With New Senate Leadership, Can Congress Can Strike a Deal on Patients’ Rights?

With Senate Democrats set to address patients' rights legislation after they assume control of the chamber, National Journal reports that while Republicans and Democrats "disagree on the details" of the issue, a deal "could be in the offing" (National Journal, 6/2). In an accompanying article, National Journal reports that the "early debate" over patients' rights could "say a lot about how the two parties will operate" when Democrats are in control of the Senate. Bush has "praised" a bill (S 889) sponsored by Sens. Bill Frist (R-Tenn.), John Breaux (D-La.) and James Jeffords (I-Vt.) and has "raised a veto threat" against rival legislation (S 283) sponsored by Sens. John McCain (R-Ariz.), Edward Kennedy (D-Mass.) and John Edwards (D-N.C.) (Cohen, National Journal, 6/2). The Frist-Breaux-Jeffords bill would afford all patients with private health insurance a "slender" right to sue their health plans after exhausting an appeals process by an outside review panel. Patients could only sue health plans in federal court, not state court, and awards would be capped at $500,000. The law allows states that have a patients' rights law in place to be exempt from the federal law if they can prove that the state law's provisions are "consistent with federal law" (Kaiser Daily Health Policy Report, 5/16). The McCain-Kennedy-Edwards bill would allow patients to 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 those involving violations of their health plan's contract. Damages awarded in federal court would be capped at $5 million, but state courts could award as much money in damages as the state allows. States with existing patients' rights laws could maintain their laws, and states without such laws can draft their own legislation, but these laws must be "comparable" to the federal version (Kaiser Daily Health Policy Report, 2/7). Kennedy, incoming chair of the Senate Health, Education, Labor and Pensions Committee, will likely use his new position to push his bill (National Journal, 6/2). Senate Minority Leader Tom Daschle (D-S.D.), who is expected to become majority leader when the Democrats take control of the Senate, intends to push the McCain-Kennedy-Edwards bill as soon as the Senate finishes business on the pending education bill (Fulton, CongressDaily, 6/1). National Journal reports that a "growing number" of Republicans "believe that they will pay a political price if they block action altogether" on patients' rights legislation. "The issue resonates too much. The Republican (leadership) can't just kill it, because too many (GOP members) could be hurt," a senior Republican aide said. In the House, Speaker Dennis Hastert (R-Ill.) may "want to cut a deal" on a patients' rights bill, National Journal reports. He has said that the House will address the issue after the Memorial Day recess (National Journal, 6/2). But National Journal reports that both parties may "refuse to compromise [on patients' rights legislation] and see who gets blamed" in the 2002 election (Cohen, National Journal, 6/2).

Breaux Optimistic
Speaking in New Orleans last Friday, Breaux said that his bill "has a good chance of being enacted soon," the New Orleans Times-Picayune reports. He added that the bill "does the job" by giving people protections within their health plans and resolving about 95% of disputes out of court. He added that unlike the rival McCain-Kennedy-Edwards bill, his bill "can be passed." Healthcare Leadership Council President Mary Grealy, who also spoke at the forum, said that the McCain-Kennedy-Edwards bill would result in a "major expansion of litigation and liability" and would raise health insurance premiums. She also said that the legislation, which allows employers to be sued if they were directly involved in making a medical decision that led to injury or harm, would "reduce the likelihood that employers" who do not currently offer health insurance to their employees will develop new insurance plans, "leaving many people without coverage" (New Orleans Times-Picayune, 6/2).