Negotiations on Patients’ Rights Legislation Stall, Passage Before November Elections Seems Unlikely
Months of behind-the-scenes negotiations between the White House and the Senate have failed to produce an agreement on patients' rights legislation, making it unlikely that Congress will approve a compromise by election day, the AP/Las Vegas Sun reports (AP/Las Vegas Sun, 5/16). While the two sides have moved closer to agreement on patient lawsuits against health plans, the amount of damages patients should be allowed to receive continues to be the main dividing point. "We all bent over backwards to get this thing resolved, and it looks like that's not coming to fruition," House Speaker Dennis Hastert (R-Ill.) said. Sen. Edward Kennedy (D-Mass.) added, "After months of talks with the White House, we've reached the 11th hour with little sign of progress from the administration" (Rogers, Wall Street Journal, 5/17). After the House and Senate passed different versions of the bill last summer, President Bush, Senate Majority Leader Tom Daschle (D-S.D.) and Hastert agreed to have Kennedy, Sens. John McCain (R-Ariz.) and John Edwards (D-N.C.) -- the co-sponsors of the Senate bill -- meet privately with Josh Bolton, the president's deputy chief of staff for policy, and Nicholas Calio, the White House's chief legislative liaison, to attempt to reach a compromise (AP/Las Vegas Sun, 5/16). But with talks stalling, Kennedy and Edwards have prepared a draft letter to Bush calling for a traditional House-Senate conference committee to work out the differences between the two bills. This route would "only make a deal more difficult, however, which is why the leadership has delayed going to conference in the hopes that the talks would be productive," the Wall Street Journal reports (Rogers, Wall Street Journal, 5/17).
The House and Senate bills are nearly identical in their non-liability provisions -- both, for example, would guarantee emergency room care coverage and access to specialists and clinical trials (AP/Las Vegas Sun, 5/16). But "major differences" remain over liability issues (Wall Street Journal, 5/17). The House bill (HR 2563) would cap non-economic damage awards in patient lawsuits against health plans at $1.5 million. Courts also 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 the insurer still refuses to cover a needed treatment (California Healthline, 8/3/01). Under the Senate bill (S 1052), patients could sue insurers 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 (California Healthline, 7/2/01).
While Bush has "insisted" on damage award caps to "give some certainty to employers," who are concerned that large awards could lead to increase health care costs, White House negotiators have considered some options that would effectively raise the $1.5 million limit set in the House bill. One proposal discussed would "calculate awards on an annual basis and therefore promise more money over time to a person injured at a young age." Another would create separate categories for injuries, with no damage caps on the most serious injuries. The latter proposal "alarmed conservatives," leading the administration to "abruptly pull it back," the Journal reports. McCain, meanwhile, has proposed a $4 million cap for the most serious injuries (Wall Street Journal, 5/17). Democrats "strongly object" to the outside appeals provision in the House bill. Despite these disagreements, the White House remains optimistic that an agreement can be reached. "We have made tremendous progress, and the president is continuing to reach out" to Democrats, White House spokesperson Scott McClellan said, adding that Bush "wants to pass legislation with strong patient protections this year" (AP/Las Vegas Sun, 5/16). McCain added, "I know things don't look good, but I want to keep trying" (Wall Street Journal, 5/17).