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Clinton Aims to Help HMOs’ Elderly Castoffs

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From Reuters

President Clinton announced steps Thursday to lessen the effect of a withdrawal by health maintenance organizations from Medicare old-age health plans.

The president said he would expedite applications by HMOs to serve areas abandoned by another HMO, would work with Congress to prevent further withdrawals and would launch a campaign to assure senior citizens they can get conventional but more expensive Medicare coverage if HMOs withdraw.

“We have to do everything we can to protect Americans who have been dropped by their HMOs and to protect the health care options of all seniors in the future,” Clinton said at the White House.

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HMOs have been seen as a way to cut costs for old-age health care while providing coverage, such as for prescription drugs and eyeglasses, not offered by traditional Medicare plans in which the government reimburses doctors for individual services.

Last year, the government expanded opportunities for HMOs to provide Medicare coverage. About 6.5 million Medicare patients, out of 39 million total, are now in HMOs.

But several managed-care companies announced last week they would cease their Medicare coverage in certain areas as unprofitable, after the government rejected calls by the industry for blanket authority to charge higher premiums and cut benefits.

The withdrawals will leave about 50,000 patients without an option to join an HMO, Clinton said.

“Those decisions have brought uncertainty, fear and disruption to the lives of tens of thousands of older Americans across the country,” Clinton said.

He said the decisions had raised concerns by some Medicare patients that they would lose coverage completely, and those concerns must be countered by a publicity campaign: “We must say to them, ‘Losing HMO coverage does not mean losing Medicare coverage. You are still protected by Medicare.’ ”

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HMOs have said they were withdrawing from areas they could no longer afford to serve, given the government objections to premium increases.

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