In the waning days of his presidency, Bill Clinton signed into effect regulations designed to protect patients' records from the prying eyes of insurance companies, Internet chat rooms and nosy neighbors. A few days later, however, a newly inaugurated President Bush slammed on the brakes. It was important, the Bush White House said, for Tommy Thompson, the new head of Health and Human Services, to have time to look over the regulations. And, Bush added, a delay would also allow the American people to weigh in on the new rules. Skeptics assumed Bush was holding off to allow insurance industry bigwigs to pitch hard against the regulations.
And that's just what they did. While Bush's reasons may have been rooted in due diligence, the insurance industry took the pause as a gift, according to Angela Choy, field director for the nonprofit Health Privacy Project in Washington, D.C. "The insurance industry has waged a pretty intensive campaign to get the public and Thompson to view these regulations as a bad idea and really pushed to get the government to change aspects of the regulations in their favor."
They weren't particularly successful. While Thompson insists the regulations have been changed from the Clinton version, observers say that with a few exceptions, everything looks the same. One hot-button addition, which grants parents access to children's medical records (including information about abortions) is still under White House/HHS consideration. The federal law, Health Privacy Project's Choy explains, won't supersede preexisting state laws concerning abortion and minor notification; states that allow minors to have abortions generally maintain fairly strict confidentiality rules. "if there are state laws allowing a minor to legally obtain care without parental consent, then the minor has the rights associated with his or her medical information," says Choy.
Back in Washington, the relative speed of the White House's privacy-rules turnaround left some, like the staff at the Health Privacy Project, happily shell-shocked.
"Up until this morning we were expecting a Friday announcement that the White House would urge a delay," Choy says. "So we were pleased and surprised when we got the word the regulations would go into effect immediately." And for once, the word "immediately" actually means something in Washington: The privacy regulations will start on Saturday.