Refusing to ‘Rule Out’ Filibuster, Lott Requests Delay on Patients’ Rights Debate

Seeking more time to review "last-minute changes" to the patients' rights bill "pushed" by "newly empowered" Senate Democrats, Republicans moved June 18 to delay debate on the legislation, the Los Angeles Times reports. The move, led by Senate Majority Leader Trent Lott (R-Miss.), "threatens to push back" debate, scheduled to begin June 19, until at least June 20 (Miller/Hook, Los Angeles Times, 6/19). The bill (S 283), sponsored by Sens. Edward Kennedy (D-Mass.), John McCain (R-Ariz.) and John Edwards (D-N.C.), 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. In addition, the bill 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 Policy Report, 2/7). Over the weekend, the bill's sponsors agreed to revisions that would "shield" doctors and insurance companies from lawsuits and "could make it harder" for some patients to sue health plans (Kaiser Daily Health Policy Report, 6/18). "Many senators would like to look at the details of the bill, the fine print, before proceeding to it. I don't think this will be a serious delay," Lott spokesperson Ronald Bonjean said (New York Times, 6/19). Democrats called their modifications "minor" and dismissed the GOP move as a "partisan tactic designed to frustrate Democrats' ability to start moving" on the bill. To delay the legislation, Lott objected to a motion that would have allowed debate to begin, a tactic that requires 60 votes to "overcome." Democrats said that they have the votes to override Lott's objection (Los Angeles Times, 6/19).

Reminding Democrats of GOP Power?
Lott's objection could mean that Democrats will be "unable to deliver" the Kennedy-McCain-Edwards bill before the July 4 recess, "as they had planned" (CongressDaily/AM, 6/19). Some observers said that Republicans may have employed the "delay tactic" to "remind" Democrats that the GOP "still control[s] considerable levers of power in the Senate" (Los Angeles Times, 6/19). Republicans may be trying to allow bill opponents time to mount an advertising campaign and build a "critical mass" of opposition to the legislation (Lambro, Washington Times, 6/19). Senate Republicans will likely offer amendments to the bill, and they have "not ... ruled out" introducing "substitute" legislation (S 889) sponsored by Sens. John Breaux (D-La.), Bill Frist (R-Tenn.) and Jim Jeffords (I-Vt.), a Frist spokesperson said (CongressDaily/AM, 6/19).

Lott's View
In an interview with the Associated Press, Lott "stressed his opposition" to the Kennedy-McCain-Edwards bill and "floated the possibility of a filibuster." He added that Republicans will "press" for a number of amendments, including expanded medical savings accounts and a provision that would allow more employees to deduct the cost of insurance premiums from their income taxes. In addition, he said that GOP lawmakers may introduce "extraneous issues," including amendments related to energy policy, into the debate. "I'm not advocating that," he said, but he called energy "much more of an urgent need" that a patients' rights bill. He added, "Senators can offer any amendment they want." Lott added that despite comments last weekend suggesting that he could be open to allowing lawsuits in state courts, he opposes the provision in Kennedy-McCain-Edwards that would allow such suits. "I don't support state court review and I would not support it at the end of the process," he said, although he "wouldn't flatly rule out supporting a final bill that includes some sort of right to sue in state court." Lott said that Republicans had "no predetermined ... strategy" for addressing the bill, but he added, "I think those of us who want a genuine patients' bill will have to consider the options of amendments, perhaps a substitute, perhaps a filibuster and also the need for the president to be prepared to veto" the bill (Espo, AP/Bergen Record, 6/19).

House Business
Lott's delay could "buy time" for the House GOP leadership to develop competing legislation, CongressDaily/AM reports (CongressDaily/AM, 6/19). The House GOP leadership reached a "tentative, staff-level agreement" last weekend with three key committee chairs on a patients' rights bill that would compete with legislation ( HR 526) sponsored by Reps. Charlie Norwood (R-Ga.), John Dingell (D-Mich.) and Greg Ganske (R-Iowa). "We expect to have legislation ready this week," a spokesperson for House Energy and Commerce Committee Chair Billy Tauzin (R-La.), who shares jurisdiction over the issue with House Ways and Means Committee Chair Bill Thomas (R-Calif.) and House Education and the Workforce Committee Chair John Boehner (R-Ohio), said. "It is our intention to have a bill this week that can be on the floor next week," a spokesperson for House Speaker Dennis Hastert (R-Ill.) added. According to CongressDaily, the measure will likely include a proposal by Rep. Ernie Fletcher (R-Ky.) to include a "bad actor dropout" provision that would allow patients to sue HMOs only in federal court "unless the HMO disregarded the decision of an outside appeals panel." It is "unclear" whether House GOP leaders will include the language in their bill and whether members of the committees "are committed" to the legislation (Fulton, CongressDaily/AM, 6/18).

On the Web
At the time the Kaiser Daily Health Policy Report was published, it was unclear if debate will begin June 19 on the Kennedy-McCain-Edwards bill. Check back throughout the day to kaisernetwork.org's Healthcast, which will broadcast the debate live once it begins. Click here to view the Healthcast. Please note: this link is only available to Web readers.