House battle over patients' rights heats up

WASHINGTON (Reuters) -- Sponsors of a far-reaching patients' bill of rights added Republican-backed tax breaks for small businesses to their bill Thursday and said they had the votes for passage next week in the House.

But House Speaker Dennis Hastert and top Republicans said they were gaining momentum in their bid to defeat the measure and pass a more narrowly tailored bill of patient protections backed by President Bush and big business.

In a final scramble for votes, aides said Hastert and administration officials were stepping up pressure on a dwindling pool of wavering Republicans to stand with the White House on the issue, which Americans rank as a top priority.

At issue is legislation approved by the Democrat-led Senate that would grant patients sweeping new rights to sue their health maintenance organizations and insurance companies over treatment decisions that result in injury or death. The managed care industry is currently shielded.

RESOURCES Big Picture:House to begin debate on patients' bill of rights

Bush has threatened to veto the bill, warning that it would drive up health-care costs and the number of uninsured by permitting jury awards of up to $5 million in federal court and unlimited damages under state law.

The president has thrown his support behind a more restrictive measure crafted by Rep. Ernest Fletcher, R-Kentuck. Fletcher's bill would cap non-economic damages in federal court at $500,000 and give patients a limited right to sue in state court if an HMO or insurer fails to abide by the decision of a medical review board.

For weeks Hastert, R-Illinois, has been struggling to build support for Fletcher's patients' bill of rights. But he told reporters on Thursday: "We have momentum on our side ... I think we'll have a good result."

Fletcher also announced several new supporters for his legislation, which an aide said "puts us in striking distance" of passage.

But sponsors of the Senate-passed bill said they had more than the 218 votes needed for approval in the House, and announced several changes to the legislation that won the backing of a key group of conservative Democrats -- the so-called Blue Dogs.

Under the changes, announced by Democratic Rep. John Dingell of Michigan and Republican Reps. Charlie Norwood of Georgia and Greg Ganske of Iowa, the legislation would allow the self-employed to deduct 100 percent of their health insurance costs.

The revised bill would also expand the use of so-called medical savings accounts favored by Republicans to help workers pay for health coverage. Under the changes, businesses with 100 or fewer employees could participate and up to 1 million Americans would be eligible.

Another provision popular with conservative Democrats would give tax credits to small businesses for up to four years to encourage them to offer insurance to their employees.

Dingell and Norwood hoped the changes would blunt charges that their legislation would increase the number of uninsured Americans.

But HMOs, insurance companies and large employers intensified their lobbying campaign ahead of the House vote, tentatively scheduled for the middle of next week.

The Health Insurance Association of America charged in a statement that the legislation would cause 6.5 million Americans to lose their insurance. Business groups also lashed out at provisions aimed at protecting employers from liability and said they would launch a new advertising campaign urging the House to scuttle the bill.