June 30, 2001 (Washington) -- After two weeks of debate, the U.S. Senate Friday night passed patients' rights legislation that was backed by Democrats and moderate Republicans. The bill offers federal guarantees for care standards in HMOs and other health plans, and gives consumers broad new rights to sue the plans in federal and state courts.
The 59-36 vote was a big victory for the Democratic Senate majority, as the health care debate was the first since the party took over the Senate in the wake of the defection of Sen. Jim Jeffords (I-Vt.) from the Republican party.
But since the measure is under a veto threat from President Bush, and the House has yet to act on the issue, it is still unclear what legislation will become law.
Two years ago, the Republican-controlled Senate approved a far weaker patients' rights package that did not include any consumer lawsuit provisions.
The current bill, brought by Sens. Edward Kennedy (D-Mass.) and John McCain (R-Ariz.), withstood a series of amendments from Republicans that especially focused on weakening its lawsuit provisions.
The patients' rights legislation covers the more than 190 million Americans with private health insurance, as well as individuals who have federal coverage such as Medicare and Medicaid.
Its patient protections include assurances of access to emergency care and to doctors including pediatricians and ob-gyns. Patients would also gain access to drugs not covered by their insurance company, increased opportunities to participate in clinical trials, guarantees of continuity of care if they have ongoing health care needs, and better information about their health plans.
The bill also lays out timeframes and standards for reviews of care denials, and independent external "second opinions."
Senators agreed Friday to require that aggrieved patients essentially exhaust their external appeals before being able to file suit against health plans.
In one compromise, senators approved a measure that would shield most employers from lawsuits over medical care. If a business owner shifted medical decision-making to a third party, the Senate moved that they would no longer be liable.
The Senate also agreed that employees from different companies could not band together for class-action suits against HMOs.
Health insurance plans and employer groups blasted the Senate bill, but prominent doctor and patient-oriented organizations - and trial lawyers - have endorsed it.
Sen. Judd Gregg (R-N.H.) said that the bill would be "candyland for lawyers," even though senators voted to limit lawyer fees to one-third of the amount of a court award.
Meanwhile, the White House has vowed to veto the bill, claiming the Senate legislation would toss more than a million Americans off of health insurance because of increased premiums.
Health and Human Services Secretary Tommy Thompson said, "this thing is just not going in the right direction."
The congressional debate on patients' rights now turns to the House, which hasn't considered the issue this year but plans to take it up in July.
President Bush is working with lawmakers to try to garner support for House passage of a less sweeping measure. He has endorsed a package brought by GOP leaders there, which allows more limited lawsuit rights than the Senate measure.
Nevertheless, Bush may face an uphill battle, since the House passed a tough HMO bill in 1999 that had close to 70 Republican supporters. Reps. Charlie Norwood (R-Ga.) and John Dingell (D-Mich.), who led the 1999 patients' rights push, say they still have strong support for their legislation.
Meanwhile, the U.S. Supreme Court announced that it would hear arguments on an Illinois case that hinges on whether states can force a managed care plan to accept an outside review of a medical decision disputed by a patient.