Clinton Calls for 2-Day Hospital Birth Coverage

Using Mother’s Day as a backdrop, President Clinton on Saturday endorsed legislation that would require health insurance companies to guarantee hospital stays of at least 48 hours for newborn infants and their mothers.

In his weekly radio address, Clinton sharply criticized health insurance companies that will not pay for new mothers to stay in the hospital more than 24 hours after childbirth.

“There is an emerging national consensus that we must put a stop to these so-called drive-through deliveries,” Clinton said. “No insurance company should be free to make the final judgment about what is medically best for newborns and their mothers. That decision should be left up to doctors, nurses and mothers themselves.”

Clinton’s sharp critique of health insurers brought him back into the ring with an old opponent. Through 1994, the president and First Lady Hillary Rodham Clinton engaged in a protracted war of words with the health insurance industry, which proved among the most dogged and effective opponents of the administration’s ultimately unsuccessful effort to reconfigure the national health care system.

At the same time, Clinton’s embrace of legislation requiring minimum mandatory hospital stays marked another small step in his effort to define a politically sustainable role for Washington at a time when, as he has declared, “the era of big government is over.”

In response to Clinton’s remarks, Richard Coorsh, a spokesman for the Health Insurance Assn. of America, argued that legislation mandating 48-hour hospital stays is unnecessary.

“Flexibility rather than a specified time is what is needed, and needed on a case-by-case basis,” Coorsh said. “In cases where there is normal delivery and the attending health care provider feels that mother and baby are doing fine . . . it can be appropriate to have a 24-hour stay.”

The Senate Labor and Human Resources Committee, on a bipartisan 14-2 vote, last month approved legislation to require health plans to provide hospital stays of at least 48 hours for regular deliveries and 96 hours for caesarean deliveries. But the full Senate has not yet voted, and the House has not taken any action on a companion bill introduced with bipartisan support in that chamber.

In his radio address, Clinton said both the American College of Obstetricians and Gynecologists and the American Academy of Pediatrics have issued guidelines recommending the minimum stays provided in the legislation. Sixteen states have already mandated minimum coverage, while 25, including California, are considering such a requirement.

Clinton said that in 1970, the average hospital stay after a pregnancy without complications was four days; by 1992, that figure had dropped to two days. Now, he continued, “a large and growing number of insurance companies” are refusing to pay for postpartum hospital stays longer than 24 hours, and “some have recommended releasing women as early as eight hours after delivery.”

“This has gone from being an economical trend to a dangerous one,” Clinton argued, “one that carries with it the potential for serious health consequences.”

Coorsh disputed that characterization. He said a recent survey by a private consulting firm found that newborns discharged from the hospital after 24 hours are no more likely to return for health problems within their first month than babies allowed to stay longer. “It would certainly seem that the president’s concern, while well-intended, is not based upon scientific merit,” he said.

Clinton’s radio address captured a subtle, though unmistakable, shift in the political winds since last year, when the Republican effort to roll back the size and influence of the federal government dominated the Washington agenda.

After his repudiation in the 1994 election, which carried Republicans to control of Congress, Clinton abandoned the ambitious efforts to expand government authority that characterized much of his first two years. But in the last nine months Clinton has moved steadily, if cautiously, toward defending a more activist role for government in policing the private marketplace.

Clinton began the shift last summer by proposing regulations to limit the marketing of cigarettes toward young people. More recently, Clinton has undertaken a flurry of actions aimed at reducing gasoline prices and raising cattle prices; he also backed recently passed legislation to make it easier for workers to maintain health insurance when they change jobs. He has staunchly resisted GOP efforts to rein in environmental regulation and is pushing for legislation to raise the federal minimum wage.

From a political perspective, Democratic strategists believe that each of these initiatives forces Republicans into the position of defending powerful business interests many Americans don’t trust, while identifying Democrats with goals broadly popular with the public, from raising wages to defending new mothers and their children.