"This legislation would put health care decisions back in the hands of doctors and their patients and take it back from managed-care companies who are only looking to the bottom line," Evans said.

He said the House Republican leadership is holding up action on the bill. The Senate passed its own legislation in July that greatly limits the number of patients who may take advantage of it and makes it more difficult for consumers to hold HMOs accountable for their actions.

The legislation Evans is supporting would extend coverage to all 161 million Americans with private health insurance and makes it easier to hold insurers accountable.

Key provisions in the bill include:

• Direct Access to Specialty Care: Patients could choose a specialist as their primary physician for special needs or ongoing conditions. Women could choose an obstetrician/gynecologist or families could designate a pediatrician as the primary doctor for their children.

• Emergency Care: Ensures that health plans cover the costs of emergency room care, even if the treatment is delivered in a facility that is not part of HMO coverage. Insurers would also be required to pay in cases where the patient legitimately believes an emergency exists regardless of the diagnosis.

• Continuity of Care: Patients would be protected against disruptions in care because of a change in a plan or a change in a provider's network status.

• Clinical Trials: Access to clinical trials can be crucial for treatment of an illness, especially if it is the only known treatment available. Plans would have to create a process for allowing patients to participate in approved clinical trials, and the plan must pay for the routine patient costs associated with the trials.

• Appeals Process: Appeals of HMO decisions could be arbitrated by a panel of medical experts.

• HMO Liability: Makes HMOs accountable by allowing lawsuits when a refusal to authorize treatment results in death or impairment of the patient.

• No "gag rules" on what a doctor call tell a patient: Consumers should have a right to know all of their treatment options. The legislation prohibits plans from gagging doctors and from retaliating against providers who advocate on behalf of their patients.

"Both consumers and doctors are complaining about the delivery of care allowed under managed care plans," Evans said.

"This is the most important health issue for the public. I know how important it is to be able to get the health care one needs. We have to respond to the needs of individuals for patient protection and access to care."

Manage-care companies now provide health insurance for most Americans. The proportion of privately insured Americans enrolled in managed care plans has grown from 13% in 1987 to 75% today, but there is no effective oversight. Over 6 million people in Illinois who belongs to HMOs lack key patient protections.

Evans said managed care is particularly important for women because they make more than 60 percent of all doctor visits and are not able to receive important preventive services because of limitations on care.