Nearly three HMOs in four are now for-profit, leading to concerns that profits may be more important that patients. In March 1997, President Clinton appointed the Advisory Commission on Consumer Protection and Quality in the Health Care Industry to address these concerns. The Commission stated that the Bill of Rights should apply to all consumers, regardless of whether they buy their own insurance, work for companies that purchase insurance on their behalf, or work for companies that have self-funded health plans. Opponents of patient protection legislation worry that mandates will increase the costs of providing health care coverage and increase regulation. The American Association of Health Plans, a managed care industry trade association, and others instead are promoting voluntary, market-based approaches.
Proponents argue that enforceable standards are necessary.
Recently, the Congressional Budget Office found that the comprehensive Patients Bill of Rights would increase premiums, on average, about 4 percent, less for plans already providing quality care or in those states that have already enacted protections. Kaiser Permanente, a strong supporter of federal standards, has stated that cost impacts on them would be minimal.