Unable to persuade enough moderates to support legislation endorsed by President Bush, House Republican leaders postponed a vote on managed-care reforms until this week at the earliest.
Bush made a rare personal visit to lobby lawmakers on Capitol Hill last week but was unsuccessful in luring enough GOP members to defect from a patients' bill of rights backed primarily by Democrats to a Republican-sponsored bill.
Both bills would allow patients to appeal if HMOs deny a covered benefit and would allow them to sue for damages in some cases. The Democratic bill, sponsored by Reps. John Dingell (D-Mich.) and Greg Ganske (R-Iowa), allows for higher damage awards, greater employer liability and more state rather than federal lawsuits than the Republican bill sponsored by Rep. Ernie Fletcher (R-Ky.).
Bush has pledged to sign a patients' bill of rights, as long as it doesn't make more workers lose insurance and doesn't lead to frivolous lawsuits. He has threatened a veto of the Ganske-Dingell measure.
"Why go through the effort (of passing either bill) when the president has said he will veto a bill that increases the number of uninsured, drives up the cost of insurance and improves the opportunities for litigation for the trial bar?" asked HHS Secretary Tommy Thompson, who lobbied lawmakers early in the week.
Numerous GOP moderates, aware of popular support, are backing the Democrats' bill, and as a result, Bush and House Republican leaders have been unable to rally the 218 votes necessary to pass Fletcher's bill in the 435-member House.
House leaders were said to be drafting amendments to the Democratic bill that would accomplish the same goals as the GOP bill: keep patients from suing their employers over improperly denied healthcare, limit damage awards and ensure that most such cases are heard in federal courts.
In so doing, House leaders hope to make the legislation more like the version that passed the Democrat-controlled Senate last month (July 2, p. 6). Industry lobbyists said the Ganske-Dingell bill was far tougher on plans and employers than the Senate-passed bill.
The Ganske-Dingell bill also has the support of Rep. Charlie Norwood (R-Ga.), who in 1999 sponsored similar legislation that passed the House with 68 Republican votes despite being opposed by employers, insurers and the GOP leadership.
White House officials see the defections as a ray of hope, but they've also reopened negotiations with Norwood in the hopes of reaching a compromise.