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News :: Civil & Human Rights : Health : Political-Economy : Regime |
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Supreme Court Decision Takes HMO's off the Hook from Improper Denials of Health Care |
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by Families USA
(No verified email address) |
21 Jun 2004
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Bush trumpets patient rights during 2000 campaign, then intevenes on behalf of HMOs before the Supreme Court....follow the money to figure this one out |
WASHINGTON - June 21 - The Supreme Court today struck down a Texas statute that had authorized patients to sue HMOs and other managed care plans for the harm caused when health care is improperly denied. Families USA was the lead organization in a friend-of-the-Court brief filed on behalf of consumer and patient groups in support of the law. [See Background attached below...]
The following is the statement of Ron Pollack, Executive Director of Families USA, about the Supreme Court decision:
"Today's Supreme Court decision takes HMOs off the hook from any liability when they deny needed health care - even when improper denials have tragic consequences. This means that health plans will no longer be deterred from making improper decisions that could severely harm patients.
"It is astounding that, after President Bush proudly boasted about the Texas patients' rights law throughout the 2000 presidential campaign, his Administration opposed it in the Supreme Court. The President's opposition may have played a key role in today's decision, which will bring great joy to HMO executives but will cause enormous harm to America's patients.
"The effect of today's ruling is that the patient protection laws of at least ten states - Arizona, California, Georgia, Maine, New Jersey, North Carolina, Oklahoma, Texas, Washington, and West Virginia - will be invalidated. Therefore, this is a big step backwards for insured patients seeking quality care."
BACKGROUND ABOUT PATIENTS' RIGHTS CASE IN SUPREME COURT
Background: In 1997, the Texas legislature adopted the Texas Health Care Liability Act to protect patients from HMOs' improper denials of needed medical care. It authorizes patients to sue in state court HMOs that wrongfully deny care, and creates remedies similar to those for harm caused by medical malpractice.
The Texas statute was challenged by Aetna and Cigna, claiming that the Texas statute is invalid because it violates the federal so-called "ERISA" (the Employee Retirement Income Security Act) law. The plaintiffs claim that the Texas statute is preempted by the federal ERISA law and lawsuits for damages cannot be pursued in state courts. The plaintiffs lost in the U.S. Court of Appeals. If the insurance companies prevail, it would invalidate similar laws in at least nine other states - AZ, CA, GA, ME, NJ, NC, OK, WA, and WV.
Since, the ERISA law bars suits for damages in federal courts from HMOs that wrongfully deny care, this case is of extraordinary importance for insured patients. The Supreme Court's invalidation of the Texas statute means that there will be no effective way for patients to hold their HMOs accountable for improper denials of care. As a result, there will be no economic deterrence to prevent HMOs from making wrongful decisions that cause significant harm to patients and their families.
President Bush's Role in the Litigation: There is a deep irony about the Bush Administration's role in this litigation. When Governor Bush ran for President in 2000, he boasted about the Texas statute and claimed that he was responsible for bringing about its enactment. For example, in response to the first question (about holding HMOs accountable for their decisions) asked during the third Presidential debate in St. Louis, Governor Bush responded:
"I do support a national patients' bill of rights. As a matter of fact, I brought Republicans and Democrats together to do just that in the State of Texas, to get a patients' bill of rights through."
"It requires a different kind of leadership style to do it though. You see, in order to get something done on behalf of people, you have to put partisanship aside. And that's what we did in my state. We've got one of the most advanced patients' bill of rights . . . ."
"We're one of the first states that said you can sue an HMO for denying you proper coverage. . . . You know, I support a patients' bill of rights, Mr. Vice President. And I want all people covered. I don't want the law to supersede good law like we've got in Texas. . . ."
"People'll be able to take their HMO insurance company to court. That's what I've done in Texas. And that's the kind of leadership style I'll bring to Washington."
Ironically, however, the Bush Administration argued in the Supreme Court on the side of Aetna and Cigna to invalidate the Texas statute. |
See also:
http://www.familiesusa.org
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