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Democrats say ‘end in sight’ on patients’ rights

WASHINGTON (AP) – Blending compromise and clout, supporters of patients’ rights legislation agreed to limit lawsuits against employers but swatted down other changes Thursday as they struggled to bring the bill to a final vote.

”The end is in sight,” said Nevada Sen. Harry Reid, the Democratic whip, after 10 days in which the bill’s backers have displayed unquestioned command over the events on the Senate floor.

President Bush has threatened to veto the measure, citing provisions he says will lead to unnecessary lawsuits, and the White House showed no sign of backing down. ”Why would the Congress want to engage in a political activity to pass something they know will not be signed into law?” asked presidential spokesman Ari Fleischer.



The legislation, which Democrats made their top priority after gaining a Senate majority last month, is designed to rein in HMOs by guaranteeing patients treatment such as emergency room care, access to specialists and the right to select a pediatrician as a child’s primary care provider.

After years of gridlock on the issue, there is relatively little dispute over the protections to be provided. Instead, the Senate has spent much of the past 10 days debating when and where lawsuits may be filed for denial of care, and what type of damages may be sought.



The Democrats, aligned politically with the nation’s trial lawyers, have drafted their bill to permit more lawsuits than Republicans want. And Republicans, who benefit from insurance industry backing, have devoted hours in debate to warning that suits will drive up the cost of insurance and prompt some employers to cancel their workers’ coverage.

According to the Center for Responsive Politics, the American Trial Lawyers Association gave $3.6 million to Democrats in the 1999-2000 election cycle, and nearly $425,000 to Republicans.

The American Association of Health Plans donated nearly $120,000 to Republicans and almost $7,000 to Democrats. The Health Insurance Association of America gave slightly more than $230,000 to Republicans, slightly more than $30,000 to Democrats.

The insurance industry is also spending heavily to shape public opinion. Officials showed a television commercial – set in an uppercrust British lawyers club – that slammed the legislation as a windfall for attorneys. It features one lawyer telling another that American attorneys ”will make millions and send (insurance) rates sky high.” And when employers can’t afford to pay, it says, ”they’ll sue them too.”

Phil Blando, a spokesman for the American Association of Health Plans, said the commercial would air around the country, but he declined to say how much HMOs would spend on it.

After several days of back-room negotiations, senators moved toward acceptance of an amendment to sharply curtail lawsuits against employers. Only those firms that insure and administer their own plans could be sued.

While supporters of the bill hailed the compromise as a breakthrough, not everyone agreed.

”I think we all recognize there’s a fair distance to go in the liability area,” said Sen. Judd Gregg, R-N.H.

The first vote of the day was on an amendment by Sen. Susan Collins, R-Maine, who proposed leaving pre-existing state patient protections in effect as long as they were consistent with the provisions of the federal law.

Opponents objected, saying that as it was worded, the amendment would leave too many patients unprotected. It was killed on a vote of 53-44. But shortly afterward, backers of the bill accepted a slightly different proposal that would leave a state protection in effect if it ”substantially complies” with the federal requirement.

But critics of the bill got nowhere with an amendment by Sen. Christopher Bond, R-Mo., to ban ”excessive trial lawyer fees” in successful lawsuits. Bond’s proposal would have limited lawyers to recovery of their expenses plus a maximum of 15 percent of the overall damages awarded by a judge or jury.

”It takes the right approach to fixing the … bill’s liability provisions, which amount to nothing less that a trial lawyers’ pot of gold,” said Sen. Chuck Grassley, R-Iowa.

Democrats argued otherwise. ”The attorneys we love to hate are necessary,” said Reid. ”How much are the attorneys for the big HMOs making to make sure patients don’t get the care they need?”

Instead, he urged Congress to separate the two issues. ”The president agrees with 90 percent of what the Senate is doing. So why can’t the Senate send to the president the 90 percent that everybody agrees on and get a bill signed into law?”

While Democrats sought to bring the bill to a final vote, some Republicans signaled they weren’t finished seeking changes. ”We have many substantive amendments we want to offer,” Sen. Don Nickles, R-Okla., the GOP whip, said after a closed-door meeting of the rank-and-file.


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