July 16, 1999
Web posted at: 10:54 a.m. EDT (1454 GMT)

WASHINGTON (AllPolitics, July 16) -- The Senate may have passed a Republican-backed "patients' bill of rights" bill Thursday night, but the debate over a health care overhaul is far from over.

President Bill Clinton has threatened to veto the measure, which passed the Senate on a near-party-line vote Thursday night. The House has yet to weigh in with its version of the measure, with floor debate expected in a few weeks. And members of both political parties expect the issue to be a major part of the 2000 elections.

After four days of debate, the Senate passed, 53-47, the Republican-backed measure. No Democrats supported the bill, and two Republicans -- Sen. John Chafee of Rhode Island and Sen. Peter Fitzgerald of Illinois -- also voted against it. But the rest of the Republicans lined up behind their leadership in support of the plan.

"This bill addresses the real problems many Americans face," said Senate Majority Leader Trent Lott (R-Mississippi).

Democrats insisted the GOP plan was full of loopholes and was designed to help health insurers more than patients.

"The president will veto this bill because he and we know we can do better," said Senate Minority Leader Tom Daschle (D-South Dakota).

Friday, the White House released a statement calling the measure a patient's bill of rights "in name only." And before Thursday's vote, Clinton professed near-amazement that the Senate could not agree on a bipartisan measure.

"This one is truly beyond me," he told reporters Thursday afternoon. Clinton said the Senate could not have a bipartisan bill because "the health insurers won't let them (Republicans) do it."

"We're not done yet, and this one won't die," Clinton said.

Thursday's vote came after a small group of senators from both parties spent the day trying to come up with a compromise between the Republican and Democratic positions on patient lawsuits. In the end, the proposal failed to gain enough Republican support to pass.

The vote topped a frustrating week for Senate Democrats, who saw amendment after amendment go down to defeat during the debate over managed care reform.

Sen. Bob Kerrey (D-Nebraska) called the process a "grudging retreat from our challenge to change the law."

But Tennessee Republican Sen. Bill Frist, a heart surgeon, defended the GOP plan, saying it will "get managed care out of the business of practicing medicine."

The key vote came earlier in the day, when the Senate voted 53-47 against an amendment that would have expanded the ability of patients to sue their HMOs. Instead, the Republican proposal contains a provision allowing patients to have decisions to deny care reviewed by an independent doctor, who will have the final say.

Democrats had argued that allowing suits would force insurers to put a patient's health before the company bottom line.

"This is the heart of the debate. This is what the patients' bill of rights is all about," argued Sen. Richard Durbin (D- Illinois), the sponsor.

But Republicans countered by saying patients would actually suffer because of the cost and expense of lengthy court fights. They also argued that allowing lawsuits -- which Frist termed a "trial lawyer lottery" -- would drive up the costs of premiums and increase the number of uninsured.

"This is a terrible idea," said Sen. Jeff Sessions (R- Alabama). "It will add expense throughout the system and will not benefit patients who need it when they need it."

Throughout the day, Chafee continued to work with a handful of Democrats to forge an acceptable compromise. Supporters claimed they had as many as four Republicans backing the idea -- which still left them short of a majority even if all 45 Senate Democrats went along.

Sen. Arlen Specter (R-Pennsylvania) said most of the negotiations have centered on the liability issue. The compromise bill would have allowed lawsuits in federal courts, but not in state courts; the Democratic plan would have allowed both. The compromise would also have banned punitive damages, and, in an effort to win more GOP support, would cap damages for pain and suffering.

"This is a classic congressional moment," said Sen. Joseph Lieberman (D-Connecticut). "Are we going to adopt the 70 percent we agree on or are we going to just leave it where it is and do nothing?"

But Lott suggested the time for compromise was not at hand. He urged senators to pass the GOP bill and suggest compromises when the measure reaches a conference committee, as is expected later this year.

Democrats and Republicans also differed on who should be covered by the proposal. Some of the reforms in the GOP plan will only apply to some 48 million insured people who are not already covered by state HMO regulations. The Democratic plan would have covered all 161 million Americans in private health care plans.

The Republicans argued that patients already covered by state laws didn't need the additional federal protection.

On Wednesday, the Senate voted 55-45 to approve an amendment offered by Sen. Olympia Snowe (R-Maine) that requires health insurers to pay for extended hospital stays for women who have undergone mastectomies.

Snowe said her plan would ensure that "appropriate medical care" dictates how long a woman remains hospitalized after breast surgery and "not an insurer's bottom line." A similar Democratic amendment with broader language was defeated Tuesday.

The Snowe amendment covers everyone with private health insurance except state and local workers, or about 140 million people.

Republicans also defeated a Democratic plan to give patients access to needed specialists even if the specialists are outside a health plan's network. The Republican version requires "timely" specialist care but would not give patients the right to go outside a network.

The Congressional Budget Office has estimated that the Democratic plan would raise insurance premiums 4.8 percent over the next five years. But Democrats also cite figures by the Budget Office that say the Democratic plan would only raise premiums by an average of $2 a month.

CNN's Jonathan Karl and Carl Rochelle and The Associated Press contributed to this report.

Friday, July 16, 1999

• Clinton pitches economic plan to Iowans
• Poll: Independent candidate would not fare well against Gore, Bush
• Health care debate far from over
• FEC filings show chips on Bush's side of the table
• House's oldest member dies of infection
• House GOP may reduce tax relief package
• Republicans, Democrats trade barbs over farm relief
• Bush intensity gets in your face
• Cisneros judge suggests he's likely to allow use of some tapes
• House OKs Congress pay hike, doubling presidential salary
• Senators hear from localities on Y2K readiness
• Bush fund-raising overwhelms Republicans and Democrats
• Boston station's swap of donor list with Democrats under review
• Mayor's race pits city's strongest politicians
• Congress sends law to White House by e-mail for first time
• Clinton raising money, touting education in Iowa proposal
• TV appearance leads to candidate's arrest on burglary warrant

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