During the debate over the proposed Patients' Bill of Rights legislation, Fletcher opposed a Democratic proposal that would have allowed individuals to sue their health maintenance organizations (HMOs), favoring instead a more limited bill drafted by Republican leadership that expanded the patient's ability to appeal HMO decisions. Many doctors in the Republican legislative caucus felt their party's bill did not go far enough; Fletcher and Tennessee Senator Bill Frist were notable exceptions. Fletcher's position cost him the support of the Kentucky Medical Association (KMA). After contributing to his campaign against Scorsone in 1998, KMA backed Scotty Baesler's bid to regain his old seat from Fletcher in 2000. However, Baesler only captured 35 percent of the vote to Fletcher's 53 percent. The remaining 12 percent went to third-party candidate Gatewood Galbraith.