Democrats in the House Face Off on Health Plan

Calling it ``the people's bill,'' House Democratic Leaders unveiled their party's ambitious health-reform proposal Friday, but a core group of conservative Democrats have yet another plan in mind.

Like President and Hillary Rodham Clinton's bill, the leadership proposal includes a requirement that most employers pay 80 percent of their workers' insurance premiums by 1999. Coupled with other provisions, this would guarantee health-insurance coverage to nearly everyone.

The bill also places restraints on the insurance industry and creates a new, government-run program called Medicare Part C, to insure the poor, the unemployed, and others who have fallen through the cracks of the current system. Part C would be paid for through controls on Medicare and Medicaid spending, a 45 cent tax increase on tobacco, and a 2 percent tax on private health insurance plans.

The Democratic leaders, still smarting from attacks on the Clinton plan by Republicans and conservative Democrats, insisted that their bill is different. ``It is less bureaucratic and has no automatic price controls,'' majority leader Richard Gephardt of Missouri said.

``We believe it is the people's bill,'' he said.

The employer mandate would cost employers from 42 cents to $1.26 per hour per employee. ``It is not unlike a minimum wage increase,'' which would not be imposed in the near future if an employer mandate is adopted, Congressman Gephardt said.

``This bill is more than about who has the votes and who doesn't,'' Gephardt said. It is a bill that the American people want, he said.

While many of the House's 258 Democrats appear ready to back this bill, a small but important number - about 50 - are not. These conservative Democrats, along with about 50 moderate Republicans, are bucking the leadership and want to bring their own less ambitious bill to the floor.

The bill the group is drafting would reform the insurance market, reform the malpractice system, and expand coverage to some of the uninsured, but not all. More important is what isn't in this bill - ``mandates, premium caps, or price controls,'' members say in a letter to Gephardt demanding floor time for their plan.

An employer mandate ``would mean significant job loss,'' said Democrat Jim Cooper of Tennessee, who, along with Rep. J. Roy Rowland (D) of Georgia and Republicans Fred Grandy of Iowa and Michael Bilirakis of Florida, are leading the group.

Mr. Cooper also may argue for the group's bill to prevent states from enacting a single-payer health care plan, a plan he calls a ``government takeover of health care.''

If they numbered under 40, these Democrats would not be the Achilles heel that they have come to be. Without their loyalty, however, the leadership will not have the 218 votes necessary to pass their bill. The majority's strategy seems to be to try to punch holes in the Cooper group's plan.

``The compromise plans are called that because they compromise your health,'' Gephardt said, adding that just reforming the insurance market will not reduce costs.

At the moment, the Cooper group's bill represents a small island of bipartisanship in the House. Its significance may swell, however, if the Senate passes a bill that does not include an employer mandate - which appears likely.

Senate majority leader George Mitchell (D) of Maine, one of 56 Senate Democrats, must compromise with the 44 Senate Republicans or face defeat. To these Senate Republicans, this means incremental reforms - and no employer mandate.

It is likely that the Senate will vote on Senator Mitchell's bill before the House takes up its bill, Gephardt said. -PATHNAME- /usr/local/etc/httpd/plweb/DBGROUPS/paper/database/tape/94/aug/day02/01042.