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Dynamic Chiropractic – July 14, 1997, Vol. 15, Issue 15

The Inside Story

By Michael Pedigo, DC
How the PARCA bill was developed and how it has advanced in Congress is an important and interesting story: one almost completely unknown to most chiropractors. Those who sometime question the value of their national trade association should pay close attention. The simple truth is that without the ACA, there would be no PARCA bill and no comprehensive effort in Congress to significantly improve the current managed care system for both providers and patients!

The story of PARCA goes back to the debate over the Clinton national health reform plan in 1993 and 1994. I am sharing with you the "inside story" so that you can get a feel for how difficult and time consuming getting legislation passed in Washington is. I also want to thank ACA's Rick Miller for his assistance in writing this article. Creating the "coalition" that has resulted in PARCA was Rick's brainchild. During the Clinton national health reform, the ACA launched a "National Mobilization Campaign," an intensive legislative effort which, for the first time in decades, put the chiropractic profession "on the map" in Washington. That campaign not only received widespread recognition in the national media, but the ACA's lobbying campaign was granted the top national award of excellence by the nation's premier group of trade association leaders, the American Society of Association Executives (ASAE).

In the fall of 1994, following the collapse of the Clinton plan, the ACA sought to prepare for the "next round" of health reform legislation and to capitalize on its new found influence in Washington. At that time, the ACA organized and chaired a "strategy" meeting of various provider and consumer organizations to discuss the possibility of launching in the newly elected GOP-controlled 104th Congress some type of joint legislative effort to address managed care concerns. At this initial meeting, the ACA specifically unveiled the concept of developing a comprehensive bill to amend ERISA and regulate the managed care industry at the federal level, which could be supported by both consumer and health provider groups.

That initial meeting led to a series of follow-up "coalition" planning meetings which took place over a period of several months. All of these meetings were organized, hosted and chaired by a representative of the ACA. After a painstaking development process which lasted into the spring of 1995, a "draft" legislative proposal, suitable to a broad "coalition" of organizations was completed. Concurrent with the completion of the draft legislative proposal, the informal coalition adopted a formal name, the Coalition for Health Care Choice and Accountability (CHCCA), and began the work of seeking a lead sponsor to introduce the bill in the 104th Congress. The ACA and ACA-PAC also provided funding to allow the CHCCA to hire a coordinator to help oversee the development of the coalition and the advancement of the legislation.

The coalition's bill was introduced in the House (104th Congress) as H.R. 2400. The ACA provided funding to print and distribute copies of H.R. 2400, and promotional materials in support of it, to consumers and provider organizations on a nationwide basis. The ACA also provided funding to establish a World Wide Web site promoting the CHCCA and H.R. 2400. The ACA provided additional funding to collect a series of "horror stories" dealing with managed care abuses which were distributed to the national news media.

For the remainder of the 104th Congress, during 1995 and 1996, the ACA continued to organize and chair all meetings of the coalition, which grew in size to about 80 different organizations. The coalition's efforts ultimately obtained 41 co-sponsors for H.R. 2400. During this period, virtually all of the coalition's expenses were underwritten by the ACA and ACA-PAC.

In the fall of 1996, after the conclusion of the 104th Congress, the ACA organized a new series of coalition planning meetings to prepare for the advancement of a new version of the bill in the newly-elected 105th Congress. ACA and their coalition partners spent several months fine-tuning the 1995-96 version of the bill, with a goal of making the bill more "Republican friendly" in the new Congress, which remained under GOP control following the 1996 presidential election.

In January 1997, a "steering committee" of key CHCCA members approved ACA's proposal to pool financial resources to hire a professional lobbying firm to lobby for the introduction of the new version of the CHCCA bill. With funds from the ACA-PAC and other coalition members the firm was put to work in February of 1997. In late April 1997, the CHCCA coalition succeeded in recruiting Representative Charlie Norwood and U.S. Senator Alphonse D'Amato to introduce the updated version of the bill. Also in late April 1997, at a press event organized by the CHCCA, the Patient Access to Responsible Care Act was introduced as H.R. 1415 and S. 644. The PARCA bill has over 100 co-sponsors in the U.S. House of Representatives.

Today, the ACA continues to demonstrate its leadership in this important health policy area by continuing to "chair" the CHCCA coalition and spearhead activities to promote this vital legislation. By demonstrating leadership on this issue the ACA is not only making the chiropractic profession relevant to the development of health policy at the federal level; it's addressing the number one concern facing the profession today. Your help is required. When you are ask to contact your legislators to support this important legislation, please do!

Michael D. Pedigo, DC
San Leandro, California

Dr. Michael D. Pedigo is a past president of the American Chiropractic Association and the International Chiropractors Association, and the only doctor to receive the Chiropractor of the Year Award from both organizations. He practices in San Leandro, Calif., and can be contacted with questions and comments via his Web site:

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