GOP senators delay debate on patients' bill of rights

By CNN Capitol Hill Producer Dana Bash

WASHINGTON (CNN) -- Debate on the bipartisan patients' bill of rights prized by the Senate Democratic majority will not begin Tuesday morning as planned. The chamber's new majority has questions about the bill, and they want some answers before floor consideration proceeds.

Saying they have not had time to review the version of the bill backed by Democratic leaders, Senate Republicans on Monday blocked an attempt to bring the bill up for debate.

Using a procedural move, Republicans prevented the bill from being taken up in the Senate. They did not give any indication how long them might hold up the bill. The Democratic leadership would need 60 votes to force the debate to begin over GOP objections.

The bill will be discussed on the floor Tuesday, but not in a formal debate setting.

Republicans say that sponsors of the measure were making changes to it as late as last Thursday in an attempt to respond to criticism that the bill would subject employers and health care providers to lawsuits.

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Republicans copy Democratic tactics

"We need to look over the fine print on the bill," said a spokesman for Senate Minority Leader Trent Lott, R-Mississippi. "We just want to give Republican senators -- and Democrats too, for that matter -- a chance to look at it."

Privately, Republican aides admit they are using a delaying tactic employed by Democrats, when they were in the minority, to slow the majority's agenda.

Democrats -- noting that a patients' bill of rights has been a hot issue in Congress for five years and that Republicans will be free to offer amendments during the debate -- contend that Republicans are trying to delay debate not because they need more time but because an alternative GOP measure, backed by the White House, does not have enough votes to pass.

"It's unfortunate that Republicans have decided on a strategy of delaying and preventing the Senate from debating the bill right away," said Jim Manley, a spokesman for Sen. Ted Kennedy, D-Massachusetts., one of the bill's sponsors.

Despite the delay, both sides still intend to start the public relations battle in earnest Tuesday morning with rallies, war rooms and a tremendous lobbying effort from interest groups on both sides of the issue.

Senate Majority Leader Tom Daschle, D-South Dakota, decided to make the patients' bill of rights the first major piece of legislation taken up since Democrats took control of the chamber earlier this month.

The version of the bill favored by Democratic leaders is sponsored by Kennedy and Sens. John Edwards, D-North Carolina, and John McCain, R-Arizona. The version of the bill favored by President Bush and most Republicans -- dubbed the "tripartisan" bill -- is sponsored by Sens. Bill Frist, R-Tennessee., John Breaux, D-Louisiana and Jim Jeffords, I-Vermont.

The most serious differences between the bills surround the recourse patients have if they are denied coverage by their HMO and are harmed by delays in treatment.

Difference in damages

The Kennedy-Edwards-McCain bill allows patients to go into either state or federal court and seek economic damages (for things such as lost wages and medical bills), as well as damages for pain and suffering, and up to $5 million in punitive damages against the HMO. Any other limits on damage awards would be governed by state law.

The Frist-Breaux-Jeffords bill would also allow patients to sue their HMOs. But suits would have to be in federal court, pain and suffering damages would be limited to $500,000, and punitive damages would not be allowed.*

Supporters of limits on damages insist that, without them, health insurance premiums will rise, benefiting trial lawyers at the expense of patients nationwide. But supporters of the plan backed by Democratic leaders say premiums would only rise about 1 percent more under their plan than under the Bush-backed plan.

The various factions on the debate met at the White House last week to try to find a compromise, but they did not make much progress, according to sources.