President Bush, Rep. Norwood Announce Compromise on Patients’ Rights Bill

After weeks of negotiations, President Bush and Rep. Charlie Norwood (R-Ga.) reached a compromise Aug. 1 on patients' rights legislation, "clearing the way for House passage" this week, the New York Times reports (Pear, New York Times, 8/2). The deal would allow patients to sue health plans in state court -- generally considered more hospitable to plaintiffs -- under a new set of federal rules that would cap non-economic damage awards at $1.5 million. Patients could also be awarded up to $1.5 million in punitive damages, but only in cases where patients win complaints against health plans before an outside appeals panel and where an HMO "still persists in refusing the care they need." In addition, patients could sue health plans after an outside review panel rejects their complaints, but lawsuits in those cases would "have a much higher burden of proof to overcome." The agreement would allow patients to sue large employers that administer their own health plans over health care disputes in federal court, not state courts (Goldstein/Eilperin, Washington Post, 8/2). House Republicans will likely offer the agreement on Aug. 2 as an amendment to the patients' rights bill (HR 2563) sponsored by Norwood and Reps. John Dingell (D-Mich.) and Greg Ganske (R-Iowa) (New York Times, 8/2). That bill, which is similar to the patients' rights bill (S 1052) passed by the Senate in June, 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 in damages as the state allows (Kaiser Daily Health Policy, 7/19).

'Inadequate' Deal?
Supporters of Ganske-Dingell-Norwood "immediately condemned" the proposal as "inadequate" (Koszczuk/Hutcheson, Philadelphia Inquirer, 8/2). According to some, the deal would "preserve a privileged status" for health plans and could "jeopardize" state patients' rights laws (Miller, Los Angeles Times, 8/2). The agreement "favors the HMO over the patient," Sen. John McCain (R-Ariz.), who co-sponsored the Senate bill, said (Epstein, San Francisco Chronicle, 8/2). Democrats "fear" that provisions in the agreement "will prove cumbersome and unworkable" (Rogers, Wall Street Journal, 8/2). Some supporters of Ganske-Dingell-Norwood have said that they "won't agree to the deal" (Welch/Keen, USA Today, 8/2). "Charlie cut his own deal," Ganske said, adding, "I think Charlie looks a little worn out. I guess they just beat him down" (Malone/Eversley, Atlanta Journal-Constitution, 8/2). However, Norwood said, "The bottom line and the goal is that we want to change the law, and the last time I looked, that's pretty difficult to do without the presidential signature" (Hutchinson, New York Daily News, 8/2).

Prospects
House Republican leaders predicted that the agreement would "almost surely" pass with the support of Norwood. "Norwood gives you the Good Housekeeping seal of approval," Hastert spokesperson John Feehery said, adding, "He will bring along a lot of undecided House members" (New York Times, 8/2). The Wall Street Journal reports that with Norwood's support for the compromise, Democrats will "find it hard to isolate" Bush on patients' rights and that "pro-business Democrats may be drawn to the compromise" (Wall Street Journal, 8/2). Still, some Democrats said that they have the votes to block the agreement. "We still think we've got the votes. We're asking our members to vote against all amendments," Rep. Marion Berry (D-Ark.) said, adding, "Last vote count I saw, we're in good shape" (Lee, Dallas Morning News, 8/2). Some Democrats also said that House leaders should delay the vote until September to allow them more time to review the agreement (New York Times, 8/2).

'Triumph' for Bush
The agreement represents a "personal triumph" for Bush (Espo, AP/Arizona Daily Star, 8/2). The New York Times reports that the deal "spares him from what could have been a major political embarrassment" (New York Times, 8/2). Although the president had threatened to veto Ganske-Dingell-Norwood, which he said would drive up health insurance costs and force employers to drop coverage for employees, the deal "gives Bush a solid bargaining position and greatly reduces the risk that he'd have to veto a popular bill" (Orin, New York Post, 8/2). However, the agreement "leaves a dark cloud over the long-term prospects" of the bill, with "bruising negotiations" likely with the Senate, the Los Angeles Times reports (Los Angeles Times, 8/2).

NYT Criticizes Norwood
Norwood "apparently sold out his own cause" in his "secretive" agreement with Bush, while the president "demonstrated his administration's obsession with winning at all costs," the New York Times says in an editorial today. The Times urges undecided House members to "go ahead and vote for the solid Ganske-Dingell-Norwood bill" and reject the Bush-Norwood agreement. The editorial says that Norwood "still deserves credit" for his "long fight" for a patients' rights bill, but adds that lawmakers should "no longer follow his lead. Real bipartisanship takes more than two men from the same party in a room" (New York Times, 8/2). Additional information on the patients' rights debate, including a chronicle of developments and a link to a live Healthcast of the Aug. 2 House floor debate, is available at http://www.kaisernetwork.org/healthcast/house/patientsrights/aug01.