The Senate's vote last week to effectively kill tobacco-control legislation could give patient-protection advocates an opportunity to pass managed-care legislation this year.
"The demise of the tobacco bill will enhance the chances of a health bill," said a physician-group lobbyist who asked not to be identified. "It was always clear they had to do one or the other."
An aide to Senate Minority Leader Thomas Daschle (D-S.D.) said that while Senate Democrats still would push for an anti-tobacco bill, managed-care regulation now is the primary focus.
Republican leaders, hungry to give their members a pro-consumer accomplishment to tout as they campaign for the November congressional elections, also might turn to managed-care regulation.
A House GOP health task force that's working on a GOP alternative to the Democratic "Patients' Bill of Rights" is expected to release an outline of its plan this week.
Republican leaders are pushing for a patient-protection bill to be debated by the Senate before early August.
Senate Assistant Majority Leader Don Nickles (R-Okla.) said he is working separately from the GOP task force on a bill that would not increase costs or the number of uninsured, as he charges Democratic legislation would. Nickles did not disclose details.
One of the most controversial questions to be decided is whether to require all employers that offer an HMO to also offer a "point-of-service" product, which would allow enrollees to see any doctors they choose at an extra cost.
Health plans say the idea will be expensive and difficult to administer in areas of the country where no POS products exist. They also say the government should not mandate what kind of insurance products are available.
For proponents of managed-care regulation, anti-tobacco advocates' loss is their gain.
In two consecutive procedural votes, the Senate effectively killed any chance of passage for the tobacco bill sponsored by Sen. John McCain (R-Ariz.), chairman of the Senate Commerce, Science and Transportation Committee.
On the first, a motion to end nearly four weeks of debate and bring the measure to a final vote, the Senate voted 57-42 in favor, three votes short of the 60 necessary for the motion to pass.
On the second vote, advocates lost ground, garnering only 53 votes, seven short of the 60 needed.
The bill would raise federal cigarette taxes by $1.10 a pack, diverting some of the money to Medicare, Medicaid and state children's health insurance programs.
Some observers believe patient-protection legislation will suffer the same fate as the tobacco bill.
"With less than 50 days left on the legislative calendar, it is unclear if patient protection will even make it to the floor for debate," said Ron Pollack, executive director of the healthcare consumer group Families USA.