superseded by the bill mandate. (The bill would supersede a State mandate unless it were "substantially equivalent" to a bill mandate; the Collins amendment proposed a "consistent with" standard). [S 1052, Vote 203, 6/28/01] XXXX Voted to Gut the PBOR and Allow States to Use Weaker Protections. In 2001, XXXX voted for an amendment “that would have allowed states wide latitude to opt out of the federal regulations” on patient protections “for workers who are covered by state laws, leaving millions uncovered, according to critics of the proposal.” This amendment would have allowed states with weaker patient protections than the federal law to opt of the federal law. [S 1052, Vote 202, 6/28/01; The Washington Post, 06/29/01] XXXX Voted For A GOP Amendment That Would Prevent Medical Reviewers From Ignoring Contract Terms. In 2001, XXXX voted for an amendment that would make clear that a medical reviewer could not require a health plan to provide coverage for items or services that were specifically excluded or expressly limited and disclosed in the health care plan's terms, regardless of any determination relating to medical necessity and appropriateness, experimental or investigational nature of the treatment, or an evaluation of the medical facts involved. The motion to table was agreed to, 54-45. [S 1052, Vote 200, 6/27/01] XXXX Voted For A GOP Amendment To Exempt Small Businesses From Health Care Liability. In 2001, XXXX voted for an amendment that would give small businesses (businesses with 50 or fewer employees) that purchased health care coverage for their employees liability from actions they take as fiduciaries, trustees, or plan administrators (this exemption from lawsuits would be equivalent to the protection the bill will give to doctors, hospitals, and other health care providers for their actions in relation to health care plan decisions). The exemption would not apply to the HMOs or other plan agencies hired by the small businesses to provide insurance. The amendment was rejected, 45-53. [S 1052, Vote 199, 6/27/01] XXXX Voted To Repeal Patient Protections If Reports Find That They Cause People To Lose Coverage. In 2001, XXXX voted for an amendment that would direct the Secretary of Health and Human Services to request the Institute of Medicine and the National Academy of Sciences to prepare and submit 5 annual reports, starting 2 years after the date of enactment, on the Act's impact on the number of individuals in the United States with health insurance coverage. If a report determined that 1 million or more people had lost their insurance as a result of passage of this Act, then the provisions to create new rights to sue employers and insurers in Federal and State courts would be repealed. The amendment was agreed to, 93-6. [S 1052, Vote 198, 6/26/01] XXXX Voted for “Blanket Immunity” to Protect Employers from Lawsuits. In 2001, XXXX voted for an amendment to protect employers, even if they are part of a patient’s medical decision, from lawsuits. [S 1052, Vote 197, 6/26/01; Note: The Senate later passed an amendment to protect many employers, but the first amendment pushed a “blanket immunity” policy that Democrats did not support.] XXXX Voted Against Providing A “Floor Of Federal Protection” For Patients. In 2000, XXXX voted against an amendment that would provide that any Federal legislation that is enacted "to protect patients against the abuses of managed care" would have to provide a "floor of Federal protection" that would apply to people insured in federally regulated private insurance plans, State-regulated private insurance plans, and State and local government insurance plans. The amendment was rejected, 47-51. [Vote 167, 6/29/00] XXXX Voted for A Republican Amendment To Limit Patient Protections To Self-Insured ERISA Plans. In 2000, XXXX voted for an amendment that would add the Patients Bill of Rights Plus Act, including “compromise language” that contained a new cause of action under which health maintenance organizations (HMOs) may be sued after completing the appeals process, but under which employers may not be sued unless they made the final decisions that caused the harm in question. The amendment would limit this protection to patients in Federally- regulated, self-insured ERISA plans. The amendment was agreed to, 51-47. [Vote 166, 6/29/00] XXXX Voted for GOP Alternative Bill Legislation Prohibiting Genetic Discrimination In Health Plans; Bill Lacked Several Protections. In 2000, XXXX voted for a Republican bill which extended protections against genetic discrimination, but failed to include more extensive patient protections. Before the law, insurance companies and health plans were barred from denying policies or adjusting premiums on those in groups plans on 180