Despite a massive lobbying blitz by labor, consumer and medical groups on Capitol Hill and grassroots activists across the country, the U.S. House of Representatives on Aug. 2 passed a weakened version of the Patients’ Bill of Rights (H.R. 2563). The vote was 226-203.

Without consulting the bipartisan co-sponsors of H.R. 2563, one of the bill’s original sponsors, Rep. Charles Norwood (R-Ga.), agreed to a weak liability provision with President Bush that protects HMOs at the expense of patients. The amendment, passed 218-213, establishes a federal cause of action, in other words, a new provision on federal torts, which controls cases that are allowed to be tried in state courts. This will hamper patients who seek redress in state court.

The Norwood amendment, which AFT president Sandra Feldman called a "great disappointment," also overturns state patient protection laws that are already in place in 10 states, including California and New Jersey, which have strong patient protection laws.

H.R. 2563, however, retains two provisions that the AFT worked hard to secure. The whistleblower provision will protect doctors and nurses who report inferior healthcare; an identical provision is included in the Senate version of the bill, which was passed in July. H.R. 2563 also includes coverage for state and local employees. While the AFT is pleased that these provisions are in the legislation, "we are disturbed that the compromise bill gives more privileges to HMOs than it does to their patients," Feldman added.

The bill now goes to a House/Senate conference, where the AFT will work to make the liability provisions more supportive of patient protection.

Home to roost

Pumped-up projections surrounding the federal budget surplus--which helped goad Congress into passing the administration’s massive, ill-conceived tax cut bill--seem to be a thing of the past now that the ink is dry on the new law.

Just weeks before the tax cut was enacted on June 7, advocates of the cut were placing a lot of weight on projections of a 2001 federal surplus of $275 billion. But by July 12, White House budget director Mitchell Daniels said the surplus could be as low as $160 billion, the Associated Press reports. That’s a markdown from only two weeks before, when presidential economic adviser Lawrence Lindsay said it could be $200 billion. The current economic slowdown and the resulting falloff in corporate tax receipts appear to be big reasons for the lower projections.

"At spending levels currently projected, the government would have to borrow from the Social Security and Medicare surpluses to avoid a return to deficit spending," reports Rebecca Thomas of SmartMoney.com. "Both political parties have publicly stated that the Social Security surplus is off the table, and Democrats say excess Medicare revenue should be off-limits, too. But given the sinking projections, both may be at risk before long," Thomas notes.