The House reaffirmed its vote to open managed-care plans to lawsuits last week as it named delegates to the negotiating team that will resolve House differences with Senate managed-care legislation.
The House's procedural vote instructed its delegates, when negotiating with Senate leaders, to insist on the provisions of bipartisan managed-care reform legislation sponsored by Reps. Charlie Norwood (R-Ga.) and John Dingell (D-Mich.). The vote was 257-167 in favor of giving those instructions.
House leaders did not appoint Norwood or fellow dissident Rep. Greg Ganske (R-Iowa) to the team.
Although the House sent a fairly strong message of support for the Norwood-Dingell bill, about 16 fewer Republicans voted for last week's procedural motion than voted for the bill Oct. 7.
Karen Ignagni, president and chief executive officer of the American Association of Health Plans, said the legislation lost some GOP support because lawmakers are continuing to hear the concerns of enrollees who believe the legislation will drive up premiums.
"I think the ground is beginning to shift," Ignagni said.
The big difference between the Norwood-Dingell measure and the Senate-passed version of managed-care reforms is whether enrollees would be allowed to sue health plans for damages resulting from the denial of covered benefits.
The House bill gives broad authority for such lawsuits, without first requiring enrollees to seek independent, nonjudicial review of a denial. The Senate allows an independent review but no lawsuits.
The bipartisan House bill also gives job protection to healthcare workers who report legal violations by plans and providers, and it requires health plans, including hospital-owned plans, to offer a point-of-service option. The bill also requires plans to pay many claims within a month.
Health plans and employers argue that allowing lawsuits will drive up insurance costs and force more companies and workers to drop coverage. Advocates, including doctors, say permitting lawsuits will make health plans accountable for their decisions.
The vote came at the same time that House leaders named members of their negotiating team. The Senate already named its team, which includes Assistant Republican Leader Don Nickles (R-Okla.), Sen. Edward Kennedy (D-Mass.) and nine others.
House Republican leaders named some leading figures on healthcare issues, such as Rep. William Thomas (R-Calif.), chairman of the House Ways and Means Committee's health panel, and Rep. John Boehner (R-Ohio), chairman of the Education and Workforce Committee's employer-employee relations subcommittee. The House team has 21 conferees.
Democratic leaders appointed Dingell and Rep. Fortney "Pete" Stark (D-Calif.), senior Democrat on the Ways and Means health subcommittee, among others.
While welcoming the vote to strengthen the House position on managed-care reforms, President Clinton charged the GOP leadership with trying to sabotage the bill.
"The House Republican leadership is seeking to defeat the will of the House . . . by refusing to appoint conferees who support this legislation," Clinton said.
A compromise bill is not expected to emerge until next year at the earliest.