House GOP Fails to Mend Fractures Over HMO Bill

Republican prospects for moving HMO legislation to the House floor next week looked increasingly dim Thursday, as GOP leaders struggled to write a bill that could keep the fractured party together.

“It’s a 70-yard field goal,” House Speaker J. Dennis Hastert (R-Ill.) said Thursday after a closed-door meeting of Republicans.

The meeting was called to discuss health care, but, with no plan to present to their members, leaders spent most of the meeting talking about spending bills.

With a razor-thin majority in the House and Democrats united against them, Republicans need virtually every GOP vote to pass a bill imposing new regulations on health maintenance organizations and other managed care plans.

“We have a problem” among Republicans, acknowledged Rep. Michael Bilirakis (R-Fla.), chairman of one of the House’s health subcommittees. Bilirakis spent hours in meetings this week looking for a solution.

Most Republicans want a limited bill that gives patients new rights to appeal denials of care and some new power to see doctors--without giving new rights to sue or removing a health plan’s right to determine what care is medically necessary.

But a group led by Reps. Charlie Norwood of Georgia, Tom A. Coburn of Oklahoma and Greg Ganske of Iowa--all health care providers before entering Congress--is pushing for more sweeping legislation, similar to the Democrats’ approach. They say they have 20 to 60 Republicans who will vote with them if the issue comes to the floor.

Ganske said he met with Minority Leader Richard A. Gephardt (D-Mo.) Wednesday. And “serious” talks with other like-minded Republicans are continuing, said Sue Harvey, a Gephardt spokeswoman.

“If we can find a way to get to a bipartisan bill that we can pass, we’re going to try to pass it,” Gephardt told reporters Thursday. It would take only a handful of Republicans to join united Democrats to pass a bill Democrats preferred.