Faced with divisions within his party and resistance from Democrats over managed-care reform, House Speaker J. Dennis Hastert (R-Ill.) decided yesterday to bypass the usual committee process and bring to the House floor next week legislation roughly modeled on a bill passed by the Senate this month.
"We're running out of time and I do think it's appropriate for the House to respond to the effort by the Senate to come together and pass a patients' protection bill," said Rep. Bill Thomas (R-Calif.), who chairs the Ways and Means health subcommittee.
Hastert's move came after two committees have been unable to craft bills to address dissatisfaction with HMOs and other kinds of managed-care plans that have come to dominate health care in the United States.
In both the Education and the Workforce Committee and the Commerce Committee, Democrats and sparring factions of Republicans have not resolved disagreements about how deeply the government should step in. In each committee, one of the most contentious issues has been whether patients should be given greater rights to sue health plans for malpractice.
One source familiar with the Commerce Committee negotiations said yesterday that the two parties had essentially reached consensus on several areas, agreeing that any law should apply to all 161 million Americans with private insurance and that outside review panels should be given the power to rule when patients complain that their HMO had denied care they believe they need.
But committee Democrats and Republicans remain divided on several matters, such as patient participation in clinical trials of new treatments and whether federal law should grant doctors the right to refrain from certain procedures -- such as abortions -- that are against their beliefs.
According to GOP sources, Hastert plans to broaden the Senate bill to encompass many more than the 48 million people who would be helped under the Senate legislation. He also plans to address the issue of health plans' legal liability, although it is not clear how.
"The speaker would like to see something on the floor next week, but it's going to be a hard road to go down," said Hastert spokesman John Feehery.
Hastert, who led an informal group of Republicans that produced the GOP's managed-care bill last year, said in an interview last week that he was confident the party could quickly develop a similar measure and bring it to a vote.
In deciding to bypass the committees, Hastert, in essence, reversed an earlier commitment to follow a more deliberative process than the House used on the patients' rights issue a year ago. Last July, the House, with little debate, narrowly adopted a GOP bill that had been introduced by party leaders only a week earlier.
President Clinton has vowed to veto legislation if it emerges from Congress in the form the Senate adopted.