By Amy Goldstein
Washington Post Staff Writer
Thursday, March 18, 1999; Page A6

A new season of debate opened in Congress yesterday over how to clamp down on managed care, but deep partisan differences remain over what role the government should play in regulating insurance plans.

Reflecting the views of the Senate's Republican leaders, a bill taken up by the Senate health committee yesterday would expand patients' rights but senators exhibited deep partisan differences about exactly what the government should do.

The bill would make it easier for patients to get their emergency room bills paid, visit the doctors they prefer and protest when a health plan balks at paying for treatment they think they need. It is expected to win rapid approval by the Senate Health, Education, Labor and Pensions Committee, perhaps as early as tonight.

The measure is part of a spate of patient-protection bills that have been introduced in recent weeks by Republicans and Democrats in both the House and the Senate – suggesting that the rallying cry of "patients' rights," which dominated Congress for much of last summer before it was drowned out by the president's impeachment, has found fresh momentum this year.

On Capitol Hill, many believe that managed-care regulations have a good chance of passing this year, because President Clinton and legislative leaders of both parties are eager to demonstrate that they still can collaborate to achieve productive results. Yet, "patients' rights" also is widely regarded as a rigorous test of whether the parties truly can surmount their differences – and whether they can resist the temptation to reserve popular issues for use in next year's election.

And as the committee's deliberations began, it was evident that the conflicting approaches to patients' rights that divided Democrats and Republicans last year are just as pronounced today. Chief among them is the question of whether patients should be given the ability to sue their health plans for malpractice, an idea that Democrats say is needed to make HMOs more accountable, but that Republicans say would merely make health care more expensive.

"You simply cannot sue your way to better health," said the committee's chairman, Sen. James M. Jeffords (R-Vt.), the bill's sponsor.

Sen. Edward M. Kennedy (Mass.), the panel's ranking Democrat, tried unsuccessfully to persuade the committee to consider his own bill, instead, saying that the Jeffords approach was flawed. Kennedy noted that the GOP bill would help about 48 million Americans who are insured through large, employer-sponsored health plans that are exempt from state insurance laws, but would not apply to about 100 million additional people in HMOs.

In addition, Kennedy said, the measure did not contain strong enough guarantees that patients could visit medical specialists or that doctors – rather than health plan executives – had the power to decide what treatment patients need.

Even before the committee vote, the White House began yesterday to try to knock down Jeffords's plan, issuing a statement from Clinton that said it "leaves out many of the most fundamental protections" and "falls far short of the legislation the American people deserve." Like Kennedy, the president, who first called on Congress to adopt patient protections in November 1997, said the GOP bill would not help enough people.

On the other hand, a large alliance of health insurers and employers already have renewed an intense lobbying campaign to try to block any additional regulation. The so-called Health Benefits Coalition has been running advertisements on radio and in newspapers in six communities since January, warning of the "unintended consequences of big-government mandates on America's health care system." A coalition spokeswoman said the group plans to begin television ads next month.

Despite the renewed sparring, the mere fact that a Senate committee is working on such a bill represents a degree of progress. Last summer, as the issue was reaching a crescendo among voters and on Capitol Hill, Senate GOP leaders produced legislation that largely resembles the Jeffords bill. But it never received a committee hearing. And in the session's waning days, Majority Leader Trent Lott (R-Miss.) did not permit either the GOP bill or its main Democratic rival to be put to a vote of the full Senate.

This time, Lott has signaled greater receptivity. Yesterday, a Lott spokesman said the majority leader "would like to bring a responsible patients' bill of rights to the floor this year. It's his intention."

In the House, GOP leaders have revived legislation that is nearly identical to a measure that narrowly passed the chamber last July. A spokeswoman for House Majority Leader Richard K. Armey (R-Tex.) said the House probably would vote on the measure this summer.

Recent public opinion surveys suggest that both parties are justified in trying to wrest control of the issue, because it continues to captivate voters. A Washington Post-ABC News poll last week found that 71 percent of the people surveyed said that "patients' rights" would be a "very important" consideration in deciding how to vote in next year's presidential election.

Staff writers Lorraine Adams and Juliet Eilperin contributed to this report.