Costs Separate Dueling Bills.

Congressional Budget Office says the Republican version of patients' rights is cheaper; House bill clarifies liability in Superfund clean-ups.

A patients' rights bill supported by President Bush would increase health insurance premiums for employer-sponsored health plans less than one expected to be pushed by the now Democratic-controlled Senate.

The Congressional Budget Office recently concluded a review of the "Bipartisan Patients' Bill of Rights Act of 2001," sponsored by Sens. Bill Frist, R-Tenn., John Breaux, D-La., and Jim Jeffords, I-Vt., and said the legislation would increase premiums by 2.9% when fully phased in over five years, Frist's office said in a statement.

The Congressional Budget Office said the "Bipartisan Patient Protection Act of 2001," introduced in February by Sens. Edward Kennedy, D-Mass., and John McCain, R-Ariz., would increase premiums by 4.2%, according to an April 23 letter to Sen. Don Nickles, R-Okla., from the Congressional Budget Office.

Frist's bill, which Bush has said he supports, allows patients to sue health plans when necessary medical treatment is denied, but it requires that suits be heard in federal courts and caps damages at $500,000.

The Kennedy-McCain plan would allow suits in state and federal courts and awards as high as $5 million.

The House and Senate passed separate versions of a patients' rights bill in the fall of 1999 but couldn't agree on a compromise. Who can be sued, where they can be sued and for how much have been--and continue to be--barriers to an agreement.

Liability issues also deter health insurers and employers from supporting patients' rights proposals. Health insurers have been saying expanded liability would drive up health-care costs and, thus, premiums. The net effect would be fewer people being able to afford coverage and more people uninsured.

Employers say they might have to discontinue sponsoring health plans if they are exposed to lawsuits because they've provided coverage.

Congress has debated patients' rights for five years, Breaux said in a statement. "I believe this bipartisan legislation has the best chance of becoming law, because it combines the best features of all plans," he said.

Rep. Charlie Norwood, R-Ga., has formally co-sponsored the patients' rights legislation opposed by the insurance industry, employers and President Bush.

Norwood actually co-authored the bill introduced in February by Sens. McCain, John Edwards, D-N.C., and Kennedy, and Reps. Greg Ganske, R-Iowa, and John Dingell, D-Mich., Norwood said in a statement.

Norwood withheld formal sponsorship of the bill in February, in hopes of brokering a deal with the White House for advance endorsement of a patients' rights bill agreeable to House and Senate supporters of managed care reform, he said.

Norwood said his decision to formally support the bill was forced by upcoming floor action in Congress.

The "Bipartisan Patient Protection Act of 2001," S 283-HR 526, was expected to be brought before the Senate the week of June 18, and to the House floor before the end of June, Norwood said.

While the issue was still on the "back burner," Norwood said he felt he had time to try to create a bill that would have universal support from Congress and the White House.

House Passes Superfund Bill With Liability Exemption

The U.S. House recently passed a Superfund-related bill exempting from liability businesses that contribute a relatively small amount of hazardous waste to Superfund sites.

Any business that has deposited fewer than 110 gallons of liquid waste or 200 pounds of solids to toxic waste sites or dumps is exempt from liability under the bill, said John Arlington, assistant vice president of federal affairs for the American Insurance Association.

Another change called for in the legislation affects small businesses and nonprofits with 100 or fewer employees. They would be exempt from liability for any municipal solid waste--nonhazardous waste or ordinary garbage--found in a Superfund site, he said.

"Lots of municipal waste can be found in Superfund sites," Arlington said. "Some Superfund sites are mostly municipal waste, because there's so much of it,"

Before this legislation, any party could be held liable for all the costs of cleaning up a Superfund site, even one that sent only a small amount of waste or even ordinary household garbage to the site, Rep. John Duncan, R-Tenn., chairman of the Water Resources and Environment Subcommittee, said in a statement.

Superfund legislation calls for joint, several and retroactive liability. If a purchaser bought a piece of property later found to be contaminated, that purchaser would be liable for the cleanup, even without having contributed to the contamination. Because of joint and several liability, the purchaser would have to pay for the entire cleanup cost if other responsible parties couldn't be found to help pay.

With that kind of liability hanging over it, a purchaser of a contaminated site wouldn't be able to get insurance.

Dennis Kelly is Washington bureau manager.