Some see doom for patients' bill of rights as politics stalls deal

April 14, 2002

Cory Reiss
Lakeland Ledger

WASHINGTON -- Sen. John Edwards added this weekend's Florida Democratic Convention to a schedule full of trips key to anyone mulling a presidential bid.

While the North Carolina Democrat may be going places, a measure that helped boost his national visibility last year is not. The patients' bill of rights is languishing, despite meetings with administration officials as recently as Thursday, leaving millions of people without HMO reforms promised them by both parties.

That means Edwards, who helped write the Senate version of the bill, still lacks a major national policy achievement. But political experts say that's not necessary at this stage of pre-primary jockeying. "He does not have a very thick legislative portfolio, but he does have this star power," said Jennifer Duffy, an analyst for the Cook Political Report.

Since the Senate passed its patients' rights bill in June, followed by House passage of a competing version in August, negotiations between the Senate sponsors and President Bush have run "hot and cold, mostly cold," a Senate aide said.

Observers are pessimistic that will change, citing political gridlock, personal grudges and the desire by both parties to keep the issue alive for future campaigns.

Both sides promoted patients' rights as recently as January, when Bush called for the patients' bill of rights in his State of the Union address. At stake are the rights of patients in health maintenance organizations to have access to specialists, emergency care and the courts, if decisions by HMOs cause them harm.

If the issue dies quietly, some think bad blood could play a role. Many observers think the involvement of Sen. John McCain, R-Ariz., jeopardizes the bill's chances with President Bush after passage last month of campaign finance reform.

"There's no question it's a factor. I'm sure he doesn't want to give Senator McCain a spotlight if he can help it," said Ron Pollack, executive director of Families USA, a supporter of the Senate version.

Edwards, a trial lawyer, joined forces with McCain and Sen. Edward Kennedy, D-Mass., on patients' rights. But McCain also championed campaign finance reform, which Congress sent to the president last month. Bush unceremoniously signed it into law, a snub to McCain that was viewed as exacerbating friction between the two since McCain vied for the Republican nomination two years ago.

Kennedy and Edwards said they don't think McCain's leadership role on the bill has become a liability, and McCain's office agreed. The three held talks with White House officials late last week, but they didn't make any progress, Senate aides said.

Analysts said the idling of patients' rights is a message.

"It wouldn't surprise me to see the White House in effect sending a signal to Congress that John McCain's involvement in your cause will hurt your cause," said Larry Sabato, a political science professor at the University of Virginia. "That's really the signal they're sending."

Especially in a congressional election year, people on both sides of the issue say, Bush is less likely to bend on another issue so bitterly opposed by core Republicans.

The versions passed by the Senate and the House mainly differ on the extent and circumstances that patients can sue their HMOs. The House version, brokered by Bush, is more restrictive of lawsuits than the Senate version.

"There's still a long way to go," Kennedy said last week.

The Senate bill's champions have avoided negotiating with the House, assuming the bill would die in an impasse with House Republicans.

But Kennedy established a relationship with Bush during negotiations last year on an education bill, and he has led the patients' rights negotiations. They reportedly made progress earlier this year, but compromises being discussed drew fire from people on both sides of the debate and talks faltered.

Sen. Bill Nelson, a Florida Democrat who was an ardent supporter of the Senate bill, said the White House is dragging its feet.

"There is no excuse for us not to have a patients' bill of rights," he said, adding that failure could come with a political price for Republicans.

Edwards, who is in his first term, said he's "relatively optimistic" that a deal can be reached. Asked whether he felt the measure would help him as he travels around the country -- including this weekend's appearance at the Florida convention with other potential Democratic presidential candidates -- Edwards said he wasn't focused on that.

"I think the reason we need a patients' bill of rights in this country is because we have patients that ought to have rights, and as long as I stay focused on them and the people I represent this other stuff will take care of itself," he said.

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