Bush Draws Closer to Backing Modified Patients’ Rights Bill

The prospects for patients’ rights legislation improved Tuesday as the White House sent new signals that efforts to modify the measure are close to winning President Bush’s support.

Citing the progress of negotiations with the bill’s sponsors, the White House adopted a new posture on legislation that Bush previously has threatened to veto.

“The nation is on a threshold of having a patients’ bill of rights that can be signed into law,” White House spokesman Ari Fleischer said.

Referring to the administration’s ongoing talks with Rep. Charlie Norwood (R-Ga.), one of the main backers of the bill, Fleischer said: “There is some additional work that needs to be done, but many of the differences that remain are easily bridgeable if others who are working with Congressman Norwood are interested in bridging those differences.”

The negotiations have produced a compromise on one sticking point but left others unresolved. And that caused some of the bill’s other sponsors to question the White House comments.

Rep. John D. Dingell (D-Mich.), for instance, said he was not aware of any imminent breakthrough on these other issues and termed the White House’s optimism “incomprehensible.”

Aides to some of the bill’s sponsors speculated that the administration is trying to heighten pressure on the talks by raising expectations. Others suggested that the White House is maneuvering to back away from opposing a bill that, at least in general terms, has broad public support.

With Congress set to close for a monthlong recess at the end of the week, there are growing signs that lawmakers on both sides are simply eager to conclude a legislative struggle that has dragged on for more than five years.

House GOP leaders, who just a week ago yanked the patients’ bill off the schedule because they didn’t have the votes to defeat it, now appear inclined to bring it to the floor Thursday, regardless of the outcome of the negotiations.

“Either way, we’re going forward,” said John Feehery, spokesman for House Speaker J. Dennis Hastert (R-Ill.).

Sponsors of the bill have claimed for weeks that they have more than enough support to muscle the measure through unchanged. But as a result of the talks with Bush, they agreed Tuesday to a White House proposal designed to shore up liability protections for large employers who fund and administer their own health care plans. Wal-Mart Stores Inc., Caterpillar Inc. and other large employers that fall in this category would still be subject to suits over denials or delays of treatment but only in federal courts, which are generally regarded as less favorable to plaintiffs than are state courts.

“That is a major step toward the president,” said Rep. Greg Ganske (R-Iowa), a co-sponsor of the patients’ bill. “This would enable the president to claim a real victory.”

But Ganske and other sponsors rejected a White House proposal that would have subjected all suits in state courts against health plans to a single federal standard.

The House bill is similar to one that passed the Senate earlier this year. And Bush and the bill’s backers are in general agreement on provisions that would give patients new rights, including guaranteed access to certain specialists and emergency room care. But they have clashed over a central component of the bill that would make it much easier for patients to sue their health plans.

Bush has argued the bill will foster frivolous lawsuits, drive up health care premiums and possibly cost millions of Americans their coverage. But sponsors, who draw most of their support from Democrats, say the liability provision is the only effective leverage patients have against companies often accused of basing decisions on money instead of medicine.

Bush and sponsors don’t appear to have made any progress on resolving a disagreement over how much patients who sue should be able to collect in damages.

The Democratic bill would allow unlimited awards for monetary losses and pain and suffering, and punitive damages up to $5 million. Bush has backed a rival patients’ bill offered by the GOP that would ban punitive awards and cap pain-and-suffering damages at $500,000.

That issue now appears likely to be resolved on the House floor. Many members expect Republicans to offer an amendment splitting the difference on the cap amounts. Norwood has said he would consider a compromise, and Ganske refused to say Tuesday how he would vote on such an amendment.