House Speaker J. Dennis Hastert (R-Ill.) decided yesterday to exclude supporters of broad patient protections from a list of congressional negotiators on health care legislation, prompting angry Democrats and a few Republicans to accuse GOP leaders of rigging the legislative process.

Hastert declined to appoint either Rep. Charles W. Norwood Jr. (R-Ga.) or Greg Ganske (R-Iowa)--who helped craft the bipartisan health bill approved by the House last month--to a group that will attempt to reconcile differences between it and a narrower Senate measure. Only one of the 13 GOP negotiators, Rep. Michael Bilirakis (Fla.), supported the patients' bill sponsored by Norwood and Rep. John D. Dingell (D-Mich.).

In the clearest indication yet that Congress will adjourn this session without making progress on the question of managed care, Hastert named Rep. Joe Scarborough (Fla.)--who is injured and will not return to Washington this year--as one of the GOP's conferees.

Hastert said he had "selected fair-minded people that represent and understand the complexities of this issue and who also understand the importance of enacting a law to protect patients."

But President Clinton charged Republicans with "seeking to defeat the will of the House . . . by refusing to appoint conferees who support this legislation."

While Democrats offered to choose Norwood as one of their own negotiators, he declined, saying, "My outspokenness against my own party's position in this matter might become an issue, and the committee doesn't need any distraction from the real issues."

Norwood warned that while GOP opponents of managed care reform "believe they can now subvert the conference committee to produce a report repugnant to" the bill he wrote, his colleagues should work to ensure health maintenance organizations face legal liability for their actions.

The Senate bill does not give individuals the right to sue their health plans and covers far fewer patients.

"I want both Republican and Democratic patients to win," he said. "To accomplish that, both parties need to honor the will of the people, instead of the will of lobbyists. As I recall, that is our job, and that is our duty."

Minority Leader Richard A. Gephardt (D-Mo.) said GOP leaders had ensured the Senate would be able to "weaken" the House health care bill. Gephardt asked why "doctors can be held accountable for their decisions but the bureaucrats" at insurance companies are not subject to the same standards.

Rep. John A. Boehner (R-Ohio), an outspoken opponent of legal liability for HMOs, argued that the House routinely compromised "with the other body" in order to produce legislation and that allowing patients to sue their insurers would raise health care costs and prompt employers to drop coverage for their workers.

CAPTION: Speaker J. Dennis Hastert named House conferees on health bill.