PATIENTS’ RIGHTS: House Passes Access Bill

      The House yesterday passed with a largely party-line vote the GOP-backed health insurance access bill, leading Democrats to charge Republicans with throwing a wrench in the legislative machinery of HMO reform. The 227-205 vote included 11 Democrats for the measure. But most minority party members "objected loudly, saying Republicans were using the measure to distract attention from their managed care reform bill, which will be voted on today." Rep. John Dingell (D-MI) said, "We came here to talk about the patients' bill of rights, not to try to obfuscate the issue with a lot of phony tax breaks." Rep. Pete Stark (D- CA) added, "What the Republicans have done is the most dishonest, obscene attempt at almost fascist politics." But Rep. Ed Bryant (R-TN) countered, "The patient protections we will be talking about later mean nothing -- zero -- to people without health care. Getting access to health care is the most basic and most important patient protection" (Scully, Washington Times, 10/7). Meanwhile, the liberal think tank Center for Budget and Policy Priorities "issued an analysis of the GOP" bill, "claiming it would disproportionately benefit those with higher incomes and might actually result in more, rather than fewer, uninsured Americans." The analysis said the tax deduction contained for individuals to purchase their own health care would reduce costs by only 15% (Rovner, CongressDaily, 10/6). The administration cited another analysis by the Joint Economic Committee that showed the bill "would benefit less than 1% of those who are now uninsured" (Murray/McGinley, Wall Street Journal, 10/7). Families USA's Ron Pollack said, "In addition to their multi-million dollar advertising and lobbying efforts, the industry has sunken so low that they are exploiting the plight of the uninsured in a last-ditch effort to kill patient protections" (release, 10/5).

Play by the Rules
      Democrats also squawked at yesterday's final 221-209 approval of the rule for the HMO reform debate, which not only will attach the access bill to any patients' rights bill that passes today, but does not allow Democrats "to offer an amendment to offset the estimated $7 billion, five-year cost of their bill" (CongressDaily, 10/6). "This legislation is completely unfunded and would therefore spend the Social Security surplus," the White House's official statement said (Rovner, CongressDaily/A.M., 10/7). President Clinton himself went even further, saying of both the rule and the access measure, "The House leaders concocted a process filled with enough poison pills and legislative sleights of hand to practically guarantee the defeat of this bill. This is a travesty. It's the sort of thing they did to kill common-sense gun legislation in the aftermath of Littleton." House Rules Committee Chair David Dreir (R-CA) called the president's allegations "absolutely preposterous." Stark said, "The Republicans have scored a procedural victory, no question. They are basically defeating patient protections through procedural legerdemain" (Pear, New York Times, 10/7).

What's in Store?
      The Washington Post reports that the "acrimonious debate yesterday was the warm-up act to the main show that will play out today" when the House considers patients' rights. Members of the leadership approached Republicans who support Dingell-Norwood yesterday in an effort to get them to switch to Coburn-Shadegg or one of the other alternatives (Goldstein/Eilperin, 10/7). CongressDaily/A.M. reports that "many Republicans Wednesday reported they were planning to vote for most of the alternatives," until one passes (10/7).

Fun and Games with Lobbyists
      In addition to trying to sway their own members, GOP leaders "have begun to ask business and health insurance lobbyists ... whether they would be willing to remain neutral" on the Coburn-Shadegg measure. But they apparently failed in their attempts, as business and insurance stepped up lobbying efforts. The National Association of Manufacturers sent a memo to about 200 moderate lawmakers Tuesday, saying that if they support Norwood-Dingell, "manufacturers that experience increases in insurance premiums would stuff a note in workers' pay envelopes urging them to protest to their congressional representative" (Post, 10/7).