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News from the American Osteopathic Association

Osteopathic Community Celebrates Major Victory! President Bush Signs Tax Bill into Law and Enacts Pro-Student Provisions

After more than a year of grassroots advocacy for pro-student tax code modifications, President Bush signed a bill into law that will ensure students are no longer punished for accepting scholarships designed to increase the number of physicians in rural and underserved areas. Today, President Bush signed the Economic Growth and Tax Relief Reconciliation Act -- which includes the student loan interest deduction legislation the osteopathic community advocated for years -- into law.

One month after D.O. and Student D.O. Day on Capitol Hill, the U.S. Congress approved important student loan interest deduction legislation. On May 26 the U.S. Congress passed the Economic Growth and Tax Relief Reconciliation Act (H.R. 1836), a bill containing two student loan interest deduction provisions strongly supported by the AOA. The House approved the measure with a vote of 240-154 (39 Members did not vote) and the Senate with a vote of 58-33 (2 Senators voted Present and 7 did not vote).

First, H.R. 1836 will modify the student loan interest deduction allowed under law. Starting in 2002 individual filers earning $50,000-$65,000 and joint filers earning $100,000-$130,000 will be eligible to deduct $2,500 of student loan interest per year for the life of the loan.

Second, H.R. 1836 eliminates the tax penalty placed on recipients of awards from the National Health Service Corps (NHSC) and Armed Forces Scholarship Programs. Any amount received by an individual under the NHSC or Armed Forces Scholarship Programs will be eligible for tax-free treatment as qualified scholarships, without regard to any service obligation by the recipient. The tax-free treatment is effective in 2002, but will not apply
to amounts designated for regular living expenses.

For several years Congress tried to correct a 1986 Internal Tax Code revision which requires limited tax deductibility for school loan interest. The AOA believes 1986 provisions unfairly limit the use of the student loan interest benefit and greatly complicate its administration. While Congress passed a correction in the 106th Congress, President Clinton vetoed the bill.

Over the past year AOA worked with the osteopathic medical community to write letters in support of a correction and in April worked with the American Association of Colleges of Osteopathic Medicine (AACOM) to coordinate a Hill day to educate members of Congress about the issue.

Nearly 450 members of the osteopathic family stormed Capitol Hill on April 26 to teach policymakers about osteopathic medicine and the importance of two issues: student loan interest deduction and health professions training funds. With so many members of the Council of Osteopathic Student Government Presidents (COSGP) and the Student Osteopathic Medical Association (SOMA) participating, the biannual event drew seven times last year's
participation. Hundreds of participants representing 40 states met with half of the U.S. Congress about student loan interest deduction.

In fact, AOA President, Donald J. Krpan, D.O. and Student Doctor Jaime Kibler of Lake Erie College of Osteopathic Medicine participated in a press conference with Rep. Phil English (R-PA), prime sponsor of the student loan interest deduction legislation.

Because of YOUR constant letters, phone calls and personal visits, the tax code will no longer punish those students who accept scholarships designed to increase the number of physicians in rural and underserved areas.
Osteopathic medical students that share in the National Health Service Corps desire to provide care to the underserved can now pursue those opportunities without fear of having additional tax burdens placed upon them and their families. The osteopathic community's efforts were clearly victorious!

Without the community's hard work, we could have not celebrated such a success. Members of Congress need to hear our thanks! Please take the time to find out how your Representative and Senators voted. If they voted in support of the legislation, please send a thank you letter!

Here's How to Thank Your Members of Congress!
(Please call the AOA Washington Office at 800/962-9008 if you have any problems accessing these links or need assistance)

1) Identify Your Members of Congress: Aside from District of Columbia residents, two Senators and one Representative represent each constituent. The two policymakers elected by your state to the U.S. Senate are your Senators. Visit the 'Senates homepage http://www.senate.gov/ to identify your Senators. For each state's district, a Representative is elected to the U.S. House of Representatives. Your five-digit ZIP code identifies the district of which you are a member. If you live in a big city with a large population, you may have to use your five-digit ZIP code with the additional four digits. This is called the "ZIP plus four." Visit http://www.house.gov/house/MemberWWW.html to identify your Representative.

2) Research how your Representative voted by clicking on http://clerkweb.house.gov/cgi-bin/vote.exe?year=2001&rollnumber=149

3) Research how your Senators voted by clicking on http://www.senate.gov/legislative/vote1071/vote_00170.html#state

4) Adopt the following sample letter for Representatives and Senators voting in support of the bill:

The Honorable [Full name of Representative or Senator]
U.S. [House of Representatives or Senate]
[insert mailing address from Member's website]
Washington, DC [20515 for the House and 20510 for the Senate]

Dear [Name of policymaker]:

[As a student/Having been a student] of osteopathic medicine at [Name of your school], I write to thank you for voting to pass the "Economic Growth and Tax Relief Reconciliation Act" (H.R. 1836). I am especially grateful for your efforts to ensure that modifications were made to the student loan interest deduction and to the taxation of financial awards received under the National Health Service Corps and Armed Forces Scholarship programs.

