Kansas City Star

WASHINGTON – Sen. John Ashcroft is having second thoughts about his opposition to a high-profile bill that would give Americans more clout to deal with health maintenance organizations.

Ashcroft, a Missouri Republican facing a re-election challenge from Gov. Mel Carnahan, calls it listening to the people. His adversaries say he merely wants to change a vote that is costing him politically.

Ashcroft was one of 51 Senate Republicans who in June voted against a bipartisan House bill that gave virtually everyone the right to sue their HMOs.

The Senate passed a more limited bill, triggering an outcry from the American Medical Association, consumer groups and Democrats. They seized on the vote as proof that Republicans put the interests of big insurance companies first.

“I’m looking for a way for the impasse in Washington to be (broken),” Ashcroft said in Kansas City on Friday. “People understand the need for us to have a new set of rights for patients.”

Ashcroft said in an interview earlier this week that he had met with the lead House sponsor of the bill about compromising, but not because of AMA pressure or Carnahan ads that said his vote killed a “real” patients bill of rights.

“I’ve been to all 114 counties in Missouri, and people are talking to me about the need to balance the equation between HMOs, health-care providers and the individual patients and consumers,” Ashcroft said.

Work for a compromise, he said, was “good government.”

Democrats say he had plenty of time earlier this year to make that move.

“He will still be held accountable for his previous record, and I think voters understand and are quite suspicious of election eve turnarounds,” said Jim Jordan of the Democratic Senatorial Campaign Committee in Washington.

The AMA and a consumer group are cautiously optimistic that Ashcroft is having a change of heart

The AMA had pressured Ashcroft and two other Senate Republicans in tight re-election races because polls showed that some 80 percent of Americans wanted more clout over their HMOs, Reardon said.

Jamie Court, executive director of the Foundation for Taxpayer and Consumer Rights, said Ashcroft was especially vulnerable because Missouri had proved to be a state where stronger patient rights were popular. A state law passed in 1997.

Stuart Roy, spokesman for the National Republican Senatorial Committee, dismissed the significance of the patients bill and said it was overshadowed by prescription drug coverage for the elderly and Social Security reform.

“It’s a zero campaign issue,” Roy said.

Marc Farinella, campaign manager for Carnahan, said polls showed it to be one of the top two voter concerns, along with education.

“Ashcroft is desperate to create some political cover for himself,” Farinella said.

Ashcroft has not avoided the patients bill issue in the campaign. He has run commercials backing the Senate bill as a meaningful step forward.

The Senate bill would limit damages to $350,000, would allow suits only in federal court, and would cover only the estimated 50 million people in self-insurance plans.

The House bill, sponsored by Republican Charlie Norwood of Georgia and Democrat John Dingell of Michigan, has no limit on damages, permits suits in federal or state courts and covers all insured people, whether in self-insured or traditional plans.

Last week Norwood said talks with some senators produced an alternate plan that would cover everyone, put a $5 million limit on punitive damages in federal court, set no limit in state courts and give protections for employers against suits over coverage.

John Stone, spokesman for Norwood, said Ashcroft had indicated he favored the compromise, but Ashcroft would not say what changes he supported.

– The Star’s Steve Kraske contributed to this report.