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Health Care Reform:

Health Insurance & Affordable Care Act

Bush-Backed 'Patient Protection' Bill Approved by House

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Many angry Democrats accused Norwood of selling out. Dingell said that the Bush deal was a "sham" for patients.

In order to sue a health plan under the Norwood legislation, a consumer would first have to complete an external appeals review with independent doctors. If those doctors sided with the plan, the consumer could still sue, although under tougher standards.

For disputes over administrative and contract issues, patients would go to federal court. For medical care delivery disputes, patients would go to state court -- but under new federal rules.

The Norwood measure puts a $1.5 million cap on "pain and suffering" awards, and a $1.5 million cap on punitive damages. Punitive damages would only apply if an external panel ruled that a health plan should provide care, but the plan then refused to provide it.

The American Medical Association, which had sided with Norwood on earlier legislation, said that it opposed his lawsuit compromise. The doctors group claimed that the measure would give health plans an easier standard in state courts than that allowed doctors in cases of negligent medicine.

The House-passed bill would also bar consumer lawsuits against employers who offer health coverage, unless employers were directly involved in medical decision making.

As with the Senate's bill, the House legislation applies to every American with private health insurance. It moves to ensure a national standard of access to emergency care, specialty care, and clinical trials. It would offer the guarantee of direct access to pediatricians and ob-gyns, would allow patients with ongoing health needs to keep the same doctor, and would increase requirements on plans to provide consumers with information about their policies. It also forbids HMO "gag rules" that limit doctor-patient discussions about treatment options.

The American Association of Health Plans said after the vote that it had "serious concerns" with the House bill. Nevertheless, the group said it was pleased that the House "moves away from the reckless litigation binge that the Senate-approved bill would encourage."

The House also approved the permanent expansion of a national test program on medical savings accounts (MSAs), a tax-sheltered health insurance alternative. The Senate bill does not include an MSA provision.

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