Politics

House Passes HMO Bill

By Pete Brush

July 24, 2001 / 5:31 PM EDT / CBS

In a victory for President George W. Bush, the Republican-controlled House of Representatives beat back a far-reaching patients' bill of rights and approved one with stricter limits on lawsuits against health plans.

Thursday's 226-203 vote cleared the way for a compromise talks this fall with the Senate on a politically popular bill that has fallen victim to gridlock for five years.

The Bush administration and House Republican leaders said passage of the White House-backed measure would ensure that millions of Americans have access to emergency care, clinical trials and medical specialists while discouraging "frivolous" lawsuits against health maintenance organizations (HMOs) and insurance companies over treatment decisions that result in injury or death.

Democrats countered that Mr. Bush's patients' bill of rights would benefit the managed-care industry more than patients, while undermining the rights of states.

Republicans sent a cheer up from the House floor when the vote was announced. Chants of "Nor-wood, Nor-wood" were audible above the din of the packed chamber. Only three Democrats supported the proposal, but only six Republicans defected and opposed it.

Asked if Republicans had left themselves room to compromise further in final negotiations, Speaker Dennis Hastert, R-Ill., replied, "There has to be." He said Mr. Bush would "remain engaged throughout the process" and called on the Democratic-controlled Senate not to "torpedo this thing."

Earlier, in a key vote, the House narrowly approved a legal liability provision crafted between Mr. Bush and a pivotal Republican lawmaker sealed scarcely 24 hours earlier in the Oval Office.

"Like it or not we have to work with this president, who has to sign this bill," said the lawmaker, Rep. Charles Norwood, responding to dozens of Democratic critics who attacked the provision as a giveaway to the HMOs. Opponents "are deluding themselves if they think they can force a bill down this president's throat," he said.

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The vote made final passage of the legislation a formality, a mid-evening vote that would clear the way for a three-way negotiations on a final compromise among the House, the Senate and the White House.

Democrats - and some moderate Republicans - vigorously attacked the bill as failing to offer patients enough leeway to sue HMOs — and win monetary damages — to enforce the new rights they would receive.

"It's a hollow bill" when it comes to patient protections, said Rep. Dick Gephardt, the Democratic leader. "I'm amazed at how much in league with the HMOs and insurance companies the Republicans ae."

Rep. John Dingell, D-Mich., one of Norwood's former allies, asked, "Just who is the president trying to protect with these secretive midnight deals? The answer can only be the HMOs."

The amendment approved on a partisan vote recasts managed-care legislation to Mr. Bush's liking by imposing federal standards on state courts and setting caps on damage awards. The vote ensures that Bush will almost certainly prevail in the House fight over patients' rights in a final vote expected later on Thursday.

Under the amendment approved by the House, patients will be able to file suit against health maintenance organizations (HMOs) and insurance companies in state court. But the proceedings would be governed by new federal standards which have yet to be spelled out.

The amendment sets $1.5 million caps for both pain-and-suffering and punitive damages - higher than the $500,000 caps Bush initially proposed, but far less the $5 million limits backed by the Senate and House Democrats.

In a victory for business, the amendment steers lawsuits against employers to federal court rather than state court, where juries are more likely to return large verdicts in favor of plaintiffs, and bars class action lawsuits.