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President Bush says he can support popular new patient rights, including new lawsuits against HMOs and other health insurance companies, but he is worried about allowing massive jury awards. Reflecting those concerns, White House officials said Tuesday that the administration would insist on limiting any damage awards these lawsuits might produce. The politically potent issue moved forward in Congress as the White House worked to slow momentum, peeling off a key House Republican as the Bush administration tries to take control of the debate. But in the Senate, supporters picked up Republican John McCain, giving the man who challenged Bush for president a fresh issue where he can play the gnat in Bush’s agenda. On Tuesday, lawmakers introduced the latest version of the patients’ bill of rights, arguing the time has come to send the measure to the president’s desk. “This legislation has been debated. It’s been discussed — on and on and on,” said Sen. Edward Kennedy, D-Mass. “Every day we fail to pass this legislation, families are being hurt.” But a sign of just how much progress Democrats and their GOP allies have made is that the debate is now over how to structure lawsuits, rather than whether lawsuits or even a new law is needed. The latest bill would send some types of lawsuits to state courts, where jury awards can be substantial, and others to federal court, where patients could win no more than $5 million in punitive damages. White House aides said they would prefer that most if not all cases be directed to federal court and would insist on lower caps on damages. “We can’t have a patients’ bill of rights that encourages and invites all kind of lawsuits,” Bush said Tuesday. “The ultimate effect would be to run up the cost of business.” He added: “I’m a little concerned about the size of the cap on punitive damages.” Aides pointed to a Texas law, which Bush signed as governor, that limits damages to $750,000. Behind the scenes, the White House worked feverishly to slow down the measure — both because Bush worries about runaway lawsuits and because aides fear he won’t get credit for improvements that move forward without his stamp of approval. They succeeded in removing Rep. Charlie Norwood, a Georgia Republican who has led the House fight for strong protections. Norwood pulled his name from the bill following a three-hour meeting with White House aides Monday. “I want him (Bush) to get all the credit,” Norwood said in an interview Tuesday. “This is going to be a George Walker Bush initiative that finally puts us together, and he’s going to be the one to sign it, so he ought to get all the credit.” Another concern, Bush aides said, is that employers themselves could be held liable for decisions made by health insurance companies. Backers say the bill is careful to hold employers responsible only if they participate in a coverage decision; that’s tricky language to write. The White House plans to outline its principles this week and make clear that Bush supports reforms that apply to all Americans. Senate Republicans, by contrast, have pushed legislation that would affect only a part of patients who are not protected by a patchwork of state laws. Bush is unlikely to put out a fully developed plan of his own, planning to work with legislators on their plan instead, a White House official said. With all 50 Democrats and a handful of Republicans on board, the legislation is likely to pass if it comes to a vote in the Senate. Backers contend they have the quiet support of 60 senators, enough to force a vote, but White House aides say they doubt it. The House has already approved an even broader patients’ rights bill and probably will do so again if the matter comes to a vote there. An aide to House Speaker Dennis Hastert, R-Ill., said the speaker wants to move ahead but will take his cues from the White House. Under legislation proposed Tuesday, a federal court would deal with questions about how to interpret a contract, such as whether a particular benefit is covered under the health plan. State courts would get medical questions, such as whether a particular test was medically necessary, or whether a treatment was experimental. The legislation also gives patients easier access to emergency room care and specialists and the right to take disputes with insurance companies to independent appeals panels. Associated Press Writer Jeffrey McMurray contributed to this report. Copyright 2001 Associated Press. All Rights Reserved. This material may not be published, broadcast, rewritten, or redistributed.

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