Health-Care Reform Bills Bounce Left and Right in Halls of Congress

IT'S been six months since President Clinton sent his health-reform bill to Congress, but it may well feel like years to him.

It is the plan against which others are measured and, as such, has come under constant fire from many major business, insurance, and medical groups.

Now, the Clintons also have Congress to worry about.

The plan is highly respected, but it may look quite different by the time legislators are through with it. Already, a number of its major tenets - such as mandatory alliances, the employer mandate, and the handling of small-business subsidies - are either being stripped away or dramatically altered by the congressional panels that have begun to debate and vote on the bill.

The health subcommittee of the House Ways and Means Committee narrowly approved a cousin to the Clinton plan. The bill was so heavily amended that voting lasted two weeks.

It was a challenge to arrive at a bill that captured both liberal and conservative Democratic votes, said subcommittee chairman Rep. Fortney (Pete) Stark (D) of California. ``My leadership has been stretched to its penultimate limit,'' he said.

That panel approved a plan that retains the employer mandate, makes the alliances voluntary, and covers employees of small companies through a newly created public system. The benefits package of the public system is not as generous as that outlined in the Clinton proposal because ``there just isn't enough money,'' Mr. Stark said, echoing what many in Congress are saying.

Stark's bill will move to the full Ways and Means Committee, but its chairman, Rep. Dan Rostenkowski (D) of Illinois, may put it aside and start with the Clinton plan or his own bill.

The liberal-leaning labor management relations subcommittee of the House Education and Labor Committee, chaired by Rep. Pat Williams (D) of Montana, will soon begin voting on two bills: one a more generous version of the Clinton plan, and the other a single-payer plan.

Like Stark's panel, Mr. Williams's version of the Clinton plan ditches mandatory alliances. It also provides greater subsidies to small businesses than those in the Clinton plan.

As is the case throughout the House, Republican votes are hoped for but not needed. ``We came up with a [bill] that can pass without a single Republican vote,'' Williams said.

The subcommittee also will take up the single-payer, or Canadian-style, plan because its liberal advocates insist on it. There are many single-payer advocates on the full Education and Labor Committee, where the bill will travel next.

The single-payer plan, once considered the underdog of the pack, has pushed forward to become one of the most popular proposals. There is ``significant new support for a single-payer system,'' said sponsor Rep. Jim McDermott (D) of Washington. It has 91 official co-sponsors and ``many more under the surface,'' he said.

The plan would abolish the insurance industry and make the federal government the financier of health coverage by levying higher income taxes. The proposal has strong opposition, however, and may not pass this year.

As a concession to single-payer advocates, Mr. Clinton includes in his plan the option for states to pick up a single-payer system. The Vermont legislature recently voted to support a modified single-payer system. In California, the issue is likely to be put on the November ballot.

In the Senate, meanwhile, Democrats will have to craft versions of the Clinton bill that Republicans can vote for. Here, mandatory alliances are not likely to survive, and the employer mandate could be a fight.

When Senate majority leader George Mitchell (D) of Maine led a health-care-reform retreat with Senate Democrats last weekend, he reportedly presented three cheaper variations on the Clinton plan that would retain the employer mandate but lighten its impact on small businesses.

The Democratic Leadership Council, the conservative wing of the party, prefers a market-driven reform plan called ``managed competition.'' DLC president Al From urged Clinton to compromise with Republicans.

The White House appears to be on an ``all hands alert'' to deflect criticism of its plan and sell it to the Congress and public. It has held more than 80 local health-care events during the recent congressional spring recess.

The Democratic National Committee recently announced that it would begin a multimillion-dollar advertising effort to promote the Clinton plan. ``Those who oppose reform have spent tens of millions of dollars to defeat what the American people want,'' former DNC health chairman Richard Celeste said.

In Baltimore, Hillary Rodham Clinton said: ``There has been a lot of money spent by special interests, and that is a factor in what happens in Congress. But I believe most members will not be influenced.''

According to White House spokeswoman Lorraine McHugh, the administration ``is not negotiating'' with Congress over health reform. Treasury Secretary Lloyd Bentsen, however, said the administration would consider boosting subsidies to small businesses.

