1986
Emergency Medical Treatment and Active Labor Act
(EMTALA) requires hospitals participating in Medicare
to screen and stabilize all persons who use their
emergency rooms regardless of ability to pay.
1986
COBRA (Consolidated Omnibus Budget Reconciliation
Act) contains specific regulations that allow
employees who lose their jobs to continue with their
health plan for 18 months.
1986
Federal budget reconciliation (OBRA 86) gives states
Medicaid option to cover infants, young children and
pregnant women up to 100% of the poverty level
regardless of whether they receive public assistance.
Raised to 185% of the poverty level in legislation for
infants and pregnant women the following year.
OBRA 86 also allowed state Medicaid programs to
pay Medicare premiums and cost sharing for qualified
Medicare beneficiaries under 100% of poverty
(QMBs). (This was later required in 1989 and
increased to certain Medicaid beneficiaries at 120%
of poverty in 1990).
1987
Census Bureau begins annual estimate of health
insurance coverage in the United States with its
Current Population Survey finds 31 million uninsured
(13% of the population) in 1987.
1987
National Medical Expenditure Survey (NMES), built
on the NMCES 1977, is conducted with household
information supplemented by surveys of medical and
health insurance providers used by respondents.
1988
Medicare Catastrophic Coverage Act (MCCA) expands
Medicare coverage to include prescription drugs and
a cap on beneficiaries' out-of-pocket expenses.
However, many believed the costs that were to be
born by the elderly outweighed the benefits.
Responding to the ground swell of negative reaction,
the MCCA is repealed the following year, retracting
these major provisions. However, the requirement
that states pay Medicare premiums and cost-sharing
amounts for poor beneficiaries through Medicaid is
maintained.
Learn more on the repeal of MCCA.
1988
The Family Support Act requires states to extend 12
months of transitional Medicaid coverage to families
leaving welfare due to earnings from work.
1989
Federal budget reconciliation (OBRA 89) mandates
coverage for pregnant women and children under
age 6, at 133% of the federal poverty level.
1985 - 1989
1990 – 1994
The Health Security Act
Making national health reform a priority early in his Presidency, Clinton proposed a "managed competition"
approach, sending a detailed plan to Congress in 1993. It called for universal coverage, employer and
individual mandates, competition between insurers, with government regulation to control costs. Support from
key stakeholders was often limited and conditional. The opposition was led largely by two groups: the Health
Insurance Association of America and the National Federation of Independent Businesses, both believing
reform would create hardship for their smaller members. Congressional Democrats were divided in their
support, and further splintered by a variety of alternative proposals that were then
generated all of which
blocked progress on the President's plan.