- The Washington Times - Thursday, July 19, 2001

House supporters of the Senate-passed McCain-Kennedy-Edwards patient protection bill are maneuvering to prevent House Republican leaders from defeating the bill with the same parliamentary strategy that derailed campaign finance reform.
Reps. Greg Ganske, Iowa Republican, and John D. Dingell, Michigan Democrat, will shelve their version of the original Kennedy-McCain-Edwards bill with a new bill being introduced today that includes the changes adopted in the Senate last month.
"All this stuff about 'the sky will fall' is just bogus," Dr. Ganske, a reconstructive surgeon, said of opponents' claims that the bill would drive up health care costs with a flood of frivolous lawsuits.
He said arguments about unnecessary lawsuits and soaring insurance rates "fell apart" with Senate changes requiring patients to exhaust appeals of health plan decisions to deny coverage before going to court, and to exempt employers from lawsuits if they do not participate in medical decisions by plan administrators.
Another change adopted by the Senate was offered by Sen. Phil Gramm, Texas Republican. That change makes clear that doctors on independent patient appeal panels cannot overturn a health plan coverage decision by providing benefits that are explicitly excluded from the plan, Dr. Ganske said.
"I've had CEOs of health insurance companies tell me privately that they've already implemented our patient protections," Dr. Ganske said. "They don't think this will cost them that much, especially the ones that deal with both individual and group health, because if they're dealing with individuals they're dealing with the state insurance commissioner anyway."
But Rep. Ernie Fletcher, Kentucky Republican and prime sponsor of a competing White House-backed patients' rights bill co-authored with Rep. Collin C. Peterson, Minnesota Democrat, said Ganske-Dingell authors were taking Senate changes to stem the loss of House support since President Bush said he would veto McCain-Kennedy-Edwards.
"I think they're trying to make the bill look more like ours in a lot of ways, because they realize we're getting a lot more support now," said Dr. Fletcher, a family physician.
"What happened under campaign finance reform is that they lost support for the bill, so they wanted to change it substantially on substance, and that's not customary," Dr. Fletcher said. "And the speaker said, now wait just a minute, if you're going to make changes in policy then you need to do that via the amendment process, not via technical amendment, what's called a manager's amendment," he said.
Last week, the House voted 228-203 to reject parliamentary ground rules requiring 14 separate votes to add Senate changes to the House version of the Senate-passed McCain-Feingold campaign finance bill, effectively killing the measure.
Dr. Fletcher hinted at a similar strategy for the patient protection bill, but Ganske-Dingell supporters said it wouldn't work.
Both camps said they have not yet been told by House leaders which bill would come to the floor for amendment, probably next week. If leaders bring up the White House-backed Fletcher-Peterson proposal or the earlier Ganske-Dingell version of McCain-Kennedy-Edwards, supporters said they would offer the modified bill being introduced today as a substitute in order to get a straight up-or-down House vote.
Dr. Fletcher said a major concern of House members was that a federal patients' rights law not pre-empt state health care laws.
"What their bill has done is establish 19 pages of criteria for evidence, causes of action, and they mandate that from a federal level onto the states," he said. "That's never been done, it's unprecedented. We have a statement [in the Fletcher-Peterson bill] that we do not in any way overturn any state law or and state causes of action."
Dr. Ganske said his revised bill includes a Senate amendment allowing state laws to govern where they are "substantially in compliance" with the federal law.

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