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Dems Halt Senate Over HMOs

Senate Democrats brought business to a standstill, refusing to let a major spending bills move ahead until controversial HMO legislation makes its way to the floor.

Lawmakers adjourned Wednesday without reaching an agreement, promising to return Thursday for more talks on what Democrats believe is a political winner.

After more than a year of discussion, the Senate has been unable to reach agreement on rules for debating the HMO issue - much less the issue itself.

Senator John Edwards, D-N.C., and other Democrats decided to force the GOP hand this week, refusing to act on anything else until they strike a deal.

Edwards outlined the three areas he feels are critical to this discussion: a patients bill of rights; an external review; and direct access to specialists. CBS News Correspondent Julie Chen reports.

Edwards explained, "Our patients bill of rights bill would cover essentially everybody in an HMO, which is about 160 million Americans [while] our opposition's bill would cover 48 million Americans, leaving the vast majority completely uncovered by the bill."

Sen. John Edwards, D-N.C. (CBS)
Edwards and other Senate Democrats are insisting on an external review that can decide if patient claims have been arbitrarily denied and/or incorrectly denied by insurance companies.

Another area Democrats bewail is access.

"Every child with cancer deserves access to a pediatric oncologist," said Sen. Edward Kennedy, D-Mass.

Democrats framed the debate in the most personal and sympathetic of terms.

Sen. Barbara Milkulski, D-Md., described her gall bladder surgery, lamenting that while she could stay in the hospital overnight, some women who have mastectomies cannot.

It is not easy to argue against these stories, GOP leaders acknowledge. So Republicans are trying to avoid taking votes "that can be misconstrued for political purposes," said Sen. Don Nickles, R-Okla., the No. 2 Republican in the Senate.

Nickles repeatedly cited a Congressional Budget Office estimate that the Democratic bill would increase the cost of health insurance by 4.8 percent.

The Republican strategy has been to offer modest legislation to address consumer fears that health maintenance organizations and other managed-care plans skimp on care to save money. Their proposals do not allow new lawsuits, for instance, and they let insurance companies keep ultimate authority to decide what care is necessary.

Neither side seems interested in finding common ground, said Drew Altman, president of the Kaiser Family Foundation, an independent health research group that has done extensive polling on the issue.

"There's no question they could reach compromise here on a package of things that would ... greatly satisfy the American people," Altman said. "There's every prospect Congress will blow the opportunity."

Edwards said, "We're the most medically advanced country in the world. But the problem isÂ… that technology really doesn't do any good unless folks have access to it."

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