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House rejects GOP-backed HMO bill

Updated:
WASHINGTON (AP) -- The House today rejected a GOP-backed patient
protection bill and set the stage for a showdown vote on a White
House-endorsed plan giving Americans broad new rights to file
lawsuits against their health insurance plans.

With the outcome uncertain to the end, President Clinton and
Vice President Al Gore lobbied lawmakers by telephone. The GOP
measure was defeated 238-193, with 29 Republicans joining all but
two Democrats.

Republican leaders had worked fiercely in recent days to rally
support for their version, which offered patients a limited right
to file lawsuits -- but only in federal court and with limits on how
much money plaintiffs could collect.

Many Republicans reluctantly supported the GOP leadership bill
in hopes of defeating the broader Democratic version, which
appeared to have enough Republican support to prevail. Had the
leadership won a majority it would have wiped out the broader
measure.

Supporters of the GOP-backed bill painted it as a compromise
between the Democratic approach and doing nothing.

"We've got a solid, balanced approach that I urge you to
support," said House Speaker Dennis Hastert, R-Ill. "The
difference in these bills is how far you go. How far you give
license to the trial lawyers."

But Democrats argued that it did not go far enough.

"It fails to hold health care providers accountable. It lets
them off the hook," said Minority Leader Dick Gephardt, D-Mo.

The rejection cleared the way for a vote on the White
House-backed bill, sponsored by Reps. John Dingell, D-Mich., and
Charlie Norwood, R-Ga.

Even if this bill passes, it must be reconciled with a
considerably more limited version already approved by the Senate.
The Senate bill has no new rights to sue and excludes many
Americans from other patient protections.

Earlier today, the House rejected, 284-145, the most modest of
four competing patient-protection bills. Backed by Rep. John
Boehner, R-Ohio, it would have given patients now new rights to
file lawsuits. It was the first choice of conservative Republicans
and their allies in the business and insurance industries.

Federal law now effectively bans such lawsuits for millions of
Americans, even if they are injured or die because of an HMO's
decision.

Managed care has dominated the health debate on Capitol Hill all
year, as Congress responds to voters' frustration over cost cutting
and fears they may be denied needed care.

Meanwhile, hoping to keep Democrats united, Clinton today sent a
letter to Capitol Hill restating his strong support for a broad
bill that would give patients a host of new rights, including broad
new rights to sue.

Democratic leaders feared that concerns over how to pay for it
may cost them votes, but Clinton sought to clarify that he still
strongly supports the bill. He promised not to sign any bill that
was not fully paid for.

"I endorse this legislation without reservation," Clinton said
in a letter to Gephardt. "I cannot support a bill that is a
patients' bill of rights in name only."

The House was considering a total of four plans, each of which
gave patients new power to demand care and take disputes to outside
arbitrators. But there were major differences over details, notably
whether patients should be given new rights to sue -- and, if so,
whether to limit them.

Later today, the House also rejected a plan backed by Reps. Amo
Houghton Jr., R-N.Y., and Lindsey Graham, R-S.C. It was quite
similar to the Coburn-Shadegg bill but was offered in hopes of
attracting more Democrats. It failed 269-160.

Democrats and some Republicans argued that the threat of a
lawsuit is needed to force insurance companies to provide promised
care.

"We tell welfare mothers, we tell deadbeat dads ... you have to
be responsible for yourself," said Norwood, the leading Republican
backer of the right to sue. Health insurance, he said, is "the
only industry in America where we say you are absolutely protected
from being responsible for your actions."

For two years, Democrats have put the GOP on the defensive over
the politically popular HMO issue. House Republican leaders,
struggling with a slim majority and a fractured caucus, did not
endorse any bill until debate opened on the issue this week.

But they worked hard Wednesday to rally opposition to a sweeping
bill backed by Norwood and virtually all the Democrats, including
Clinton. That bill gives patients new power to see specialists, get
emergency room care and take denials of care to an outside panel of
experts.

Most controversially, it allows patients to sue HMOs in federal
or state court and to collect whatever damages a jury might award.

Going into this week's debate, Democrats appeared to have the
votes they needed to pass their HMO bill. But they said Wednesday
that they may lose the votes of some conservative Democrats because
there was no way to pay for the HMO bill, estimated to cost the
federal government some $7 billion in lost tax revenue over 10
years. The bill, if it became law, likely would mean higher
insurance premiums, which means businesses would be able to take
higher tax deductions on their insurance costs.

The GOP strategy has been to focus attention on the uninsured,
as Republicans argue that new rights will drive up the cost of
insurance and force employers to drop coverage. Hammering the point
Wednesday, Republicans pushed through a bill, 227-205, aimed at
reducing the ranks of the uninsured, which now stand at 44 million.



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