October 7, 1999
Web posted at: 7:56 p.m. EDT (2356 GMT)

WASHINGTON (CNN) -- Defeating all three of the GOP-sponsored alternatives, the U.S. House of Representatives has approved, 275-151, the White House backed bipartisan patients' bill of rights measure, which gives patients a broad new ability to sue their Health Maintenance Organization (HMOs) in state courts.

Both President Bill Clinton and Vice President Al Gore spent Thursday on the telephone trying to drum up support for the bill, sponsored by Rep. John Dingell (D-Michigan) and Rep. Charlie Norwood (R-Georgia).(More details on all the bills)

"The passage of this bill represents a major victory for every family and every health plan, " Clinton said after the vote.

Yet while the White House and congressional Democrats may be celebrating their win, Clinton acknowledged the bill is far from becoming law.

The Senate version of the HMO reform bill passed in July lacked Democratic support and Clinton threatened to veto it, saying it would not do enough to make sure managed care plans give patients the care they need.

Specifically it does not allowed people to sue their HMOs for punitive damages in cases where coverage of medical procedures was delayed or denied.

Bill heads to conference committee

Differences between the two bills must now be resolved in conference committee.

"When the House and the Senate negotiators meet ... the Republican leaders must resist the urge to weaken the patient protects guaranteed in the Norwood-Dingell bill," Clinton warned. "They must also resist the urge to load up the final legislation with poison pill provision that they know I can't sign."

But while 68 Republicans sided with Democrats to pass the bill, Clinton has good reason worry about how the leadership might affect the bill's final structure.

The GOP leadership, including House Speaker Dennis Hastert, had thrown its support behind an alternative to the Norwood-Dingell bill. That measure, sponsored by Reps. Tom Coburn (R-Oklahoma) and John Shadegg (R-Arizona), included a limited provision giving patients new rights to sue their HMOs, it did not go as far as the White House back bipartisan legislation and was turned back in a 238-193 vote.

The Republican leadership had to work vigorously to try and build support for their measure.

"We've got a solid balanced approach," House Speaker Dennis Hastert said moments before the vote. "No one has any idea what the cost implication would be if you went too far."

Two other GOP-sponsored alternatives were also voted down Thursday. One measure, sponsored by Reps. Amo Houghton Jr. (R-New York) and Lindsey Graham (R-South Carolina) was voted down 269-160. Another, sponsored by Rep. John Boehner (R-Ohio), was also defeated 284-145. Boehner's alternative would have given patients no new rights to file lawsuits against their Health Maintenance Organizations (HMOs) and was supported by many business and the insurance industries.

"It does not hold insurance companies accountable when they make medical decisions that harm people," Rep. Sherrod Brown, (D-Ohio) said of Boehner's measure.

Approval of the bipartisan legislation, which was originally expected to pass the House, fell into question when the House leadership offered its rules of debate -- rules that Democrats say endangered the bill

The legislation is expected to cost several billion dollars over several years, and the rules of consideration did not allow for amendments to pay for the cost. Democrats said the rules proposed by the leadership endanger the bill because they couldn't offer amendments on how to pay for the bill, and that bothered many conservative Democrats.

The Norwood-Dingell bill would give patients a host of new rights in dealing with their health insurance companies. It would:

• Make it easier to go to an emergency room or see a specialist

• Give patients the chance to take their complaints to independent panels.

• Lifts a federal ban and allows patients who are still not satisfied the right to sue an HMO in state court.

Tax break or poison pill

Debate on the health care reform measures began Wednesday with House Republicans passing a package of health care tax breaks. The GOP wanted to debate their tax-break bill first, hoping to shift attention to the estimated 44 million Americans who lack insurance and away from the White House-backed bill to strengthen patients dealings' with their insurance companies.

"We have to deal with access, affordability and choice in order to get quality," said Shadegg.

The measure includes generous tax deductions for health insurance and long-term care and a dramatic expansion of tax-free savings accounts for medical expenses.

Under the rules of the debate, the measure approved Wednesday will be automatically merged with Norwood-Dingell bill before heading to the conference committee.

Democrats called the tax breaks, which were approved on a largely party-line 227-205 vote, a cynical ploy, saying Republicans know attaching their plan would be a "poison pill" for the broader legislation.

They opposed the tax break bill saying that the plan would consume a portion of the Social Security surplus. They also say the savings accounts for medical expenses only help the wealthy, and will drive up costs for the rest of the insurance pool.

Clinton pleads for passage

Thursday morning Clinton sent a letter to House Minority Leader Dick Gephardt (D-Missouri) urging Democrats to support of the patients' bill of rights legislation, despite the tax-break amendment.

The president called for support, even while expressing "deep concerns about and disappointment with the partisan manner in which the Republican leadership has stacked the process."

But the president wrote: "I strongly believe the House should vote for this legislation and against any and all substitutes, so as to keep the hope of this necessary legislation being enacted."

Clinton expressed hope that if the newly revised measure is passed the flaws can be corrected during negotiations in the House-Senate conference committee.

CNN's John King, Eileen O'Connor and Bob Franken The Associated Press contributed to this report.

Thursday, October 7, 1999

• Trump pondering White House bid to reverse 'lack of spirit'
• House approves bipartisan patients' bill of rights legislation
• Comparison of the health care reform bills before the House
• Test ban treaty in limbo; U.S. nuclear policy on the line
• Dole promises to fight for drug-free America
• McCain, Forbes deny trying to derail Dole
• Recall petition filed to remove Ventura from office
• Memorial wall conceived by Coelho has no names of contributors
• 'The Body' goes to school -- Ventura visits Harvard
• Gingrich motion asks judge to force wife to turn over money
• GOP, Democrats elbow for position on Social Security, spending
• Democrats introduce bill on amusement park safety
• Bush swings for New Jersey GOP
• Buchanan says he's leaning toward Reform Party
• Democrats, GOP agree research tax credit should be permanent
• Bradley proposes relief for working parents
• For Bauer, a world with few moral gray areas
• Using Congress, Bush makes early move to center
• McCain calls on other GOP hopefuls to support 'soft money' ban

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