WASHINGTON — A sweeping patients' rights bill gained momentum Tuesday as Senate Democrats won critical votes over the measure's foes and neared compromise on key sticking points.
Amid these signs pointing toward Senate passage of the bill, President Bush stepped up his involvement in the debate. He followed up his recent threats to veto the measure with calls to at least three centrist lawmakers; White House aides said it was the start of a personal lobbying campaign to encourage efforts to produce a compromise that he can sign.
Democrats won a key test Tuesday when the Senate defeated, 57 to 43, an amendment by Sen. Phil Gramm (R-Texas) that would have given employers blanket protection from health care lawsuits by workers. The amendment's opponents argued that it was too broad, unfairly giving immunity even to employers who administer their own health plans and get directly involved in coverage decisions.
Both sides were careful to catalog remaining obstacles, including a still-elusive agreement on capping damages patients could collect in court when suing health maintenance organizations. But Democratic leaders expressed new optimism that they can pass the bill, or at least have broad agreement on its major components, by the end of the week.
"We're down to a few key issues," Senate Majority Leader Tom Daschle (D-S.D.) said. "We can say with greater optimism today that we will resolve these issues--perhaps even without a narrow vote."
The bill would create a host of new protections for the roughly 180 million Americans covered by health plans, giving them guaranteed access to specialists and emergency room care, and greatly expanding their ability to sue HMOs over denials of coverage.
All of the Senate's 50 Democrats voted against the Gramm amendment, including Sens. Barbara Boxer and Dianne Feinstein of California. They were joined by six Republicans and Sen. James M. Jeffords (I-Vt.).
"The clear momentum is with us," Sen. John Edwards (D-N.C.), one of the bill's sponsors, said after the vote. Tuesday's action was "an indication that our legislation is supported by a majority of the Senate."
After thwarting the Gramm amendment, the bill's sponsors moved toward a critical compromise on the issue of employer liability with four Senate moderates who have also been courted by the White House: Olympia J. Snowe (R-Maine), Mike DeWine (R-Ohio), Ben Nelson (D-Neb.) and Blanche Lambert Lincoln (D-Ark.).
