The decision by seven Republicans to co-sponsor a Democratic managed-care regulation bill, while largely symbolic, puts more pressure on GOP leaders to produce a proposal of their own, if only to give their members something to support in an election year.
The seven GOP House members who broke ranks with their colleagues did so in part to send a signal to their leadership that the issue of "patient protection" isn't going to go away quietly. In fact, one of the seven, Rep. Lindsey Graham of South Carolina, announced that while he was co-sponsoring the Democratic bill, he would not vote for it because of his concerns about the content.
Except for Rep. Jon Fox of Pennsylvania, who won his 1996 election by about 100 votes, all the GOP defectors won election in 1996 by comfortable margins. But they are concerned about going into an election appearing to oppose efforts to curb managed care.
The Democratic bill supported by the seven GOP members is sponsored by Rep. John Dingell (D-Mich.) (See chart). The Republican leadership in both the House and the Senate has opposed all versions of patient-protection bills as too regulatory and costly.
"This shows that if the (Republican) leaders don't do something on their own, there is going to be a discharge petition, and something is going to move this year one way or another," said one GOP aide who asked not to be identified.
A discharge petition is a parliamentary procedure used to bring a bill to the floor for a vote that is otherwise stalled because of opposition by House leaders.
An aide to Dingell said that adding Republican support to the Demo-cratic bill would jump-start the move to pass managed-care regulation, which had seemed to stall over the past several weeks.
"This has created a huge amount of momentum and a huge amount of interest," said another aide to Dingell.
For months, task forces set up by GOP leaders in the House and Senate have been working on their own managed-care regulation schemes. However, the conventional wisdom was that both task forces would have been happy to continue considering their options past the end of the congressional session.
But according to several sources, the GOP defections have moved up the timetable. The House GOP healthcare task force, led by Rep. J. Dennis Hastert of Illinois, will release its own plan before Congress leaves for its Memorial Day recess, according to sources. The Senate task force, led by Sen. Don Nickles (R-Okla.), one of the most vocal critics of managed-care regulation, is readying its own plan which will be released soon as well, sources said last week.
Such a measure, which some people are calling a watered-down version of the bill supported by Rep. Charles Norwood (R-Ga.), would allow rank-and-file GOP members a chance to support popular managed-care regulation.
"(Patient protection) is very popular, and I think that the (Republican) leadership needs to give their members something to sign onto," said a hospital lobbyist who requested anonymity. "The best result for (GOP leaders) would be a bill that Republicans running for office can get behind but which ultimately goes nowhere."