Senate, House Make PBOR Moves

June 21, 2001 ( - After a full day of discussion Wednesday, the Senate will likely move closer to some consideration of the patients' bill of rights legislation today.

Senate Republicans agreed to a vote this morning on a motion to proceed to consideration of amendments to the McCain-Kennedy-Edwards bill (S. 1052).  According to the American Benefits Council, this motion is likely to pass and only requires a simple majority, rather than the 60 votes that are required to actually move pass the amendment stage to vote on the bill.

In what at times seems a mirror image of the tax bill discussions, Republicans are reportedly planning to offer many amendments to the bill.  However, the Council notes that Democrats are under pressure to remain united and oppose them.

Party “Lines”

Wednesday’s rhetoric, while relatively civilized, accentuated differences in support for the McCain-Kennedy bill versus the Frist-Breaux-Jeffords alternative.  Supporters of the former emphasized the need to preserve patient protection versus “unfeeling” health maintenance organization (HMO) bureaucrats, who were granted a “near-blanket immunity” under ERISA.  On the other hand, Frist proponents pointed to the higher costs of the McCain alternative, and the likely drop in coverage by employers driven off by the higher costs, and fears of litigation.

The Congressional Budget Office has projected the increase in premium costs for the McCain-Kennedy bill at 4.2% over the next decade, while the same office has attached a 2.9% premium increase for the Frist alternative over the same period.  In yesterday’s debate, Senator Bill Frist (R-TN) noted that the real costs of the bills lay in the cost of lost health care coverage – and that for every 1% increase in premium costs, 300,000 workers would lose their health insurance.

Employer Impact

Senators on both sides of the issue were equally adamant in the bill’s impact on employers.  Georgia Democrat Zell Miller, who supports the McCain proposal, was firm in his declaration that he would “never support a bill that exposes employers to that kind of liability.”  Democrats continue to maintain that the bill allows suits against employers only when the companies themselves participate in a medical decision.

On the other hand, Republicans were just as adamant that the bill would effectively take health insurance away from many Americans. “How can you possibly call something a patients’ bill of rights when the practical effect of the bill is to create more people without any insurance?’ asked Sen. Judd Gregg (R-NH).  “Those people (1.2 million projected to lose health coverage under the McCain bill) aren’t going to get any new right to sue. They lose all the rights they have.’

Presidential Preference

Speaking at the 21st Century Workforce Summit, President Bush reiterated his support for the version sponsored by Senators Frist, Breaux and Jeffords.  According to the Associated Press, Republican sources, speaking on condition of anonymity, said the administration was considering a stronger statement that would include a formal written veto threat against the McCain/Kennedy/Edwards bill.

House Status

Meanwhile, House Republican leaders gave a grudging approval to a limited new right to sue HMOs.  That draft would reportedly allow patients to sue HMOs if they won an appeal of a denial of care – and if the insurance company refused to abide by that result.  In those cases patients would be allowed to bring suit in state courts and seek punitive damages, which are unlimited in some states.  That position is in direct contrast to the Frist bill, which offe

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