WASHINGTON (AP) -- Capping a two-year struggle, the House
approved a sweeping bill meant to give patients a stronger hand in
dealing with their health insurance companies, including a
controversial new right to file lawsuits.
The final vote, 275-151, came after intense lobbying on both
sides, including President Clinton, who phoned lawmakers from Air
"It is time we asked the insurance industry to be responsible
for its actions," said Rep. Charlie Norwood, R-Ga., who joined
with Democrats to push the bill -- first to the House floor and then
Earlier today, the House rejected a GOP-backed patient
protection bill that included new rights to sue, but only in
federal court and only in limited circumstances. That vote was
238-193, with 29 Republicans joining all but two Democrats.
For two years, Democrats have put the GOP on the defensive over
the politically popular HMO issue. 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 fiercely in recent days to rally support for
their version. Many Republicans reluctantly supported it in hopes
of defeating the broader Democratic bill, and supporters 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.
Now the House bill 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
Also 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.
It also rejected a similar plan backed by Reps. Amo Houghton
Jr., R-N.Y., and Lindsey Graham, R-S.C. Backers hoped it would
attract more Democrats, but it failed 269-160.
Federal law now effectively bans such lawsuits for millions of
Americans, even if they are injured or die because of an HMO's
The bill approved today allows patients to sue HMOs in federal
or state court and to collect whatever damages a jury might award.
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 restating his strong support for a broad bill that would
give patients a host of new rights, including broad new rights to
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.
Democrats and some Republicans argued that the threat of a
lawsuit is needed to force insurance companies to provide promised
"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."
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.