House Vote Limits Catastrophic Health Law

AS Wednesday's House vote shows, Congress clearly is moving at least to curtail the catastrophic health insurance law that it passed last year. Possibly Congress will repeal the measure altogether. The House voted to repeal the measure by a 360-to-66 vote. The Senate, which is believed to be leaning in favor of retrenchment, is to vote in the next few days.

One of several aspects of the measure that angered the elderly is that it failed to cover long-term nursing care. Such care is the most frequent reason that Americans over 65 run up huge bills during illnesses, or so-called ``catastrophic illness.''

Daniel Thursz, president of the National Council on the Aging, cited three reasons that affluent elderly Americans revolted against the existing catastrophic insurance bill:

It doesn't cover the major catastrophic expense of seniors, for long-term nursing care.

It duplicates the private supplementary health insurance plans that many seniors have purchased.

It taxes only the elderly to pay for expensive medical procedures, some of which aid younger Americans who do not pay the tax.

In addition, many among the elderly had protested that the law required them to pay for the new government insurance, irrespective of whether it duplicated their own private supplementary coverage.

There are several ramifications for future legislation, congressional observers note.

For one thing, over the next few years Congress is virtually certain not to pass new legislation to meet America's broadest health issues, such as revamping the entire health-care system or providing some kind of federal insurance coverage to the estimated 37 million citizens without health insurance.

No one knows how to finance such expensive programs, which would cost billions of dollars. Congress will not be likely to try to finance a program by taxing those who are supposed to benefit from it, in view of the fierce protest from the affluent elderly. The tax would have financed part of the cost of the catastrophic health insurance bill. It is this unrelenting campaign of protest that has led both houses of Congress to backtrack from the measure that only last year many members of Congress had trumpeted as as a major legislative achievement.

But Congress is almost certain not to provide financial help over the next year or two at least to families facing the expenses of long-term care, which can run $25,000 a year or more. The only feasible way that many members formerly could see of financing such a program would be to have the elderly pay part of the costs. But Congress would not propose such a measure now due to protests by the elderly.

It is possible that one narrow area of need among elderly Americans will gain congressional action over the next year or two. That would be a carefully targeted effort to provide financial aid to the poorest among the elderly - the one-eighth of Americans over 65, disproportionately female and minority, who live below the poverty line.