Probable impact of the 1994 elections on laboratory medicine

During the past quarter century, federal health policy makers concerned themselves with: (a) improving the quality of healthcare delivered to the American public; (b) increasing access to needed healthcare services; and (c) curtailing the escalating cost of such services. These goals led Congress to expand the role of the federal government in regulating the delivery of healthcare. The enactment of the Clinical Laboratory Improvement Amendments of 1988 (CLIA '88) was a significant and widely discussed example of how Congress, when controlled by the Democrats, sought to correct healthcare problems and achieve federal objectives. In November 1994, the Republicans won majorities in both the Senate and the House, promising to reduce the federal government's power. Many now believe that CLIA '88, or significant parts of it, could be substantially modified as part of this effort. This paper addresses the developments that led the Democrats to seek enactment of CLIA '88 and the likely arguments that may be offered by the Republicans to lessen the rigor and scope of the law.