Gramm Amendment Falls, House Members Unveil Alternative

June 26, 2001( ? The Kennedy-McCain version of the proposed Patient?s Bill of Rights continued to gain momentum Tuesday, as Democrats beat back Republican amendments, including a limit on employer liability in healthcare decisions proposed by Senator Phil Gramm (R-Texas).

Those moves came as Republican leaders in the House of Representatives unveiled their own version of patient protections.

That version offered liability limits that would make the measure more palatable to those concerned about the increased costs ? and resulting lack of coverage ? that might emerge under the version under debate in the Senate.

Meanwhile, the Senate continued to consider amendments that would address the concerns expressed by the current version, which President Bush has threatened to veto.  meanwhile, the Senate returned from lunch to find another written communication from President Bush.

At the same time, proponents on both sides of the issue ? and in both houses of Congress ? continued to emphasize that they were in agreement on 90% of the components.

And despite the at times heated rhetoric, and threats to forego the scheduled July 4 recess, McCain-Kennedy is not scheduled to go into effect for another fifteen months.

Gramm Amendment Falls

Significantly for employers, the Senate rejected an amendment (56? 43) proposed by Senator Phil Gramm (R-Texas), that would have provided employers full immunity in health care disputes. Democrats said Gramm’s amendment went too far in barring patients from seeking remedies for abuse.

Instead, Democrats plan to offer a bipartisan compromise with moderate Republican Senator Olympia Snowe (R-Maine) that would offer some protection, by allowing employers to relinquish the responsibility for making health care decisions that affect their workers by selecting a “designated decisionmaker.”

Designated Drivers

However, that compromise attempt only deals with part of the problems with McCain-Kennedy, according to the American Benefits Council .

“Adding a provision that would allow a ?designated decisionmaker? to assume direct responsibility for certain plan operations that could expose one to unlimited liability under Kennedy-McCain fails to solve the front-end problem that the legislation fails to clearly specify what those responsibilities are”, according to American Benefits Council President James A. Klein.

Klein also noted that the bill’s current language leaves open liability for “failures in the performance of a duty under the terms and conditions of the plan”, which might include duties that employers routinely perform in the managing health benefit plans.

Tuesday morning, the Senate also defeated a motion (61-39) by Senator Charles Grassley (R-Iowa) that would have sent the bill to committee for reconsideration.

House Alternative

During a break in the Senate debate, Representative Ernie Fletcher, (R-Kentucky), Vice Chair of the Education and Workforce Subcommittee, unveiled the Patients Bill of Rights 2001. Standing with a group of roughly a dozen of his colleagues, including Reps. John Boehner (R-Ohio), Bill Thomas (R-California) and Billy Tauzin (R-Louisiana), the congressmen expressed concerns for the 43 million uninsured Americans ? a number feared likely to increase under the current McCain-Kennedy proposal.

Fletcher noted that their proposal offered:

  • Patient’s protection
  • Encourages quality medicine, rather than the defensive medicine supported by the McCain-Ke
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