Business Organizations Wary of Patients’ Rights Compromise, To Lobby Against Senate Bill

Fearing that House and Senate negotiators will "strike a deal" on patients' rights legislation, business lobbyists have initiated a new lobbying strategy to "limit the fallout," CongressDaily reports. Lobbyists had hoped that lawmakers would either vote down patients' rights legislation or pass a bill that would not give patients new rights to sue insurers, but the House and Senate both passed bills that include such rights. Because attempting to "undermin[e]" the conference committee would be a "direct affront" to President Bush, who has given the House bill (HR 2653) "his strong endorsement," "senior GOP lobbyists" said that they will "try to steer" negotiators toward the House bill, whose "more circumscribed" liability provisions make it "the lesser of two evils." For example, the Health Benefits Coalition, a group representing businesses, will likely launch a print advertising campaign in Washington next month "attacking" the Senate bill (S 1052), HBC spokesperson Todd Irons said. A trade association lobbyist said, "The only thing people like about [the House bill] is that it's not [the Senate bill]" (Koffler, CongressDaily, 8/16). Under the House bill, passed earlier this month, patients could sue health plans in state courts -- generally considered more favorable to plaintiffs -- under a new set of federal rules that would cap non-economic damage awards at $1.5 million. Courts could award patients 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 an HMO "still persists in refusing the care they need" (Kaiser Daily Health Policy Report, 8/2). The Senate bill, passed 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. 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, 2/7).

Done Deal?
Although lobbyists recognize that Bush "is serious about wanting to sign" a patients' rights bill and sources said that House Speaker Dennis Hastert (R-Ill.) "wants the matter done with," some lobbyists do not believe that House and Senate negotiators will reach an agreement. American Association of Health Plans lobbyist Mark Merritt said that "no one knows where the conference is going," adding that AAHP plans to highlight the "flaws" in both the House and Senate bills. Business officials "appear to agree" that a deal depends on the whether Democrats will move toward the House bill. Some point out that Democrats may "fear they will be tarred as obstructionists if things fall apart," saying that Bush has "already appeared flexible" in negotiations. Lobbyists also launched "feverish" speculation about whether Sen. Edward Kennedy (D-Mass.), a co-sponsor of the Senate bill, will "play dealmaker" or "take a tougher line" (CongressDaily, 8/16).

'Sideshow' Amendment?
Meanwhile, a Kennedy aide is "calling [Sen. Don] Nickles' [(R-Okla.)] bluff" on an amendment to the Senate bill that would include federal employees, as well as Medicare and Medicaid beneficiaries under the legislation, CongressDaily reports. Nickles' staff "smiled" when some federal employee unions "suddenly got late-in-the-game jitters" about the Senate bill after the Senate approved Nickles' amendment, expressing concern that the amendment's "litigatory threats" could "destabilize" some health plans. But the aide said that the provision would "simply spread new rights [to sue health plans] more widely." The aide added that Republicans will not likely "push hard" for the provision in conference, calling the amendment "a sideshow and a smokescreen." However, House lawmakers have "opened the door" for negotiators to debate the issue by adding language to their bill that the bill's provisions should apply to those enrolled in federal health programs (Jacobson, CongressDaily, 8/16).