House OKs Bush-backed patients' rights bill

WASHINGTON (CNN) -- The House of Representatives narrowly approved a patients' bill of rights Thursday night after endorsing a compromise backed by the White House over lawsuits.

The House dumped key language from a Democratic-backed managed care overhaul bill for a deal hammered out Wednesday between President Bush and Rep. Charlie Norwood, R-Georgia. That cleared the way for the final 226-203 vote.

"The president has committed to sign our bill with this amendment," Norwood said. "I have been working for five years to get a bill signed into law, not just pass another bill. Like it or not, we have to work with this president."

The measure would require insurers to cover emergency room care, guarantee the right to see specialists and participate in government-backed medical trials. But Norwood's amendment would not go as far as the original bill in guaranteeing the right to challenge HMOs' decisions to deny coverage in court.

VIDEO CNN's Peter Viles explains how the patients' bill of rights may affect small employers (August 2) Play video (QuickTime, Real or Windows Media) CNN's Kelly Wallace reports on the compromise President Bush reached with Rep. Charlie Norwood (August 1) Play video (QuickTime, Real or Windows Media) Bush and Norwood announce revised patients' bill of rights (August 1) Play video (QuickTime, Real or Windows Media)   EXTRA INFORMATION Comparison: Patients' Bill of Rights   Background: The issues in the House debate     RESOURCES CNN Access: Thompson on the patients' rights compromise   Message Board: Health care     MORE STORIES Time.com: White House to Charlie Norwood: Let's make a deal

Most Democrats lined up behind a bill sponsored by Reps. John Dingell, D-Michigan, and Greg Ganske, R-Iowa. Bush and other Republicans warned that Dingell-Ganske would have encouraged frivolous lawsuits, making health coverage more expensive and leaving fewer people without insurance.

Although Thursday night's vote was a win for Bush, the bill will still need to be reconciled with the Senate, which passed its own version of the Dingell-Ganske bill in June. Norwood, a former co-sponsor of the measure, abruptly found himself on the opposite side of the debate after Wednesday's Oval Office handshake.

"The problem is our own bill wasn't going to get out of conference. And if it did, it was going to get vetoed," he told CNN on Thursday.

Dingell said the compromise worked out by Bush and Norwood puts too much of a burden of proof on patients who try to challenge an insurer's decisions in court.

"We want to see to it that we still have medical decisions being made in favor of and on behalf of the patients," Dingell said. "This is to see to it that the HMOs are treated the same as anybody else, not given preferential and reverential treatment. That's what the Norwood amendment does."

Until Wednesday, the House Republican leadership had supported a rival bill that would place restrictions on lawsuits against health maintenance organizations and cap damage awards. But the GOP lined up behind the Norwood compromise when debate opened Thursday.

The bill that passed would guarantee access to specialists and allow patients to sue insurers in state courts under some circumstances. It allows lawsuits in state court, while the Bush administration preferred to limit lawsuits to federal courts -- but it caps "pain and suffering" damages at $1.5 million and allows for $1.5 million in punitive damages.

Punitive damages could be applied when a jury finds a health maintenance organization refused to provide care even after an independent review sided with the patient.

The bottom line, House Speaker Dennis Hastert told CNN, is "to get people the health care they need."

"If you have to go sue, you have that as a last alternative, but we want to get people into health care," said Hastert, R-Illinois. "People don't want to go to court, a lawyer's office, to get into a doctor's office."

Bush spent part of the day on the phone with five members of the House, including Hastert, to check on the Norwood measure's progress and lobby for the measure.

Bush previously had agreed to support non-economic damages up to $500,000 and was flatly opposed to punitive damages. Bush and Norwood agreed patients should have the right to sue even if the independent review board agreed with an HMO's decision to deny coverage. In these cases, however, the patient would face a higher burden of proof.

Critics argued Norwood's bill would weaken stronger state laws in places such as California and Texas. Rep. Edward Markey, D-Massachusetts, said Norwood's compromise "guts the patients' bill of rights, and what's left behind? Nothing more than an HMO bill of slights."

Bush and Vice President Dick Cheney traveled to Capitol Hill early in the day to thank Republicans for a succession of key legislative victories in recent days, including Thursday's early-morning passage of the Bush energy bill in the House.

But the Senate is controlled by Democrats, and many of its members were not pleased with the House move.

"We're going to resist it," Sen. Edward M. Kennedy, D-Massachusetts, told CNN on Thursday. "We're going to fight it if it comes over to the Senate."

-- CNN's Kelly Wallace, Kate Snow, Jonathan Karl, Ian Christopher McCaleb and Matt Smith contributed to this report.