For the second time in two years, the Senate late last week rejected a Democratic patient-protection measure but forced Republicans to cast another embarrassing vote against managed-care reforms.
The Senate's 51-48 vote to reject the "patients' bill of rights" legislation came at the end of a hotly partisan week, as Democrats led by Sen. Edward Kennedy of Massachusetts bypassed conference committee negotiations over the differing House- and Senate-passed versions of the legislation and took the House-passed bill directly to the full Senate.
Kennedy did so by attempting to attach the bill as an amendment to a military spending measure. The attempt failed.
Senate Republicans' defeat of the bill may have cost them politically, and the vote was more narrow than the 53-47 vote in favor of a Republican alternative last July.
The House version of the legislation, passed in a bipartisan vote last October, is far more stringent for health plans than the Senate proposal. It gives patients the right to sue plans for injury or death that results from the denial of covered benefits.
A GOP compromise proposal early in the week launched the Kennedy-led action. It conceded the right-to-sue issue but required that complaints first undergo independent medical review; health plans did not have to comply with the reviewers' decision.
It also would have imposed caps on punitive and noneconomic damages in lawsuits, although the GOP did not state what those caps would be.
Kennedy and other Senate Democrats, along with House Republicans who backed the House-passed legislation, said the compromise proposal didn't offer significant protections for managed-care enrollees.
"We're simply concerned that time has run out," said Rep. Charlie Norwood (R-Ga.), a dentist who sponsored the House-passed legislation. "The conference isn't where it needs to be."
It isn't clear how the vote will affect continuing negotiations of the conference committee.