House Speaker Dennis Hastert said Sunday that talks between the Bush administration and sponsors of a far-reaching patients' bill of rights were making progress and suggested he may delay this week's vote until September if negotiators needed more time.
Administration officials and Republican Rep. Charles Norwood of Georgia, the bill's chief sponsor, are trying to settle differences over legislation that would expand the rights of patients to sue health maintenance organizations and insurance companies over treatment decisions that result in injury or death.
"We're hoping to come together," Health and Human Services Secretary Tommy Thompson told "Fox News Sunday." But he said the White House was just six to 10 votes short of what it needed to defeat Norwood's measure and push through an alternative favored by President Bush.
While Hastert said it was his hope to bring the hotly contested bill to the House floor before Congress adjourns Friday for its monthlong summer recess, the Illinois Republican told NBC's "Meet the Press": "Why stop that process now when you're making progress?"
"We need to get a bill that the president will sign," Hastert said, adding the House vote could slip if "there is a serious discussion going on" that could lead to a bipartisan compromise.
Like the patient protections approved by the Democrat-led Senate in June over White House objections, the far-reaching measure proposed by Norwood and Democratic Rep. John Dingell of Michigan would clear the way for injured patients to file suit and win jury awards of up to $5 million in federal court and unlimited damages in state court.
Bush has threatened to veto the measure, warning it would drive up the cost of health care and force millions of Americans into the ranks of the uninsured.
The president and House Republican leaders favor legislation by Kentucky Republican Rep. Ernest Fletcher that would cap noneconomic damages in federal court at $500,000 and let patients sue in state court only if an HMO failed to abide by the decisions of a medical review board.
While lobbying by Bush has increased support in the House for Fletcher's bill, administration officials and their Republican allies concede they are still short of the votes they need, although not by much.
To avert what would be an embarrassing defeat, Bush renewed talks with Norwood and last week offered fresh concessions that would let patients sue HMOs and insurers in state court — a key demand of the bill's sponsors. But under Bush's proposal, these state cases would be governed by federal standards, which have yet to be drawn up.
Republican Sen. John McCain of Arizona, who championed the bill in the Senate, told ABC's "This Week" he was "hopeful we could get something worked out."
Aides said Norwood planned to meet with his supporters Monday to plot strategy.
Democrats and some Republicans objected, saying the plan would limit the remedies available to patients and preempt laws in states that have enacted their own patient protections.
House Democratic leader Richard Gephardt of Missouri accused the White House of doing the HMO industry's "bidding," telling CNN's "Late Edition" Sunday the Norwood-Dingell bill was the "minimum that you need in order to enforce these rights."
But both sides promised to continue the negotiations, though it was unclear whether an agreement could be reached before the end of the week and Congress adjourns.
Beyond the dispute over using federal standards in state courts, negotiators must still work out their substantial differences over caps on damage awards. Bush told lawmakers he would accept somewhat higher caps but they said it was unclear how far he was willing to go.