House, Senate Patients’ Rights Bills Will Be ‘Hard to Reconcile,’ CQ’s Goldreich Says

The patients' bill of rights (HR 2563) passed by the House on Aug. 2 will be "hard to reconcile" with a "much stronger" bill (S 1052) that passed the Senate in June, Congressional Quarterly's Samuel Goldreich says in a kaisernetwork.org HealthCast on the Hill report. Goldreich explains that the House bill, which emerged "overnight" from negotiations between President Bush and bill co-sponsor Rep. Charlie Norwood (R-Ga.), "weakens the right to sue health plans and imposes federal rules that would block huge jury awards by state courts." Although Norwood said that the compromise bill represented the first time Bush had agreed to allow patients "injured by health plans' coverage decisions to sue in state court and seek punitive damages up to $1.5 million," critics of the measure -- including co-sponsors Reps. John Dingell (D-Mich.) and Greg Ganske (R-Iowa) -- "respond that these are false promises" because the bill places several new restrictions on lawsuits. For example, before suing, patients must complete an external appeals process that "critics say is stacked against them," and patients who ultimately win in court can only collect punitive damages if they prove the health plan refused to follow the appeals panel's orders. Employers who run their own health plans may be sued, but only in federal court, "where it can take years to get a trial date." By contrast, Goldreich says, the Senate bill allows patients to sue health insurers and employers who run health plans in either state or federal court, depending on the type of dispute, "provid[ing] the prospect" of unlimited punitive damages in state courts and up to $5 million in civil penalties in federal court. Goldreich notes that a House-Senate conference committee tasked with working out such differences "risks drifting into the same kind of stalemate that doomed legislation last year."

Also on the Hill
Goldreich also weighs in on recent Medicare reform proposals and on the Bush administration's Aug. 4 announcement that it will allow state Medicaid programs to reduce benefits for optional beneficiaries and to shift the money to cover increased numbers of uninsured residents. He predicts that when Congress returns from its August recess, the biggest news will be about "[t]hree things: the uninsured, Medicare and what I call weird science, the issues of human cloning and stem cell research." Patients' rights, he says, will remain on the agenda, but adds, "I ... expect that battle to continue into next year." Goldreich's full report can be heard online ("Goldreich on What's Next on the Hill," kaisernetwork.org, 8/6).