Senate Republicans slow patients’ rights bill

WASHINGTON (CNN) – The long-anticipated debate on the bipartisan patients' bill of rights prized by the Senate Democratic majority did not begin Tuesday morning as planned, when Senate Republicans objected to Majority Leader Tom Daschle’s motion to bring the bill to the floor.

The chamber's new GOP minority has questions about the bill, and Republicans say they want some answers before floor consideration proceeds.

Coming to the Senate floor at the appointed time late in the morning, Daschle, D-South Dakota, advanced a motion to bring up the bill for general debate.

"This has been a long time coming," Daschle said. "We’ve talked long enough. There is only one thing left to do. We need to pass a real, enforceable bill of rights now."

But when Daschle made his motion, Sen. Craig Thomas, R-Wyoming, lodged an objection, stopping debate before it opened. His move was not unexpected. Republicans had indicated late Monday that they would stall the debate, blaming the new majority Democrats for producing changes to the bill too quickly.

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.

"This bill has not had a hearing since March of 1999, and it is one heck of a complicated bill," said Sen. Judd Gregg, R-New Hampshire, on the Senate floor Tuesday morning. "The bill we got Wednesday isn’t the bill we got on Thursday. We have to at least read the bill and figure out what is in it."

It was not clear how long the Republicans would keep their objection in place. Daschle said as the noon hour approached that he would call for a vote to break the logjam on Thursday morning. The new chamber leader will need at least 60 votes at that time to open debate.

In a bid to jolt his GOP colleagues into relenting, Daschle also threatened to keep the Senate in session over its scheduled July 4 break.

"It is my intention to stay on this bill for whatever length of time it takes," he said.

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

Republicans copy Democratic tactics

Privately, Republican aides have admitted 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.

"This issue is way too important in this country for such potential dilatory tactics," argued Sen. Bill Nelson, D-Florida, on Tuesday morning. "You’re either for protecting patients, or you’re for the status quo of the laws that protect the HMOs."

Daschle decided to make the patients' bill of rights the first major piece of legislation taken up since Democrats took control of the Senate earlier this month.

The version of the bill favored by Democratic leaders is sponsored by Sens. Ted Kennedy, D-Massachusetts, 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.

"Big insurance companies and HMOs are privileged citizens, and the American people want to take away their privileged status," Edwards said Thursday. "They are the only group that can say your child is not going to get the medical care your doctor says they need. Some young clerk sitting behind a desk somewhere can overrule a doctor."

McCain, a consistent thorn in the president’s side, said Tuesday he would be willing to work with the administration.

"But for us to do nothing," he said, "is not fair and honest to the American people."

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.

CNN’s Ian Christopher McCaleb and Dana Bash contributed to this report.