White House, Norwood ‘Making Progress’ on Deal for Patients’ Rights; House Likely to Vote on Bill Thursday

House leaders plan to bring a patients' rights bill to the floor for a vote on Aug. 2, while President Bush and his congressional opponents "spar" over "how close they are to a compromise" on the issue, the Washington Post reports. After a week of "intense" negotiations with Rep. Charlie Norwood (R-Ga.), the White House said yesterday that "the nation is on the threshold" of patients' rights legislation (Goldstein, Washington Post, 8/1). "We don't have a deal yet ... but we're making good progress," Bush said ( USA Today, 8/1). However, Democrats dismissed White House "claims" about a potential compromise as "overstated" (Richmond Times-Dispatch, 8/1). Norwood and Reps. Greg Ganske (R-Iowa) and John Dingell (D-Mich.) are the sponsors of a patients' rights bill (HR 2563) supported by most House Democrats and a number of Republicans (Washington Post, 8/1). The legislation 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. It would cap damages awarded in federal court at $5 million, but state courts could award as much in damages as the state allows (Kaiser Daily Health Policy Report, 7/19). Bush has threatened to veto the bill, which is similar to the bill passed in June by the Senate, saying that the legislation would drive up health care costs by funneling lawsuits against health plans into state courts, often "viewed as more friendly to plaintiffs" than federal courts (Pear, New York Times, 8/1).

Negotiations
During negotiations on July 31, Norwood suggested adding a provision to Ganske-Dingell-Norwood that would allow patients to sue large employers that administer their own health plans for employees over health care disputes in federal court, not state court (Washington Post, 8/1). Ganske said such a move would represent "a major step toward the president" (Miller, Los Angeles Times, 8/1). The White House "reportedly had not responded" to the offer on July 31 (Rovner, CongressDaily/AM, 8/1). Supporters of Ganske-Dingell-Norwood rejected a White House proposal that would have "subjected all suits in state courts against health plans to a single federal standard" (Los Angeles Times, 8/1). "We're not budging on that," Ganske said (McQueen, Associated Press, 8/1). Bush and Norwood also "don't appear to have made any progress" on resolving a dispute over a cap on damage awards (Los Angeles Times, 8/1). According to the White House, Bush would support a $750,000 cap on damages awarded in federal court. Ganske-Dingell-Norwood has a $5 million cap (Archibald, Washington Times, 8/1). Bush also has discussed capping damages awarded in states that have not set their own limits and "trying to find middle ground on circumstances in which class action suits would be allowed" (Associated Press, 8/1). Although Republicans "expressed optimism" about reaching a compromise with Norwood, they said that Democrats would not likely "be willing to make concessions" (Espo, AP/Boston Globe, 8/1).

House Vote Thursday?
House GOP leaders "appear inclined" to move ahead with a vote on patients' rights legislation "regardless of the outcome" of negotiations with the White House. "Either way, we're going forward," John Feehrey, a spokesperson for House Speaker Dennis Hastert (R-Ill.), said (Los Angeles Times, 8/1). Hastert has set a vote on Ganske-Dingell-Norwood tomorrow, but Feehrey said that the vote "could be postponed" until after Labor Day (Koszczuk, Philadelphia Inquirer, 8/1). The House Rules Committee will likely meet today to set rules for debate and amendments to the bill. According to the Washington Times, Republicans may offer rival legislation (HR 2315) sponsored by Rep. Ernie Fletcher (R-Ky.) as a substitute bill (Washington Times, 8/1). Under the Fletcher bill, patients could sue health plans in federal court for quality of care issues and non-quality of care issues, but could only sue in state court in cases where health plans refused to abide by decisions made by outside appeals panels. The bill would cap non-economic damages in federal court at $500,000, but state courts could award as much money in damages as the state allows. It would prohibit punitive damages (Kaiser Daily Health Policy Report, 7/9). However, the Fletcher bill "appears to remain a handful of votes short" of a majority, and Republicans will likely offer the legislation "in pieces" as amendments, including provisions to expand medical savings accounts and establish "association health plans" (Rovner/Wegner, CongressDaily, 7/31). GOP lawmakers also will likely propose an amendment to reduce the $5 million cap on damages (Washington Times, 8/1).