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HIPAA, 10 years after; With the act now a decade old, experts weigh in on its triumphs and failings.

Article Excerpt
Byline: Joseph Conn

Ten years ago this month, the Health Insurance Portability and Accountability Act dramatically changed the U.S. healthcare landscape, in some ways for the better and in some ways for the worse, industry experts contend.

"It's had a tremendous effect,'' says Chip Kahn, president of the Federation of American Hospitals. He echoes the comments of observers who believe the current pressure to expand information technology in healthcare stems in large part from the law that has come to be known as HIPAA.

"It assumed a world that we are slowly heading for now,'' Kahn adds.

HIPAA is most often recognized today for its three main provisions-promoting electronic transmission standards for claims data, and regulating both the privacy of electronic medical records and the security of medical data storage and transmission. But HIPAA's roots, which grew into a Christmas tree of healthcare legislation, began in the U.S. Senate in 1995 as an insurance reform bill introduced by Sen. Edward Kennedy (D-Mass.) and former Sen. Nancy Kassebaum (R-Kan.).

Kennedy-Kassebaum, as the bill became known, quickly gained what would be considered today an astonishing level of bipartisan support, particularly considering its main aim was to curb market distortions in the health insurance industry. Its supporters included liberals such as the late Sen. Paul Wellstone (D-Minn.) and conservatives such as Sen. Richard Lugar (R-Ind.) among its 66 eventual Senate co-sponsors. The final version, which emerged from the Senate-House conference committee, passed the Senate by unanimous consent, 98-0.

The Senate bill was an extension of insurance reforms passed a decade earlier in the Consolidated Omnibus Budget Reconciliation Act, according to Kahn, who, in those days, watched the HIPAA legislation take shape as staff director for the House Ways and Means Committee.

COBRA allows workers leaving a job to continue to purchase the same health insurance coverage they had under their employer-based plan. The Kennedy-Kassebaum bill constrained payers from limiting or excluding employees from coverage for pre-existing medical conditions, a particularly beneficial protection for workers in small group plans.

In the House, a bill containing what would become the "administrative simplification'' provisions of HIPAA was introduced in March 1996. The House version reflected the recommendations of the Workgroup for Electronic Data Interchange, or WEDI, whose members were called together by the first Bush administration in 1991 to find...

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