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Worried GOP leaders back plan giving patients right to sue HMOs

House GOP leaders have agreed for the first time to back new patient rights proposals to sue HMOs as they try to hold their fractured party together on health care.

The move comes a day after 20 Republicans signed on with Democrats to support a bill that is much broader than GOP leaders would like.

Speaker Dennis Hastert, R-Ill., promised a floor vote in September on measures being developed by Reps. Tom Coburn, R-Okla., and John Shadegg, R-Ariz. The bills will include the right to take disputes to an independent panel, the right to choose doctors outside a network and easier access to gynecologists, obstetricians and pediatricians.

Most significantly, they will include new rights to sue. GOP leaders, including Hastert, met with Coburn and Shadegg well past midnight after Democrats announced Thursday their alliance with Rep. Charles Norwood of Georgia and other Republicans. Norwood has been working for more than a year to get Republicans to back a broader HMO bill but gave up and joined with Rep. John Dingell, D-Mich., and other Democratic leaders.

If most Democrats unite behind the bill, it would have enough support to pass.

The new alliance catapulted GOP leaders into action, said Coburn, who had been working with Norwood but decided to stay with the GOP.

Hastert deputized Rep. Porter Goss of Sanibel to use the Rules Committee to forge an alternative plan. Earlier efforts by three other committees had foundered on arguments among Republicans over how far they should go in protecting patients' rights.

Details of the GOP leadership bill were not yet worked out, but Coburn said the right to sue provisions would be limited. Patients would have to demonstrate that they were injured to a certification panel before they could sue. If a health plan had "followed the rules and done nothing egregious," it would not be subject to punitive damages.

The Dingell-Norwood bill also limits suits. Companies obeying an independent panel's ruling could be sued in state courts, but would not be liable for punitive damages.

GOP leaders didn't act earlier, Coburn said, because they were trying not to hurt the business and insurance communities.

Those two groups were mobilizing Friday to get employers to lobby Congress. The American Association of Health Plans, an HMO trade group, was planning TV ads targeting 60 congressional districts.

The GOP bill also includes several provisions meant to help people without insurance get coverage. That includes medical savings accounts and new ways for small businesses to pool their employees to buy insurance. It also will include new tax deductions to help people buy insurance on their own.

Judy Waxman of FamiliesUSA, a consumer advocacy group, said her organization is examining the proposals. She said some parts of the Coburn-Shadegg bill would drive up premiums for older or ailing patients. Medical savings accounts, she said, would lure healthy people from regular insurance plans, leaving behind higher-risk policyholders in a shrunken insurance pool that would have to charge more.

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