WASHINGTON – As negotiations continue, Democrats are complaining that President Bush's latest designs for patients' rights will create a shield for employers conspiring to deny health coverage to their workers.
Under the reported Bush proposal, employers would only be subject to federal laws governing contract disputes.
The provision would stand even if employers instructed or pressured a health plan into making a medical decision to deny a patient a needed test, medicine or operation.
Negotiators for both parties planned to spend the weekend analyzing Bush's plan.
Some Democrats are already pronouncing the plan fatally flawed.
"Opponents have put forth a weaker alternative," Sen. Jean Carnahan, D-Mo., said Saturday in the Democrats' weekly radio address.
"They hope we will agree to lesser protections for the American people. But make no mistake, there are real differences between our proposals. On every major issue, they side with the insurance companies and we side with patients."
Carnahan said Bush's plan would still leave some people unprotected.
"Our bill gives you access to a fair, independent review by a medical professional when you're denied care," Carnahan said. "Theirs does not."
Bush, who had intensified his Capitol Hill lobbying after losing GOP moderates' support on a more limited bill, presented the state plan to Rep. Charlie Norwood, R-Ga., the chief bargainer for the moderates.
The president's compromise would essentially steer lawsuits involving HMO care to federal courts, but allow some cases to be heard in state courts — particularly if they apply to the local medical malpractice laws, said sources familiar with the plan, speaking on condition of anonymity.
White House spokesman Ari Fleischer said he would not give "a play-by-play on any of the negotiations."
"The discussions that are under way right now are what you would expect at the end of a legislative issue that is very serious and is approaching, it's possible, a vote sometime soon," Fleischer said.
The bill favored mostly by Democrats would expand the medical treatments health plans must offer their patients — and more controversially, give wronged patients access to federal or state courts and potential jury awards.
GOP leaders have resisted attempts to push cases into state court. A 1974 federal pensions and benefits law confines most cases against HMOs and other employer-sponsored health plans to federal court.
Despite Bush's efforts, Republican moderates may force GOP leaders to compromise on patient lawsuits when the House takes up the legislation next week.
Bush told a small group of lawmakers that he would consider higher limits on damages, but did not name a specific figure, sources familiar with the meeting said.