PATIENTS’ RIGHTS: Clinton Plans New Managed Care Effort
While the conference committee on managed care stagnates, the White House is planning to wage a major fight to generate a patients' rights bill this year, relying on "election year pressures" to capture Republican votes, CongressDaily/A.M. reports. With a recent near-win in the Senate, Clinton advisers remain "guardedly optimistic" about prevailing on another vote. "One way or another, that was not the last vote on the patients' bill of rights," one senior White House official said Wednesday. Following the narrow 51-48 defeat last week, Senate Democrats gained two new GOP supporters, Commerce Chair John McCain (R-Ariz.) and Sen. Lincoln Chafee (R-R.I.), which could shift the balance in favor of patients' rights legislation. "We think there's a majority there, if we can ever get a clean shot," Clinton said. HHS Assistant Secretary for Legislation Richard Tarplin agreed, noting, "Our experience is, when the sun shines on this issue, bipartisan support grows stronger each time." The White House will target Republican senators facing tight races this year, including Sens. Spencer Abraham of Michigan, Rick Santorum of Pennsylvania, John Ashcroft of Missouri, Slade Gorton of Washington and William Roth of Delaware (Koffler, 6/15).
GOP Tactics Raise Ire Among Dems
Meanwhile, House and Senate Democratic managed care conferees continue their struggle to hammer out a final bill. Rejecting the GOP compromise offer, the Democrats demanded a change in conference ground rules from Republican leaders. "It is plain that the process of closed meetings involving a limited number of members discussing concepts and generalities is a failure," Democrats wrote Tuesday in an "angry" letter to conference chair Sen. Don Nickles (R-Okla.). According to a Nickles spokesperson, the Senate Majority Whip expressed disappointment over the letter, which Nickles says "meets neither the form nor the substance of a serious negotiation." The spokesperson said, "He is not interested in theater; he is interested in legislating." She added that Nickles will proceed with only House and Senate Republicans if necessary. In the letter, Democrats attacked the GOP proposal, criticizing right-to-sue and coverage provisions. "[Republicans] ignored our proposals and continued suggestions that would actually weaken the few protections that patients already have under current law," the letter concludes (Rovner, CongressDaily, 6/14).
AMA Joins the Fight
The AMA's attention is also focused on patients' rights, as it launches an advertising blitz in targeted states of senators who oppose its managed care reform position. The campaign mentions senators' names specifically, seeking to change the minds of Republican lawmakers who opposed patients' rights legislation earlier this year. Targeted senators include John Ashcroft (R- Mo.), Slade Gorton (R-Wash.) and Spencer Abraham (R-Mich.). "We are tired and frustrated with the foot-dragging (on the legislation)," Dr. Ted Lewers, the AMA's board chair, said. In response, Senate Majority Leader Trent Lott (R-Miss.) said, "The AMA has just about broken off all of their working relationships with Republicans. If they keep up these tactics, it may be a permanent rupture" (Jaspen/Neikirk, Chicago Tribune, 6/15).
Patient Education over Appeals
While managed care conferees battled for hours in a "never ending" debate on the appeals process for patients denied care, they may be "wasting their time," CongressDaily/A.M. reporter Julie Rovner notes. According to a Kaiser Family Foundation/Consumer Reports survey, most people denied care by HMOs failed to enter the "external appeals" process, mainly because few know that the option is available, the editorial explains. "Most people simply don't know they exist," Larry Levitt of the Kaiser Foundation agreed, adding that legislators should focus on providing "the education consumers need to exercise [their] rights" (6/15).