Patients’ Bill Gets Unstuck

Potentially eliminating one of the stumbling blocks to a sweeping patients’ rights bill, Senate Democrats signaled Friday they are prepared to support a Republican amendment that would give employers greater protection from liability over their health plans.

GOP foes of the patients’ bill of rights legislation have focused much of their attack on provisions they say would expose employers to costly and frivolous lawsuits arising from disputes over coverage.

A compromise on the issue would likely make the legislation more palatable to President Bush, who has threatened to veto the bill partly out of concern for the adverse effect he believes it would have on employers.

Still another major dispute concerns how broad a right patients should have in suing HMOs and whether caps should be imposed on damage awards. Little progress has been made in resolving this disagreement, and Bush also has threatened a veto over the issue.

The amendment involving employers, likely to be offered Monday by Sen. Olympia J. Snowe (R-Maine), would allow businesses to deflect liability by designating a “decision maker” to administer the company’s health plan.

A spokesman for Snowe stressed that the senator is still meeting with sponsors of the patients’ bill and other lawmakers to negotiate the language of the amendment.

“We think we have the basis for an agreement,” said Dave Lackey, Snowe’s press secretary. But he added, “It’s not settled.”

Snowe, a centrist, holds a key vote on a bill that has largely divided the Senate along party lines.

Senate Majority Leader Tom Daschle (D-S.D.) indicated his support for the possible compromise Friday, saying Democrats’ willingness to back the approach reflects “our desire to go the extra mile” to ensure employers face only limited liability.

Jim Manley, a spokesman for Sen. Edward M. Kennedy (D-Mass.), a sponsor of the patients’ bill, said: “I think this is something we can work out.”

A compromise would clear a significant hurdle for the bill, which would give patients a number of new protections in health plans, including the right to see specialists and an expanded right to sue when there is a dispute over denial of treatment or payment.

Republicans opposed to the bill have spent much of their energy hammering away at provisions they said would leave employers vulnerable to costly lawsuits that might prompt many of them to drop coverage for employees.

Sen. Phil Gramm (R-Texas) proposed an amendment Friday that would go further than Snowe’s approach by exempting employers from health plan-related lawsuits altogether. A vote on the Gramm proposal is set for next week.

The bill’s sponsors have insisted that the measure would expose employers to suits only in extreme circumstances, such as when an employer intervened in a coverage decision. But in supporting the Snowe amendment, the sponsors are taking a step toward embracing the wording in a rival GOP-backed patients’ bill sponsored by Sens. Bill Frist (R-Tenn.) and John B. Breaux (D-La.).

Daschle said Friday he still plans to push for final passage on a patients’ bill by the end of next week, but he repeated his threat to work through the Fourth of July recess if necessary.

Democrats took their first step toward passage Thursday, when they defeated a Republican amendment that would have carved out new tax breaks for small businesses but threatened to derail the patients’ bill on procedural grounds.

The only vote Friday came on an amendment offered by Sen. John McCain (R-Ariz.), who with Kennedy is a sponsor of the Democrat-backed bill. McCain’s proposal was designed to gauge support for requiring HMOs to cover certain breast cancer treatments and clinical trials.

The nonbinding amendment passed, 89 to 1. The lone senator voting against the amendment was John Enzi, a Republican from Nevada.