Politics of Healthcare (Part 1): HIPAA of 1996

While preparing a lecture for our 3rd year students covering significant laws in pharmacy practice, I decided to dive into the history of the Health Insurance Portability and Accountability Act of 1996 (HIPAA).  I was only 12 years old when HIPAA was passed by Congress, but it is funny to reflect on the major political players involved in its passage (Bob Dole, Newt Gingrich, Ted Kennedy, Nancy Kassebaum, Bill Clinton, Al Gore, etc.).  It is even more hilarious to think about the politics of the mid to late 1990’s versus the politics over the past few years and how the political parties have changed.  I’ve decided to put together a few posts to discuss major policy changes in the United States that have had a major impact on healthcare.  While I have my opinions on the matter, I plan to post just a simple summary (with links to references) of the politics involved and the policy changes along with a few interesting tidbits, then you as the reader can take from it what you wish.  Hopefully, this will entice you to read further into the history of our healthcare system and how policies are made.

Left to Right: Al Gore, Bob Dole, Bill Clinton, Newt Gingrich

Left to Right: Al Gore, Bob Dole, Bill Clinton, Newt Gingrich


Brief Review of the Political Environment:

Purposes of the Legislation:

  • Make the delivery of healthcare more efficient
  • Increase the number of Americans with health insurance coverage

Main Provisions of the Legislation (See History of HIPAA and the Privacy Rule):

  1. Portability of insurance
  2. Tax provisions
  3. Administration simplification (also addressing electronic transmission of health information)

Interesting Pearls of Information about HIPAA of 1996:

  • HIPAA set new standards for health insurance coverage in 5 areas: Preexisting conditions, availability of coverage for small employers, availability of coverage for individuals, discrimination based on health status, and renewal requirements. (Remember that a Republican controlled House and Senate passed HIPAA in 1996, I encourage you to skim through some of the full act passed in 1996 to see some of the language supported by politicians less than 2 decades ago)
  • 1996 Legislation gave congress until 1999 to pass comprehensive health privacy legislation, but it failed to do so, which put the Department of Health and Human Service (HHS) in charge to enact regulations. (See HIPPA and its impact on pharmacy practice)
  • Final rules adopted on August 14, 2002 (remember that HHS is under the executive branch of government, and by 2002 there was a new President)
  • While the main goals of the bill were to address many of the “health insurance” issues Americans faced in the 1990’s, for healthcare providers HIPAA has had a profound impact on practice and privacy of health information in the United States.



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Joey Mattingly, PharmD, MBA is an assistant professor at the University of Maryland School of Pharmacy located in Baltimore, Maryland. Joey has managed retail and long-term care pharmacy operations in Kentucky, Illinois and Indiana. Leading Over The Counter is a blog of Joey's views and opinions on the topics of pharmacy leadership and management and do not represent the University of Maryland, Baltimore. Joey can be followed on Twitter @joeymattingly.

One Response to “Politics of Healthcare (Part 1): HIPAA of 1996

  • Joey, thanks for the great HIPAA post and a look back down memory lane with Clinton, Dole, and the rest of the gang. I would like to add that Covered Entities and Business Associates should be focusing on the true merits of HIPAA compliance, and that’s putting in place documented HIPAA information security and operational policies, procedures, and processes. I’ve worked with so many healthcare providers that lack the basic and fundamental documentation for HIPAA compliance, therefore it’s easy to see why non-compliance issues are still a major factor with HIPAA. I also hear healthcare companies express cost concerns about developing such documents, along with implementing risk assessment and security training initiatives, but with all the free and cost-effective tools available (some of them straight from hhs.gov!), there’s really no excuse for not being HIPAA compliant. Everyone needs to be ensuring the safety and security of PHI, it’s really that simple.

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