PATIENTS’ RIGHTS: Scope of Law Dividing Legislators

      Lawmakers are entering rough waters in their patients' bill of rights negotiations. The main bone of contention seems to be over who will be protected against HMOs, the Washington Post reports. "If we were able to agree on scope, we could probably settle most everything else," Sen. Judd Gregg (R-N.H.) said, adding, "It's almost the linchpin on which everything else depends." The Senate plan, led largely by the GOP, would cover less than one-third of those under the House plan, applying only to those not covered by state regulations. But the House plan, a bipartisan effort led by Reps. Charles Norwood (R-Ga.) and John Dingell (D-Mich.), would include all Americans with private insurance plans -- estimated at 191 million people. "We can pass the greatest [patients' rights] bill in the world, but if we leave off more than 100 million people, we've not done very well," Norwood argued. But some Republicans, including Senate Assistant Majority Leader Don Nickles (R-Okla.), claim state regulations of managed care plans "are working." He asked, "Do we really think the federal government should preempt state regulation of health care?" Democrats counter that the wide variation in regulations allow many to fall through the system's cracks.

Election Year
      Because polls are showing strong public support for managed care protections, over 60 House Republicans are going against their Senate counterparts and supporting the Norwood-Dingell proposal. GOP leaders are anxious to have a bill passed quickly to "keep Democrats from exploiting the issue in this fall's election," but the Post says the "coverage issue has the potential to derail the whole deal." With the Senate's return to action today from a week-long recess, negotiators are expected to hash out other controversial issues, such as whether patients can sue for malpractice, whether to allow tax-free medical savings accounts and how much control insurers have over patient treatment (Dewar, 3/19).