In any case, there's plenty of action this year in state legislatures. Since January about 1,000 bills have been introduced in 49 state legislatures that would protect consumers in one way or another. Forty-one states have already passed 188 of them. And more are signing up each month. But this expansion has been accompanied by an explosion of consumer complaints.
Some critics go further.
Polls find that most consumers are happy with the service they're receiving from managed-care plans, say industry representatives. Susan Pisano of the American Association of Health Plans, which represents 1,000 managed-care organizations, says her association is voluntarily addressing many of the concerns raised by consumers. But critics point out that these safeguards and improved administrative practices, albeit welcome, don't have the force of law and don't necessarily have the desired effect. A case in point is the incident well-publicized in Missouri in which an accident victim got caught up in the bureaucratic machinery of his HMO, slowing his ability to get needed care. As the man's story was told at a state legislative hearing last year, he stepped off a curb in Columbia, Mo.,and broke his ankle.