Patients' rights compromise faces Senate vote

WASHINGTON (CNN) -- A bipartisan compromise on health insurance reform faces a Senate vote that is expected sometime Thursday.

In a key victory for Democrats, the Senate approved a compromise amendment allowing states to craft and implement their own patients' bill of rights, so long as they are in "substantial compliance" with the new federal protections.

"State plans would not be superseded," said Sen. John Breaux, a Louisiana Democrat, who crafted the amendment which passed 64-36 after the Senate set aside a Republican alternative.

GOP-sponsored amendments the Senate defeated Wednesday included one that would have shielded small businesses against lawsuits over medical decisions.

VIDEO President Bush says Democrats' patients' rights bill in Senate is unacceptable. CNN's John King reports (June 27) Play video (QuickTime, Real or Windows Media) Republicans in the U.S. Senate failed to drop employer liability from patients' rights legislation. CNN's Kate Snow reports (June 26) Play video (QuickTime, Real or Windows Media)   RESOURCES Big Picture: Debate begins on patients' rights legislation   Comparison: Patients' Bill of Rights options, differences   CNNfyi.com: A parents and teachers guide to the patients' rights debate     ALSO CNN Access: Will HMO reform be good for consumers or lawyers?     MESSAGE BOARD Health care reform

Senators defeated 53-45 a measure by Sen. Wayne Allard, R-Colorado, that would have given blanket protection from lawsuits to all companies with 50 employees or less.

But a bipartisan group of senators Wednesday released a compromise on employer liability they hope will pave the way for breakthroughs on other points.

The bipartisan measure -- negotiated by Sen. Olympia Snowe, R-Maine, Sen. Mike DeWine, D-Ohio, Sen. Ben Nelson, D-Nebraska, and Sen. Blanche Lincoln, D-Arkansas -- is expected to come to a vote Thursday.

The sponsors say the measure is the best attempt to satisfy most senators' desire to hold someone accountable for decisions involving an employee's health -- while limiting their employer's liability.

The compromise offers companies that contract with an insurer the option to assign someone as the "designated decision maker" so that person, not the whole company, would be liable for faulty medical decisions.

Companies that choose not to assign a designated decision maker and large companies with self-funded, self-administered plans would remain liable only if they are directly involved in the medical decision.

President Bush indicated support for the compromise. Bush has said he would veto the Democratic-backed bill, arguing it leaves employers open to lawsuits and could force them to drop health insurance for their workers.

Key differences still exist on the right of patients to sue their health maintenance organizations, including whether cases should be filed in state or federal courts and how much patients could win in damages. The White House maintains that unless Democrats compromise on those issues, Bush will not withdraw his threat of veto.

Senate Majority Leader Tom Daschle, D-South Dakota, said he hoped a compromise on employer liability would force the White House to back down from the veto threat. Daschle said Bush told him Wednesday he "felt that the progress we have made in the last couple of days was constructive."

Meanwhile, the Senate unanimously approved a compromise measure to protect insurers from being sued for not rejecting a treatment if their contract explicitly does not allow it.