The osteopathic community has strongly supported modifications to these two provisions for many years. On April 26th the American Osteopathic Association and the American Association of Colleges of Osteopathic Medicine co-hosted D.O. and Student Day on Capitol Hill at which over 450 osteopathic physicians, students, spouses and supporters discussed the importance of modifying student loan interest deduction provisions with their Members of
Congress. In addition to this effort, the osteopathic medical community wrote many letters urging Members to support changes to the 1986 Internal Tax Code.

I am pleased that my efforts may have assisted in your efforts to include these important provisions. You may be assured that I will let all members of the osteopathic medical community know of your actions.

Sincerely,
Name
School
Address

C: Heidi Ann Ecker, Director of Grassroots & Washington Communications, American Osteopathic Association, 1090 Vermont Avenue, NW, Suite 510, Washington, DC 20005

Mark Your Calendars

The next D.O. Day on Capitol Hill is Thursday, September 13, 2001. Registration starts July 1 and ends August 2.
Register Online before Aug 2, 2001 at http://www.aoa-net.org/Government/relations/doday01.htm
(Note: Washington event location and hotel lodging information/rates to be announced shortly)

Senate Approves Patients' Rights Legislation with Amendments

On Friday, June 29 the United States Senate approved the AOA-backed "Bipartisan Patient Protection Act of 2001" (S. 1052) by a vote of 59-36.

Authored by Sens. McCain (R-AZ), Edwards (D-NC) and Kennedy (D-MA), the new bill is an updated version of S. 283, crafted by the same three Senators in January. While both bills allow physicians to determine medical necessity; hold health plans accountable for their actions, ensure a fair and independent appeals process available to patients, and apply to all Americans, S. 1052 clarifies complicated language.

Unlike S. 283, this new patients' bill of rights: (1) further clarifies that a treating physician or treating hospital cannot be held liable in federal court for negligent coverage denial; (2) further clarifies that the exclusionary language for treating physicians, health care professionals and hospitals cannot be construed to limit health plan liability; (3) further tightens the limited exceptions for full exhaustion of review process by eliminating reference to "allegation" of irreparable harm or death; and (4) excludes from federal liability persons whose involvement with the group health plan was solely to provide advise or administrative services to the employer or other health plan sponsor in the selection of health insurance coverage.

Senate Debate Amends Legislation

As AOA predicted last week, the Senate debated S. 1052 and offered amendments (59) on medical necessity, employer liability, scope and caps on damages. Compromises were reached on three of the four issues. While the Senate did not reach compromise on caps for any non-economic or punitive damages, it did identify an amount of damages awarded that attorneys can demand as payment. This amendment cleared the way for final passage and
solidified the opinion that this bill was designed to benefit patients and not trial lawyers.

The Senate approved S. 1052 with the following amendments:
* Amendment #833, introduced by Sen. Warner (R-VA), limits the percentage of awards attorneys can demand as payment.
* Amendment #853, introduced by Sen. Thompson (R-TN), clarifies which law applies in a State cause of action.
* Amendment #849, introduced by Sen. Ensign (R-NV), prohibits genetic discrimination by health plans.
* Amendment #819, introduced by Sen. Thompson (R-TN), requires that the external appeals process must be given 31 days to reach a decision before a lawsuit may be filed. It also allows for the admission of information used during the external appeals into the lawsuit.
* Amendment #842, introduced by Sen. DeWine (R-OH), limits class-action lawsuits to employees of one company covered by one plan. This amendment essentially eliminates national class-action lawsuits.
* Amendment #843, introduced by Sen. Gramm (R-TX), ensures the sanctity of the health plan contract.
* Amendment #839, introduced by Sen. Hutchinson (R-AR), requires that plans must provide information to participants on desenrollment.
* Amendment #834, introduced by Sens. Snowe (R-ME) and Nelson (D-NE) and improved by Sen. Frist (R-TN), allows employers to utilize a designated decision-maker who will administer the health plan and assume all liability.
This provision is designed to protect employers from the liability created by the legislation.
* Amendment #830, introduced by Sen. Breaux (D-LA), requires states to illustrate that their patient protection laws are in substantial compliance in the areas of patient protections, benefits and rights of action as the federal law. If a state were unable to do so, then the federal law would apply.
* Amendment #820, introduced by Sens. McCain (R-AZ), Bayh (D-IN) and Nelson (D-FL), clarifies that independent review panels may not consider services that are explicitly excluded or limited by the health plan contract. Citing that medical discretion is "reviewable", the amendment is designed to protect the "intent" of the health plan contract and prevent plans from being accountable for services that are explicitly not covered by
the contract.
* Amendment #816, introduced by Sen. Bond (R-MO), sunsets employer liability provisions of S. 1052 when the number of uninsured Americans increases by 1 million. It also requires Congress to examine the issue at
that point to implement alternatives less damaging to employers.
* Amendment #812, offered by Sen. McCain, provides "Sense of the Senate" language stating health plans shouldn't be allowed to choose the external reviewer to settle disputes. S. 1052 requires that the external reviewers be independent of the health plan.
* Amendment #809, introduced by Sen. McCain (R-AZ), provides "Sense of the Senate" language that encourages managed care organizations to cover the cost of clinical trials.

