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GOP Rejects Patient Rights Bill

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WASHINGTON (AP) — Senate Republicans, holding ranks on a politically charged issue, rejected a White House-backed patient rights bill Thursday that would give Americans broad new authority to sue their HMOs for denial of care.

The vote was 51-48 against the proposal, and came as GOP senators accused Senate Democrats of walking away from promising talks on a bipartisan compromise in search of political advantage in an election year.

Sen. Phil Gramm, R-Texas, said Democratic Sen. Edward M. Kennedy was committing a ``cynical political act'' in forcing the vote. But Kennedy, D-Mass., said the private talks thus far had been ``an endless road to nowhere.''

The contentious debate unfolded on the Senate floor while a quieter struggle was under way in the House, both evidence of the importance the parties attach to health care in the run-up to the fall elections.

House Republicans, eager for a campaign-season show of bipartisanship, pressed Democrats to join them in sponsoring a plan to offer private prescription drug insurance coverage to Medicare recipients.

Democratic Rep. Collin Peterson of Minnesota said, ``I'm going to be there'' when the GOP unveils its plan on Monday, a step he said was part of an effort to bring greater HMO Medicare coverage to his state.

But other Democrats, speaking on condition of they not be identified, said they were under pressure from their leadership to deny the GOP their support.

Republican sources, speaking on condition of anonymity, said party leaders were also attempting to gain backing from the American Medical Association in advance of the formal announcement of the legislation. Republicans also were hoping for a positive signal from at least one insurance company, these officials said, to cast doubt on claims that prescription drug policies would be unavailable.

The Senate vote left the fate of a patients rights bill in doubt, although Sen. Don Nickles, R-Okla., the GOP whip, pledged to renew the closed-door compromise efforts that he has been chairing.

The debate broke down along familiar lines.

``The patients' bill of rights affects thousands and thousands of people on a daily basis,'' said Senate Democratic leader Tom Daschle of South Dakota. ``Thousands of people who go into hospitals and clinics hoping that the might be able to get the care they so desperately need.''

But Nickles argued that passage of the Democratic bill would lead to a ``dramatic, draconian increase in the uninsured'' by driving up the cost to businesses that now offer coverage for their employees.

And Sen. Bill Frist, R-Tenn., said Democrats were ``gambling with the lives and the health of those individuals, many of whom are barely scraping by'' who would lose their coverage.

Democratic strategists expressed satisfaction that win or lose, they would succeed in requiring GOP senators — 17 of whom face the voters this fall — to cast a public vote on the politically popular measure.

Flying home from Japan, President Clinton weighed in on the HMO debate, dispatching a letter that urged senators to ``put the interests of patients before those of the special interests'' and enact a measure along the lines of one that cleared the House last year.

Drafted in response to a spate of HMO horror stories, the bill would give patients easier access to emergency rooms as well as specialists and women would be permitted to see a gynecologist without needing a referral from a primary care physician.

The bill backed by the White House and congressional Democrats would apply to all Americans with private health insurance. Majority Republicans forced passage of a less sweeping measure in the Senate last year, one that covered far fewer people and omitted any right to sue.

Closed-door negotiations to resolve differences between the two bills have sputtered for months, although Republicans earlier this week floated a compromise that envisioned a limited right to sue in federal court, with restrictions on damages.

In his Senate floor remarks, Kennedy said that so far, the House-Senate negotiation effort ``has been an endless road to nowhere.... It is time to take stronger action.''

Nickles tartly responded that behind the closed doors of the talks, Republicans had made ``significant compromises and adjustments.... We really have to ask ourselves, `Are the Democrats interested in an issue, political theater?' and that's exactly what this is.''

The events during the day underscored that even though the election is five months distant, time is running short in the congressional calendar and the leaders of both parties are intent on scoring political points before adjournment.

Health care and Medicare both rank high among the issues voters care most about, public opinion polls say. Democrats traditionally have held an advantage on them — and an internal House GOP survey two weeks ago gave the Democrats a 20-point advantage on Medicare.

Clinton and most Democrats favor a new prescription drug benefit for Medicare, but House Republicans are committed to an alternative in which private insurance companies would offer policies on an open market to Medicare recipients.

An outline of the GOP plan circulating in the Capitol provided little new detail beyond what Speaker Dennis Hastert, R-Ill., disclosed several weeks ago.

The measure would provide full government subsidies to individuals whose income is 135 percent of poverty and less. Those with incomes of up to 150 percent of poverty would receive a smaller subsidy. Another provision would cap costs to both individuals and the insurance companies, and have the government pick up the difference.
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