Copyright 1996 by Paul Starr. Preferred Citation: Paul Starr, "The Signing of the Kennedy-Kassebaum Bill," August 22, 1996 ( /signing.html).


by Paul Starr

August 22, 1996 -- President Clinton's signing of the Health Insurance Portability and Accountability Act was a bittersweet occasion for those of us gathered on the South Lawn yesterday who had worked on the original Health Security Act in 1993 and 1994.

"Better than nothing" was the sentiment heard frequently among the former health reform staffers. The bill limits preexisting condition exclusions and for the first time makes the regulation of private health insurance a federal responsibility. But it does not extend coverage to the uninsured, and while it prohibits insurance companies from refusing to renew coverage, it sets no limits on what they can charge.

The true achievement of the bill was underlined by Merrit Kimball of the Alliance for Health Reform, who spoke eloquently of how personal the problem of preexisting conditions had become for her when she was recently diagnosed with breast cancer.

The great limitations of the bill were underlined by Senator Edward M. Kennedy, who spoke of his continued dedication to extending health insurance coverage to "all Americans," words he then repeated quietly for emphasis.

President Clinton celebrated the legislation as an example of what Democrats and Republicans could do when they put the country's interests first. The signing was a bipartisan event. Also addressing the crowd was Senator Nancy Kassebaum, whom Senator Kennedy introduced as the "kinder and gentler" senator from Kansas. President Clinton paid tribute to Dennis Hastert and other Republican congressmen present for their role in negotiating final passage of the bill. And he gave his wife credit for her hard work on health care reform.

Would this Congress have passed the Health Insurance Portability and Accountability Act if the previous one had not failed to pass comprehensive health care reform? Perhaps not. The failure to perform of the Democratic Congress in 1994 and the retribution taken by voters at the polls that year served as a stimulus to Republicans and Democrats to get something done on health care reform in 1996. Both Senators Kennedy and Kassebaum also paid tribute to the prodding of Congress by President Clinton in his State of the Union this year to pass the Kennedy-Kassebaum bill.

Whether Kennedy-Kassebaum will relieve pressure for further health care reform or set a basis for new efforts isn't clear. After the dust settles, it may become clearer that we still haven't solved the problem of financing health care for about one of every six Americans.

As the crowd was leaving, one former White House lawyer noticed a group of about a half dozen of the original Health Security team. "Quick, let's screw something up," he said. But that will at least have to wait for a second term.

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