T'S been six months since President Clinton sent his health-reform bill to Congress, but it may well feel like years to him.

It is the plan against which others are measured and, as such, has come under constant fire from many major business, insurance, and medical groups.

Now, the Clintons also have Congress to worry about.

The plan is highly respected, but it may look quite different by the time legislators are through with it. Already, a number of its major tenets - such as mandatory alliances, the employer mandate, and the handling of small-business subsidies - are either being stripped away or dramatically altered by the congressional panels that have begun to debate and vote on the bill.

The health subcommittee of the House Ways and Means Committee narrowly approved a cousin to the Clinton plan. The bill was so heavily amended that voting lasted two weeks.

It was a challenge to arrive at a bill that captured both liberal and conservative Democratic votes, said subcommittee chairman Rep. Fortney (Pete) Stark (D) of California. ``My leadership has been stretched to its penultimate limit,'' he said.

That panel approved a plan that retains the employer mandate, makes the alliances voluntary, and covers employees of small companies through a newly created public system. The benefits package of the public system is not as generous as that outlined in the Clinton proposal because ``there just isn't enough money,'' Mr. Stark said, echoing what many in Congress are saying.

Stark's bill will move to the full Ways and Means Committee, but its chairman, Rep. Dan Rostenkowski (D) of Illinois, may put it aside and start with the Clinton plan or his own bill.

The liberal-leaning labor management relations subcommittee of the House Education and Labor Committee, chaired by Rep. Pat Williams (D) of Montana, will soon begin voting on two bills: one a more generous version of the Clinton plan, and the other a single-payer plan.

Like Stark's panel, Mr. Williams's version of the Clinton plan ditches mandatory alliances. It also provides greater subsidies to small businesses than those in the Clinton plan.

As is the case throughout the House, Republican votes are hoped for but not needed. ``We came up with a [bill] that can pass without a single Republican vote,'' Williams said.

The subcommittee also will take up the single-payer, or Canadian-style, plan because its liberal advocates insist on it. There are many single-payer advocates on the full Education and Labor Committee, where the bill will travel next.

The single-payer plan, once considered the underdog of the pack, has pushed forward to become one of the most popular proposals. There is ``significant new support for a single-payer system,'' said sponsor Rep. Jim McDermott (D) of Washington. It has 91 official co-sponsors and ``many more under the surface,'' he said.

The plan would abolish the insurance industry and make the federal government the financier of health coverage by levying higher income taxes. The proposal has strong opposition, however, and may not pass this year.

As a concession to single-payer advocates, Mr. Clinton includes in his plan the option for states to pick up a single-payer system. The Vermont legislature recently voted to support a modified single-payer system. In California, the issue is likely to be put on the November ballot.

In the Senate, meanwhile, Democrats will have to craft versions of the Clinton bill that Republicans can vote for. Here, mandatory alliances are not likely to survive, and the employer mandate could be a fight.

When Senate majority leader George Mitchell (D) of Maine led a health-care-reform retreat with Senate Democrats last weekend, he reportedly presented three cheaper variations on the Clinton plan that would retain the employer mandate but lighten its impact on small businesses.

The Democratic Leadership Council, the conservative wing of the party, prefers a market-driven reform plan called ``managed competition.'' DLC president Al From urged Clinton to compromise with Republicans.

The White House appears to be on an ``all hands alert'' to deflect criticism of its plan and sell it to the Congress and public. It has held more than 80 local health-care events during the recent congressional spring recess.

The Democratic National Committee recently announced that it would begin a multimillion-dollar advertising effort to promote the Clinton plan. ``Those who oppose reform have spent tens of millions of dollars to defeat what the American people want,'' former DNC health chairman Richard Celeste said.

In Baltimore, Hillary Rodham Clinton said: ``There has been a lot of money spent by special interests, and that is a factor in what happens in Congress. But I believe most members will not be influenced.''

According to White House spokeswoman Lorraine McHugh, the administration ``is not negotiating'' with Congress over health reform. Treasury Secretary Lloyd Bentsen, however, said the administration would consider boosting subsidies to small businesses.