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March 25, 2004

Bush Flip-Flop on Patients’ Bill of Rights May Have Been Driven by Campaign Donors

Bush Touted Texas Law Passed While He Was Governor; Now, He Opposes It

WASHINGTON, D.C. – The prominence of health insurance industry executives among Bush campaign bundlers suggests that special interests played a part in President Bush’s flip-flop on patients’ rights to sue HMOs, Public Citizen charged today.

In a televised presidential debate on Oct. 17, 2000, candidate Bush said, "If I’m the president … people will be able to take their HMO insurance company to court," adding that while he was governor of Texas, "We’re one of the first states that said you can sue an HMO for denying you proper coverage."

But on Tuesday, the Bush administration argued before the U.S. Supreme Court that the same Texas law touted by candidate Bush is invalid because it is pre-empted by a federal law. This is the opposite of what then-Gov. Bush’s Texas Department of Insurance argued in a lower court in 1997.

Among Bush campaign Pioneers (bundlers of $100,000 or more in contributions) are seven former or current HMO executives: UnitedHealth Group CEO William McGuire; former Health Net Chairman Dr. Malik Hasan; Anthem Inc. Chairman L. Ben Lytle; Blue Cross and Blue Shield of Florida lobbyist Michael R. Hightower; WellCare’s CEO Todd S. Farha and finance director David Hart; and AmeriGroup chairman and CEO Jeffrey L. McWaters. (A complete list of Rangers and Pioneers is available at www.WhiteHouseForSale.org.)

The Texas Health Care Liability Act, passed in 1997 when Bush was governor, was the first state law to give patients the right to sue HMOs for denying "appropriate and medically necessary" treatment. Texas chose to prevent HMOs from padding their bottom lines through abusive denials of coverage by holding HMOs to a professional medical standard of ordinary care. Nine states have since followed Texas’ lead and enacted similar legislation.

"When the Patients’ Bill of Rights was a hot campaign issue in 2000, Bush was only too happy to claim responsibility for the Texas law," said Joan Claybrook, president of Public Citizen. "Now that the issue is not in the news, Bush has done a flip-flop and aligned himself with his big campaign contributors from the HMO industry."

In the current Supreme Court case, the Bush administration joined the insurance industry in arguing that the Texas law is completely pre-empted by federal law. The case involves the rights of patients who suffered severe medical complications when their HMOs decided that treatments recommended by their physicians were not medically necessary.

The Bush administration argues that these claims fall exclusively under the Employee Retirement Income Security Act of 1974 (ERISA). ERISA limits recoveries to the value of the denied insurance benefits and does not consider the injuries suffered by patients as a result of denied care, which can include death or permanent and severe disability. The unfairness of this law was a major factor provoking bipartisan congressional support for a Patients’ Bill of Rights until that legislation was derailed by the Sept. 11, 2001, terrorist attacks, among other factors.


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