HMO Vote: A Rehearsal for Campaign 2000?

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The rhetoric is blaring, the parliamentary maneuvering is intense, and the lobbying is scorching. In another preview of election 2000 ó the other main issues are gun control, tax cuts and campaign-finance reform ó the Senate is engaging this week in amendment-by-amendment combat over a patients' bill of rights for HMOs. Democrats, including a vociferous President Clinton, are pressing for a broad set of provisions that would expand access to emergency-room care and specialists, and enlarge the right to sue recalcitrant HMOs for denial of treatment. Republicans, while pressing for some of the same reforms, are seeking a more limited bill covering fewer people and with no broad new rights to sue. Turning up the heat on Tuesday, President Clinton called the Republican proposals "toothless, half-hearted protections." Countered Senate Majority Leader Trent Lott: "We want solutions, not problems caused by courts."

"This debate is again setting up the dynamic for the election," says TIME congressional correspondent John Dickerson. Encouraged by the rhetorical and political momentum they gained over gun control, Democrats are trying to force the Republicans to go through some "tough political votes" over health care, says Dickerson. Republicans would prefer not to have to deal with the HMO issue, he reports, but, aware of the political draw of the matter, they are seeking to enact a limited bill that will both pass public muster and maintain the GOPís reputation as the party of fiscal responsibility. At the moment there does not appear to be much wavering in the Republican ranks, which means that come the end of the week, the GOP majority will probably manage to push through its version. Both parties will then take their health-care agendas to the voters.