WASHINGTON -- Senate Republicans pledged to forge ahead with patients' rights legislation, but said Democrats have damaged chances of getting a bill passed this year.
''Everything the White House and the Democrats have done in the last few days has been very detrimental to getting a bill enacted,'' said Sen. Don Nickles, R-Okla., GOP whip and chairman of a House-Senate committee working on compromise legislation.
Senate Republicans narrowly beat back a patients' rights bill favored by the White House on Thursday by a 51-48 vote. Democrats had forced the issue onto the Senate floor, introducing it as an amendment to a defense bill, after complaining that the conference committee was getting nowhere.
All 51 votes against the measure were cast by Republicans. Forty-four of the 45 Senate Democrats, joined by GOP Sens. John McCain of Arizona, Peter Fitzgerald of Illinois, Lincoln Chafee of Rhode Island and Arlen Specter of Pennsylvania, registered their support. Democrat Kent Conrad of North Dakota did not vote.
McCain, who spoke out for strong patients rights during his failed presidential bid, said the narrow outcome puts pressure on Republicans to pass a bill this year.
Nickles and Republicans said they would attempt to work with GOP lawmakers in the House to fashion a measure that could win over some Democrats.
But many House Republicans have favored a broader bipartisan bill similar to the one Nickles helped defeat, so it's unclear whether the party can unify on the issue and pass a bill this year.
Democrats vowed to keep pressing the issue. Sen. Edward Kennedy, D-Mass, who spearheaded Thursday's vote, said that the narrowness of the setback indicated the effort to pass the measure was gaining ground, and ''a few more days like this and the Republicans will stop stonewalling.''
The bill would give patients easier access to emergency rooms as well as specialists and women would be permitted to see a gynecologist without needing a referral from a primary care physician. Patients would also get expanded rights to sue their health plans if harmed when coverage was denied.
All 161 million Americans with private health insurance would get the protections. Majority Republicans forced passage of a less sweeping measure in the Senate last year, one that covered far fewer people and did not expand rights to sue.
During Thursday's two-hour debate, members of both parties claimed to have the interests of American families at heart. Republicans argued that passing the bill would hurt their pocketbooks by driving up premiums and could leave many families without insurance because business owners will drop health benefits for workers rather than face expensive lawsuits.
They accused Democrats of catering to the legal bar by insisting that patients settle their disputes with HMOs in the courts.
Democrats said their bill would improve health care for Americans and accused Republicans of writing a bill that protected HMOs, not patients.
Republicans earlier this week floated a compromise that envisioned a limited right to sue in federal court, with restrictions on damages.
Kennedy, a member of the compromise committee, called the proposal ''a sham'' but said he was willing to go back to the negotiating table.
But without a breakthrough, he vowed to bring the bill to the floor again.
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