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In this analysis, the authors suggest that any of the main federal patient protection proposals will substantially expand regulation of managed care. The authors conclude: the number of people receiving patient protections will increase under all the main federal bills; the practical impact of any proposed patients' rights bill will depend on state circumstances such as the proportion of people covered by managed care, the type of managed care plan, and the extent to which the state has enacted patient protection legislation; most of the federal proposals are similar to existing state laws; and enforcement provisions, including standards for appeals and the right to sue, vary widely among the federal proposals.