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House Battle Looms Over Patients' Bill of Rights

WebMD Health News

July 24, 2001 (Washington) -- With its outcome in doubt, the battle over federal rules for HMOs is about to hit the House of Representatives as lawmakers ready to vote on competing patient rights bills.

One bill, drafted by Rep. Ernie Fletcher (R-Kan.), MD, is favored by the House Republican leadership but very few Democrats. The other, from Reps. Greg Ganske (R-Iowa), MD, Charlie Norwood (R-Ga.) and John Dingell (R-Mich.), commands support from most Democrats and some Republicans.

The bills have many similar provisions, including steps to guarantee better emergency room coverage and access to medical specialists and measures to permit patients an external appeal of a health plan's denial of coverage.

But the big controversy is over a consumer's right to sue an HMO.

Both bills permit lawsuits in state and federal courts, but the Fletcher bill limits these circumstances and puts tighter caps on damage awards.

Fletcher says the Ganske measure would encourage frivolous lawsuits, drive up the cost of insurance, and force many employers to drop health coverage.

According to Dingell, however, the Ganske bill would bring about premium increases to the tune of maybe one Big Mac per month and would shield employers that do not make medical decisions from lawsuits.

President Bush has signaled both his endorsement of the Fletcher measure and his intention to veto the Ganske legislation.

Nevertheless, in 1999, the House overwhelmingly passed an earlier version of the Ganske bill, with votes from nearly 70 Republicans who bucked GOP leaders' opposition to the measure.

And last month, the Senate approved legislation similar to the Ganske measure on a 59-36 vote.

The patient rights legislation may come up for a House vote as early as Thursday. That timetable may slip, however, as Republicans delay consideration while they scramble to gain majority support for the Fletcher plan.

Today, Bush's health secretary Tommy Thompson visited Capitol Hill to press the case for Fletcher and against Ganske.

"We've made substantial inroads," Fletcher said today, noting that several GOP lawmakers have announced that they had switched support from the Ganske bill. Ultimately, a "handful" of undecided lawmakers would determine which of the competing measures would pass, he said.

The American Medical Association backs the Ganske proposal, claiming that the Fletcher bill has inferior patient protections and could weaken some state laws that already give consumers the right to sue.

By contrast, the American Association of Health Plans, or AAHP, is bitterly opposed to the Ganske bill, and unsupportive of the Fletcher bill.

"The patient-protection discussion is no longer about what's best for patients. It's about how many ways can health plans be sued," complained AAHP President Karen Ignagni.

A spokesperson for the U.S. Chamber of Commerce tells WebMD that the business community similarly does not support either bill but is focusing its efforts on opposing the Ganske measure.

During his tenure as governor of Texas, Bush vetoed an initial patient rights bill but let subsequent legislation become law without his signature.

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