Future Happenings in the House

Now that the Senate has completed its work on patients' rights, the AOA expects Reps. Ganske (R-IA), Dingell (D-MI) and Norwood (R-GA) will offer S. 1052 as amended on the House floor and request a vote. If approved by the House, the bill would be sent directly to President Bush. Stay tuned for more AOA patients' rights updates!

How Your Senators Voted

The following nine Republicans voted with 50 Democrats in support of the bill: Sens. Chafee (RI), Collins (ME), DeWine (OH), Fitzgerald (IL), McCain (AZ), Smith (OR), Snowe (ME), Specter (PA) and Warner (VA).

The following is a listing of how each Senator voted on final passage of S. 1052.
Alabama: Shelby (R), Nay Sessions (R), Nay
Alaska: Stevens (R), Nay Murkowski (R),Not Voting
Arizona: McCain (R), Yea Kyl (R), Nay
Arkansas: Hutchinson (R), Nay Lincoln (D), Yea
California: Feinstein (D), Yea Boxer (D), Yea
Colorado: Campbell (R), Not Voting Allard (R), Nay
Connecticut: Dodd (D), Yea Lieberman (D), Yea
Delaware: Biden (D), Yea Carper (D), Yea
Florida: Graham (D), Yea Nelson (D), Yea
Georgia: Cleland (D), Yea Miller (D), Yea
Hawaii: Inouye (D), Yea Akaka (D), Yea
Idaho: Craig (R), Nay Crapo (R), Nay
Illinois: Durbin (D), Yea Fitzgerald (R), Yea
Indiana: Lugar (R), Nay Bayh (D), Yea
Iowa: Grassley (R), Nay Harkin (D), Yea
Kansas: Brownback (R), Nay Roberts (R), Nay
Kentucky: McConnell (R), Nay Bunning (R), Nay
Louisiana: Breaux (D), Yea Landrieu (D), Yea
Maine: Snowe (R), Yea Collins (R), Yea
Maryland: Sarbanes (D), Yea Mikulski (D), Yea
Massachusetts: Kennedy (D), Yea Kerry (D), Yea
Michigan: Levin (D), Yea Stabenow (D), Yea
Minnesota: Wellstone (D), Yea Dayton (D), Yea
Mississippi: Cochran (R), Nay Lott (R), Not Voting
Missouri: Bond (R), Nay Carnahan (D), Yea
Montana: Baucus (D), Yea Burns (R), Nay
Nebraska: Hagel (R), Nay Nelson (D), Yea
Nevada: Reid (D), Yea Ensign (R), Nay
New Hampshire: Smith (R), Nay Gregg (R), Nay
New Jersey: Torricelli (D), Yea Corzine (D), Yea
New Mexico: Domenici (R), Not Voting Bingaman (D), Yea
New York: Schumer (D), Yea Clinton (D), Yea
North Carolina: Helms (R), Nay Edwards (D), Yea
North Dakota: Conrad (D), Yea Dorgan (D), Yea
Ohio: DeWine (R), Yea Voinovich (R), Nay
Oklahoma: Nickles (R), Nay Inhofe (R), Nay
Oregon: Wyden (D), Yea Smith (R), Yea
Pennsylvania: Specter (R), Yea Santorum (R), Nay
Rhode Island: Reed (D), Yea Chafee (R), Yea
South Carolina: Thurmond (R), Nay Hollings (D), Yea
South Dakota: Daschle (D), Yea Johnson (D), Yea
Tennessee: Thompson (R), Nay Frist (R), Nay
Texas: Gramm (R), Not Voting Hutchison (R), Nay
Utah: Hatch (R), Nay Bennett (R), Nay
Vermont: Leahy (D), Yea Jeffords (I), Nay
Virginia: Warner (R), Yea Allen (R), Nay
Washington: Murray (D), Yea Cantwell (D), Yea
West Virginia: Byrd (D), Yea Rockefeller (D), Yea
Wisconsin: Kohl (D), Yea Feingold (D), Yea
Wyoming: Thomas (R), Nay Enzi (R), Nay

© 2002 Texas Osteopathic Medical Association
Last updated 01/14/2004