Republican congressional leaders are trying to stifle legislation barring managed-care "gag clauses," apparently because they don't want to antagonize two powerful constituencies-doctors and insurers.
Meanwhile, the Senate late last week stopped work on a spending bill for the Treasury Department because lawmakers were deadlocked over a version of the bill sponsored by Ron Wyden (D-Ore.).
So-called gag clauses are provisions of contracts between physicians and insurers that prohibit doctors from disclosing treatment options, coverage limits or financial arrangements between providers and the health plans.
The House Commerce Committee approved a bill sponsored by Rep. Greg Ganske (R-Iowa) that would ban clauses applying to oral and written communications between physicians and patients about treatment options or other medical information.
The American Medical Association had sought broader language that also would have prohibited gag clauses relating to physicians' financial arrangements with plans. But that measure failed to gain enough support in the committee to advance.
The Ganske bill must still move through several House panels, including the Ways and Means Committee, before it can reach the full House for a vote. But some GOP leaders, wary of getting in the middle of a fight between physicians and insurers, are seeking compromise language that would limit the prohibitions only to written communications.
Rep. William Thomas (R-Calif.), chairman of the Ways and Means health subcommittee, said he was "uncomfortable" with a bill that would attempt to prohibit clauses restricting oral communications because of the difficulty of proving offenses.
The compromise seems to satisfy no one.
Julie Goon, vice president of government affairs at the American Association of Health Plans, said even with the changes "this is a bad bill."
"The federal government is trying to get in the middle of negotiations between private entities," Goon said.
Physicians, who say most of the communications with patients are oral, also were not mollified by the compromise.
A House Republican aide said it was uncertain whether the measure would reach the House floor before Congress recesses later this month.
Meanwhile, the Senate late last week appeared ready to defeat its own version of the bill. The Senate measure is sponsored by Ron Wyden (D-Ore.).
In the Senate, an amendment sponsored by Wyden that would also restrict the use of gag clauses forced Majority Leader Trent Lott (R-Miss.) to halt work on a spending bill for the Treasury Department and the Postal Service. Republican leaders said they wanted to hold committee hearings on the issue before legislating, but Wyden and Edward Kennedy (D-Mass.) said they would hold up the bill unless Lott ordered a vote on the Wyden amendment