What's Behind the Bush-Norwood Patients' Bill Of Rights Deal

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RICK BOWMER/AP

'At the mike before he could reconsider': Norwood and Bush tout their deal

It appears that events may have overtaken Charlie Norwood. For more than six years, the Georgia Republican was the standard-bearer in any debate over a patients bill of rights, pushing for an expanded right to sue negligent HMOs in state and federal court.

Wednesday, with head-spinning speed, President Bush, who has repeatedly threatened to veto any legislation that didn't limit the right to sue, convinced Norwood to back off his hard line on the issue. Moments after a handshake in the Oval Office, the Representative was on national television, announcing the deal, and leaving many of his colleagues in the House and Senate totally bewildered.

According to the compromise, the specifics of which have yet to be disclosed, patients will be able to sue their HMOs in state court, but only under federal rules. The liability cap, which was the second major point of contention between the two sides, will be raised to $1.5 million, a figure that may be introduced only in the most extreme cases. Norwoods concessions will be the subject of House debate Thursday. Republican leaders express confidence the measure will be voted on by the end of the day, but some House Democrats are hinting the bill may die a procedural death before its approved.

Of course, that isnt the last step for Bush. The Senate has already passed its own bill of rights, sponsored by Edward Kennedy and John McCain, that provides patients with sweeping opportunities to sue their HMOs in both state and federal court. If the House accepts the Bush-Norwood deal, negotiators from the two chambers will have to reconcile the versions in conference committee.

TIME White House correspondent John Dickerson, who is following the patients bill of rights through its travels across Capitol Hill, spoke with TIME.com Thursday morning:

What happened between Norwood and the President Wednesday?

John Dickerson: The White House, in a smart move, pinpointed Norwood because of his outsized importance on this issue. They grabbed Norwood and put him in an office with President Bush, who talked to him for hours, and made a point of charming him. And then, as soon as an agreement surfaced, the White House got Norwood on television so he couldnt back out.

Did Norwood cave to White House pressure?

At this point I would say yes, Norwood caved from his position, but I dont know if he sold out. Its not clear exactly how much Norwood gave up — well have to wait and see how the details of the agreement shake out.

We do know that the President got Norwood to move from a $5 million cap on liabilities to a $1.5 million cap, which is a lot closer to the White Houses initial $500,000 limit. So thats a pretty substantial compromise on Norwoods part.

How is Norwoods decision playing on Capitol Hill?

His former allies are furious. McCain and Kennedy and Ganske, among others, are incredibly put off by this move. These guys all assumed Norwood would come back to them with the next step, because hed been acting as a sort of emissary between the two negotiating tables. So they were pretty surprised when they saw Norwood going to the podium rather than coming back to them. Until this point, theyd been vetting and looking at everything the White House offered.

So Norwood can expect a chilly reception from some circles on Capitol Hill?

My guess is that Norwood figured, okay, who would I rather have mad at me: Ganske or the President? Its not a tough question. But I think its safe to say the Norwood-Ganske three-legged race team is off for the moment.

What did the White House offer Norwood in exchange for agreeing to compromise?

I would be surprised in the White House offered him anything out right, but I suspect the President probably made it clear in 50 different ways that Norwoods life will be much easier if he does what Bush wants.

I think a lot of people are wondering why, after six years of fighting for a patients bill of rights he could be proud of, Norwood gave in now.

I think thats just it — after six years of banging his head against a wall Norwood probably figured this was his best chance for something approximating success.

Now the bill will probably land in conference committee. How will Senate leaders approach this deal?

Thats the big question. On the one hand, the President has momentum he didnt have when the Senate was debating this issue. On the other, he may well have to compromise a bit more with Kennedy and whomever Daschle appoints to the committee.

By no means is the President finished with this issue. But given where he was a week ago with 68 Republicans opposing him in the GOP-controlled House, hes certainly in a much better place now.