Patients in Medicaid HMOs are gaining new protections as President Clinton presses ahead on what has become a major campaign issue.
The announcement Thursday came with health legislation stuck in Congress. In fact, Senate Majority Leader Trent Lott used a parliamentary maneuver Wednesday to prevent the Democrats' health measure from coming to the floor for debate."Can you believe that?" the president asked in a speech to the International Brotherhood of Electrical Workers' convention. "Why would they shut the Senate down? Because when you go to an emergency room or an operating room or a doctor's office, nobody asks you whether you're a Republican or a Democrat."
Clinton said the administration was extending patient protections to 15 million people in Medicaid, the health insurance program for the poor, which is increasingly steering people into health maintenance organizations and other managed care plans. He already took similar action for Medicare beneficiaries.
The new rules require states to give Medicaid recipients a choice of HMOs if they require them to go into managed care.
Medicaid also must guarantee patients the right to appeal if they are denied care and give people easy-to-understand information about their benefits.
Also, Medicaid HMOs must pay for reasonable emergency room visits, allow women direct access to gynecologists, and let people with severe medical conditions see specialists without having to go to a primary care doctor first, under the measure.