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Getting Funds From All Sides

By Deborah Barfield. WASHINGTON BUREAU

Washington - Jay Witter, a lobbyist with the American Chiropractic Association, was among those meeting with Sen. Alfonse D'Amato last year and urging him to do something to better protect patients in managed care plans. In a show of support, the association's political action committee gave $4,000 to the Republican senator's re-election campaign and plans this year to boost that contribution to $10,000, the maximum for an election cycle. Meanwhile, the Health Insurance Association of America, whose 250 members include managed care plans opposed to that same measure, also met with D'Amato's staff and donated $3,500 to his campaign. "For a guy like D'Amato you know he's going to get it from both sides," said Steven LaPierre, political director for the American Chiropractic Association, which has led the fight for a tough patients' rights bill. "As long as he's open to considering our issues, political groups are going to continue to give. We'd support him even he wasn't . . . He's an important player in the U.S. Senate." The contributions - small in comparison to the millions D'Amato rakes in overall - help illustrate how the New York senator manages to collect tens of thousands of dollars from political action committees on opposite sides of a politically charged issue. One such issue, patients' rights, is now the subject of intense congressional debate. Critics of campaign fund-raising say it also shows how special interest groups can support lawmakers who champion their causes, while at the same time contribute to those who have the power to limit damage in measures they oppose. For groups looking to give money on issues from tobacco to health care, D'Amato is the man. Unlike most lawmakers, he is known for his fund-raising skills; by netting some $10 million in campaign contributions this election cycle, he has the biggest war chest in Congress. He is also known for successfully working the political system, speaking out on issues he cares about and wielding power as chairman of the Banking, Housing and Urban Affairs Committee. "If they support me because I'm a good legislator and a fighter, that's great," D'Amato said. "But I'm going to call it the way I see it. I'm not backing off that." Patients' rights is one of the issues D'Amato says he cares about, and it is particularly hot this election year. D'Amato recognized this last year when he authored a broad and tough patients' rights measure. Last week, the issue brought President Bill Clinton to Capitol Hill to rally for his party's bill after Republicans unveiled their version, which would not give patients the right to sue managed care plans if their denial of care causes injury or death. The competing Republican and Democratic measures would drastically change the way managed care companies do business, giving patients more rights to choose doctors and appeal coverage decisions. D'Amato's bill, and a companion introduced by Rep. Charlie Norwood (R-Ga.) would allow patients to sue - something Democrats now insist must be in the final bill. Critics, however, complain that D'Amato did little in the Senate to advance his own version, which has yet to move through any committee. He has been so quiet, some say, opponents of his bill didn't even view it as a threat. "Norwood had put his heart and soul into it," said Judy Waxman, director of government affairs for Families USA, a consumer advocacy group. "As far as I can tell, D'Amato has done nothing. He did not work the bill." From the outset, Norwood and D'Amato worked out a strategy that called for the senator to wait it out as Norwood pushed the issue in the House, where until recently the battle had centered, congressional staff aides said. "He said, `Me going out and busting my behind the way Charlie does . . . is fruitless,' " said John Stone, a Norwood spokesman, quoting D'Amato. Both members also calculated that Republican Senate leaders would have blocked the measure had D'Amato moved first. "He can lay low and let other people duke it out over whether the bill is coming to the floor or not," said Jennifer Shecter, a researcher for the Center for Responsive Politics. "It's an issue where all politicians are treading very carefully because people want reform. The money is clearly coming in from both sides . . . I think he's just playing it safe." D'Amato argues the money doesn't matter. "I don't care. It doesn't make a difference," he said. The patients' rights issue has posed a dilemma for lawmakers. On one hand, patients are demanding that they be given more choices of doctors and avenues to appeal insurance company denials. Yet insurance companies and businesses argue those changes - which they brand as unfair government mandates - would drive costs higher and leave those who can't afford it without coverage. The issue has also pitted powerful coalitions of medical professionals against managed care plans, both of which have recently launched ad campaigns and together have pumped nearly $4 million into the coffers of federal lawmakers and political parties from January, 1997, to March, according to the Center for Responsive Politics, a non-partisan campaign finance watchdog group. During that same period, after D'Amato and Norwood introduced their measures, D'Amato collected $39,000 from members of the PARCA Alliance, a coalition of about 60 health professional groups supporting his bill, ranking him second among recipients in the Senate, the center found. He followed Minority Leader Tom Daschle (D-S.D.). At the same time, D'Amato ranked third among the top recipients with $14,000 in contributions from health maintenance organizations, the Health Insurance Association of America and Blue Cross / Blue Shield and their affiliates - groups opposed to the measure. John Breaux (D-La.), chief minority deputy whip, topped the list, followed by Connie Mack (R-Fla.), chairman of the Republican conference. "We are like any other organization. We believe in supporting incumbents and candidates over the course of time," based on their record and not a particular bill, said Richard Coorsh, a spokesman for the Health Insurance Association of America. Overall, D'Amato has amassed $724,434 from all health-related groups since 1993 and nearly $4 million from the insurance, financial and real estate sector, which includes health insurance groups such as the Health Insurance Association of America and Blue Cross / Blue Shield during the same period. Congress has grappled with health policy for much of the past decade. During that time HMO campaign contributions have steadily increased as the relatively new industry settled in. HMOs contributed $1.6 million in 1991-1992 - the same amount it chipped in in the first 15 months of this election cycle. Seventy percent of those contributions have gone to Republicans. On the other side of the issue, members of the PARCA Alliance have contributed $2.2 million to congressional campaigns from January, 1997, to March, 1998, a little more than half going to Democrats, according to campaign records. Even though D'Amato's bill would impose more controls over managed-care plans, federal records show the industry has continued to support him. "They need to make some form of investment if they want a return," Shecter said. "No side wants to take any chances." As with D'Amato, the bulk of Norwood's campaign contributions have come from bill supporters, including $130,884 from groups of health professionals, according to the Center for Responsive Politics. He also collected about $18,250 from insurance companies. Critics say taking money from both sides allows lawmakers to sit on the fence and wait out such controversial issues as patients' rights. They point to how uncharacteristically quiet the senator has been about this bill compared to others he has championed. For example, D'Amato recently fought to attach a measure to a tobacco bill that would allow women longer hospital stays after a mastectomy. The tobacco bill has since died, but Senate Republicans have tacked the provision to another patients'-rights measure to satisfy D'Amato. "He knows how to act when he wants to," said Waxman of Families USA. "At the moment, he's taking the safe road." D'Amato said he supports the patients' rights bill proposed by Senate Republican leaders, but will continue to fight to include liability provisions as his measure called for. "We're not going to win the war for patients' rights in one large battle," D'Amato said. "It will probably take us many small battles before we ensure and protect their basic rights."

Copyright 1998, Newsday Inc.

Getting Funds From All Sides., 07-19-1998, pp A08.