remarked on the importance of this legislation by saying, "The potential loss of health care benefits is the greatest threat there is to motorcyclists, because none of us can afford to ride without coverage. This bill should prevent employer provided health care plans from discriminating against motorcyclists."

Curtin further credited, "Congressmen Phil Crane (R-IL), Jim Ramstad (R-MN), Scott Klug (R-WI), Paul Gillmor (R-OH), Brian Bilbray (R-CA), Jim Quillen (R-TN), Bill Archer (R-TX) and Bill Thomas (R-CA) and Senators Carol Moseley-Braun, Ben Nighthorse Campbell (R-CO), Dan Coats (R-IN), Nancy Kassebaum and Ted Kennedy (D-MA) as being the key members of Congress who brought about this legislative victory for motorcyclists."

However, the work on this issue is not complete. Now that the legislation has become law, federal regulations to administer the law will have to be developed before P.L.104-191's effective date of June 30, 1997. Proposed regulations will be published in the Federal Register in the coming months. There will then be a comment period for the public to respond, and request different language, before final regulations are issued. Curtin stated, "It will be motorcyclists' responsibility to ensure that the final regulations include requirements that reflect the legislation's intent to prohibit discrimination against motorcyclists in health care insurance." In addition, the AMA is beginning a program to educate the business community about the requirements of this legislation and to assist them in coming into compliance with P.L.104-191.

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