Jeffords Party Switch to Affect Patients’ Rights, Rx Drug and Abortion Debates

After Sen. James Jeffords (I-Vt.) "upended the political status quo" by leaving the Republican Party to become an independent May 24, Senate Democrats "moved quickly" to "map out a legislative agenda," which will likely include a patients' bill of rights and a prescription drug benefit under Medicare, the New York Times reports. Democrats will assume control of the Senate -- now divided among 50 Democrats, 49 Republicans and one Independent --after Congress passes President Bush's proposed tax cut or on June 5, whichever comes later. In the new alignment, Democrats will assume the chairmanships of all committees and will control the legislative calendar and the legislative agenda (Seelye/Clymer, New York Times, 5/25). In most committees, the chairmanships will likely transfer to the ranking Democrat (Lancaster/Dewar Washington Post, 5/25). The Christian Science Monitor reports that the Democrats' "rise to power" in the Senate "means at least this: There's a new agenda in town" (Grier/Chaddock, Christian Science Monitor, 5/25). Still, Democrats admit that their new majority is "so precarious that they would not be able to will their agenda into place." Sen. Tom Daschle (D-S.D.), who will likely become Senate majority leader, said, "What does not change with this new balance of power is the need for principled compromise. This is still one of the most closely divided Senates in all of our history" (Seelye/Clymer, New York Times, 5/25). Explaining his decision, Jeffords said, "Looking ahead, I can see more and more instances where I'll disagree with the president on very fundamental issues -- the issues of choice ... and host of other issues, large and small," including some health-related concerns (Boyer, Washington Times, 5/25).

Patients' Rights
Democrats "made plain" that they would "move quickly to put their stamp on the policy debate," announcing plans to bring a "long-stalled" patients' rights bill (S 283), sponsored by Sens. John McCain (R-Ariz.), Edward Kennedy (D-Mass.) and John Edwards (D-N.C.) (Hook, Los Angeles Times, 5/25). Under the bill, patients could sue HMOs in state court for denial of benefits or quality of care issues and in federal court for non-quality of care issues, such as violations of their health plan's contract. The legislation would cap damages awarded in federal court at $5 million, but state courts could award as much money in damages as the state allows (Kaiser Daily Health Report, 2/7). Daschle promised "quick action" on the bill, after passing education legislation (Brownstein, Los Angeles Times, 5/25). "We'll complete that [education] bill. The second bill will be the patients' bill of rights," he said (Kuhnhenn, Philadelphia Inquirer, 5/25). Sen. Tom Harkin (D-Iowa) said, "I think the first bill we're going to do is a patient bill of rights" (AP/Richmond Times Dispatch, 5/25). According to Sen. Robert Torricelli (D-N.J.), "The entire prospect for a patients' bill of rights has just advanced enormously" (Burger, New York Daily News, 5/25).

Only 'Marginal Impact'?
Still, CongressDaily/AM reports that Jeffords' decision to leave the Republican party will likely have a "marginal impact" on patients' rights legislation. Referring to the numbers required to defeat a filibuster and override the veto President Bush has "promised," Ron Pollack of Families USA said, "Having Democrats in charge of the floor schedule will make it easier for them to bring" the legislation to the floor, but "they still don't have 60 votes and they don't have 67 votes." Opponents of the bill added that the "situation is unlikely to change much," despite Jeffords' move. "It will still be a very, very closely divided Senate," Phil Blando of the American Association of Health Plans said, adding, "It's clear any effort to move legislation forward ... will require a bipartisan approach" (Rovner, CongressDaily/AM, 5/25). However, the AP/Nando Times reports that although the McCain-Kennedy-Edwards bill "has enough support to avert a filibuster" and other opponents' delays, "there are no plans to change it to appeal to foes" (McQueen, AP/Nando Times, 5/25).

Rx Benefit 'In Play'
In addition to managed care reform, Democrats hope to "push sooner" on a prescription drug benefit under Medicare (Hook, Los Angeles Times, 5/25). Kennedy, "poised" to replace Jeffords as chair of the Senate Health, Education, Labor and Pensions Committee, said that a prescription drug benefit is "in play now" (Earle/Mitchell, CongressDaily/AM, 5/25).

Move Will Affect Abortion Debate
Jeffords, an abortion rights supporter, received a 100% rating from the National Abortion and Reproductive Rights Action League for his record on choice in 2000, based on votes on abortion clinic violence, women in the military and emergency contraception bills (NARAL release). According to CongressDaily/AM, his decision to leave the Republican Party "will be felt in the perennial debate" over abortion rights (Rovner, CongressDaily/AM, 5/25). For example, Sen. Patrick Leahy (D-Vt.) will likely replace Sen. Orrin Hatch (R-Utah) as chair of the Senate Judiciary Committee (Washington Post, 5/25). "Instead of having an anti-abortion leadership and chair of the Judiciary Committee ready to push anti-abortion judges and bills, the opposite will now be the case," CongressDaily/AM reports. Alison Herwitt, director of government relations for NARAL, said, "[I]t makes it more difficult for (President Bush) to send up [judicial] nominees who aren't middle of the road." In addition, a Judiciary Committee under Democratic control "squelches (abortion opponents') ability to move freestanding abortion bills like the Unborn Victims of Violence Act (which passed the House earlier this month), the Child Custody Protection Act and the next generation of a partial birth abortion ban," she said (Rovner, CongressDaily/AM, 5/25). The Feminist Majority Foundation also called Jeffords' defection -- which will place "pro-choice" Democrats, rather than "anti-choice" Republicans, in Senate leadership positions -- "crucial" to women's and reproductive rights (Feminist Majority Foundation release, 5/24). However, lawmakers will still face abortion rights "battles," including amendments to House-passed appropriations bills and the "ability of abortion foes to try to force the House-passed bills to the floor without Senate committee action or to attempt to amend them to other bills" (Rovner, CongressDaily/AM, 5/25).

Affect on Rx Firms
Meanwhile, the health care industry has begun "bracing for changes that could affect the costs and profits" of drug companies, insurers and employers under a Senate controlled by Democrats (Freudenheim, New York Times, 5/25). The industry will likely "lose significant clout" in a Democratically controlled Senate (Labaton, New York Times, 5/25). Managed care lobbyists have criticized patients' rights legislation favored by Democrats, while drug companies are preparing for a "fight over management of a prescription drug benefit for the elderly." Alan Holmer, president of the Pharmaceutical Research and Manufacturers of America, said that drug companies remain "optimistic" that Congress and Bush would agree on "meaningful expansion of prescription drug coverage for seniors" under Medicare. Washington Analysis health care specialist Ira Loss said that Kennedy "has a much keener interest" than most Republicans "in drug pricing, advertising, marketing ... a laundry list of items that the drug industry would prefer not to have discussed in public forums." Drug stocks declined "slightly" May 24, "partly reflecting concerns about the structure of a Medicare drug benefit." Investors also worried that Democratic committee chairs would "intensify an examination of drug prices and drug marketing practices." However, managed care stocks rose after a number of Wall Street analysts said that Democrats would "still lack the votes to overcome an expected presidential veto" of their "far-reaching" patients' rights bill (Freudenheim, New York Times, 5/25).