Senate, White House Negotiations on Patients’ Rights Legislation Stall
Negotiations between the Senate and the White House on patients' rights legislation stalled yesterday, "significantly reducing the chances" that a bill will become law this year, the New York Times reports (Pear, New York Times, 8/2). Both the Senate and House passed patients' rights bills last year, but Senate Majority Leader Tom Daschle (D-S.D.) has delayed the appointment of conferees to allow the sponsors of the Senate bill -- Sens. Edward Kennedy (D-Mass.), John Edwards (D-N.C.) and John McCain (R-Ariz.) -- to negotiate an agreement with the White House, which supports the House bill (Goldstein, Washington Post, 8/2). The Senate bill would allow patients to sue HMOs in state courts -- which often award larger damages than federal courts -- for denial of benefits or quality of care issues and in federal courts for other of care issues. The legislation would cap damages awarded in federal courts at $5 million but would allow state courts to award as much damages as states allow. The House bill would only allow patients to sue health plans in state courts for noneconomic damages up to $1.5 million. The legislation also would allow courts to award patients as much as $1.5 million in punitive damages, but only in cases where patients had won complaints against health plans before an outside appeals panel and an HMO still refused to provide care (California Healthline, 6/7).
The Senate bill sponsors and White House aides said that negotiations had "floundered" over the question of caps on damage awards (Washington Post, 8/2). The White House wants patients' rights legislation that includes caps on damage awards to "discourage frivolous lawsuits," which it says could lead to increased health care costs. The senators, however, support legislation with "robust legal rights" for patients (Hook, Los Angeles Times, 8/2). In negotiations, senators and White House aides considered a compromise that would have placed a $1.5 million cap on damages awarded to patients for most injuries and would have allowed larger awards for "particularly serious" injuries. However, the two sides could not agree on a definition for particularly serious injuries. The White House had asked the senators to agree to a narrow definition, the Post reports (Washington Post, 8/2). The White House had proposed a $4 million cap on noneconomic damages for the "most serious" injuries, but senators said that courts should determine the impact the injuries have on patients. A Kennedy aide added that a patients' rights bill should not establish limits on damages for the most serious injuries, such as brain damage, blindness or loss of a limb (New York Times, 8/2).
Analysts considered the negotiations between the senators and the White House the "best hope for resolving differences" between the Senate and House versions of patients' rights legislation, the Los Angeles Times reports. (Los Angeles Times, 8/2). Daschle said that he will appoint several senators to a conference committee to prevent the legislation from "dying right away" (Washington Post, 8/2). Supporters had hoped to avoid a conference committee, where patients' rights legislation has died in the past (New York Times, 8/2). A Senate GOP aide said that Republicans have not yet agreed to a conference committee and would not agree to one without notification of the proposed members and party ratios. The aide said that Daschle "just wants an objection before the recess." The aide added, "But if he wants to switch attention from one failure -- prescription drugs -- to another, that's fine" (Rovner/Fulton, CongressDaily/AM, 8/2). The House also may decide not to participate in a conference committee, the Post reports (Washington Post, 8/2). Rep. Charlie Norwood (R-Ga.) said, "If negotiations between the White House and Kennedy could not succeed, adding a dozen more voices isn't going to make things any better" (CongressDaily/AM, 8/2). "This decision will effectively end the prospects of the legislation," he added (Washington Post, 8/2).
Democrats hoped that the "current anti-corporate climate" would prompt Republicans to compromise on patients' rights legislation rather than "continue to defend the interests of HMOs," the Los Angeles Times reports (Los Angeles Times, 8/2). Kennedy said, "Unfortunately, the Bush administration has been unwilling to hold HMOs and insurance companies fully accountable when they make medical decisions." He added, "A right without an effective remedy is no right at all, and the administration was unwilling to provide injured patients with any effective remedy." However, McCain and Edwards said that the White House has made a "good faith effort" to reach an agreement, the New York Times reports (New York Times, 8/2). White House spokesperson Scott McClellan said, "The issue appears to be whether or not the interest of powerful personal injury lawyers will prevail over the health care needs of the American people" (Los Angeles Times, 8/2). HMOs have opposed both the Senate and House bills over concerns that the legislation would increase health care costs. American Association of Health Plans President Karen Ignagni said, "Every employer and every union is registering concerns about rising health care costs" (New York Times, 8/2).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.