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Houses Passes Managed Care Bill With Bush-Norwood Compromise 226-203

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NU Online News Service, Aug. 2, 12:08 a.m. – The U.S. House of Representatives voted 226-203 today to pass a version of H.R. 2563, the managed care “patient rights” bill, that incorporates changes proposed by President Bush.

House Democrats voted 5-202 against the bill, but Republicans pushed it through by voting 220-0 in favor of passage.

Republicans also beat back a last-minute effort by Democrats to kill the Bush amendments, by voting 3-216 against a motion to send the bill back to committee. The motion to send the bill back lost 208-220.

Now that the House has approved H.R. 2563, it’s up to a House-Senate Conference Committee to work out differences between the House bill and legislation approved earlier by the Senate.

Bush negotiated changes in the House version with Rep. Charlie Norwood, R-Ga., a leader in the managed care legislation effort who has disagreed with the Republican leadership over how much power Congress should give patients to attack health insurers, health maintenance organizations, and employers that sponsor self-funded health plans in court.

The Bush-Norwood compromise would put some limits on suits by giving federal courts jurisdiction over self-funded health plans and disputes over contract terms, and state courts jurisdiction over coverage decisions.

The compromise would create some classes of persons that would be protected from liability, including directors of companies that buy health coverage for employees; employers that delegate responsibility for care to health insurers and other “designated decisionmakers”; and “designated recordkeepers” that simply keep records for plans.

The compromise would put tight restrictions on class-action suits.

But the compromise would also allow plaintiffs to sue health insurers, HMOs and employers that actively administer self-funded plans for unlimited economic damages, up to $1.5 million in damages for pain and suffering, and up to $1.5 million in punitive damages.

States could give health plans some protection by enacting their own, lower caps on damages.

The text of the Bush-Norwood compromise amendment is available on the Norwood Web site, at

The Bush administration has posted a text of the president’s comments on the amendment, and an audio recording of the comments, on the White House site, at