Fletcher Patients’ Rights Bill Lacks Votes for Passage
Despite a "full-throttled campaign" by the Bush administration to push patients' rights legislation (HR 2315) sponsored by Rep. Ernie Fletcher (R-Ky.) and backed by the House Republican leadership, the bill does not have enough supporters to pass, White House officials and Bush's congressional allies "acknowledged" yesterday, the Washington Post reports (Goldstein/Eilperin, Washington Post, 7/24). Under Fletcher's bill, patients could sue health plans in federal court for quality of care issues and non-quality of care issues, and could sue in state court only in cases in which health plans refused to abide by decisions made by outside appeals panels. The bill would cap non-economic damages in federal court at $500,000, but state courts could award as much money in damages as the state allows. The legislation would prohibit punitive damages. The White House and Republican leaders have targeted "twin messages" at House Republicans who previously voted against the party leadership on patients' rights, the Washington Post reports. In one message, they say that the Fletcher bill gives them a "sound alternative" to the competing bill (HR 2563) sponsored by Reps. Greg Ganske (R-Iowa), John Dingell (D-Mich.) and Charlie Norwood (R-Ga.), unlike two years ago, when 68 House GOP members voted for the "broader" Norwood-Dingell bill for lack of an alternative. The second message suggests that if House Republicans support federal protections for HMO members, they should vote for the Fletcher bill because Bush intends to veto the Ganske-Dingell-Norwood bill if it should pass (Washington Post, 7/24). The Ganske-Dingell-Norwood bill, which is similar to the Kennedy-McCain-Edwards bill (S 1052) that passed the Senate earlier this month, 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. The legislation would cap damages awarded in federal court at $5 million, but state courts could award as much in damages as the state allows. In the last month, Bush has hosted three meetings on patients' rights at the White House with 61 House Republicans, but his "entreaties have changed few minds," the Post reports. Reps. Marge Roukema (R-N.J.) and Steve Horn (R-Calif.), for instance, have said that despite pleas from Bush, they intend to vote for the Ganske-Dingell-Norwood bill. But some Republicans who supported that bill in the past have changed their minds, and now intend to vote for the Fletcher bill (Washington Post, 7/24). John Feehery, spokesperson for House Speaker Dennis Hastert (R-Ill.), said, "We will need [Bush's] help. I don't think we are there yet. We've made great progress. We have momentum on our side. But we're still working on our votes." Bush will have to "plunge personally into the debate as soon as he returns from Europe on Tuesday night," Republicans leaders said.
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Supporters of Ganske-Dingell-Norwood say they expect fewer Republican votes this time than in the last Congress, particularly because voting for the bill means "defying a Republican president," the New York Times reports (Mitchell/Pear, New York Times, 7/24). However, a Norwood aide said yesterday that all but "perhaps three" Democrats seem to "steadfastly suppor[t]" the Ganske-Dingell-Norwood bill, while 10 Republicans have signed on as official co-sponsors -- "enough to pass ... even without additional Republicans," the Post reports (Washington Post, 7/24). The House is expected to debate the competing bills Thursday, but Republican House leaders said yesterday that they may postpone a vote until Friday in order to give President Bush time to "drum up support" for the Fletcher bill (Wodele/Bennett, CongressDaily/AM, 7/24).