Health-Insurance Politics

THE health-insurance bill that passed the Senate 100 to 0 Tuesday is an attempt to find a lowest-common-denominator approach that everyone can agree on. The insurance industry and small business, which could not abide President Clinton's far more sweeping proposals, can live with it. Even so, it faces serious hurdles before it becomes law.

Sponsored by Sens. Nancy Kassebaum (R) of Kansas and Edward Kennedy (D) of Massachusetts, the measure would guarantee that most people in employer-sponsored health plans could obtain insurance after switching jobs without being denied because of their health problems. It also bars health plans from limiting or denying coverage for more than a year for health problems diagnosed or treated in the previous six months.

Among the hurdles:

*The Senate plan mandates that health plans provide coverage for mental illness equal to that for physical illness. Insurers and business are adamantly opposed to the idea, which the Congressional Budget Office estimates would increase health costs "by tens of billions of dollars."

*The House has passed a broader bill that includes provisions for tax-exempt medical savings accounts and limits to damage awards in medical- malpractice cases. Clinton and many Democrats oppose both, and the White House has threatened to veto any bill containing either provision. House majority leader Richard Armey insists the final bill should contain both; he has a strong ally in Senate majority leader Bob Dole.

*Meanwhile, an underground anonymous fax and e-mail campaign insists that the bill would outlaw alternative or holistic treatments and threaten their practitioners with prison terms. Neither the House nor the Senate bill would do anything of the kind.

Both Republicans and Democrats would like to take credit for doing something to address Americans' health-care concerns in an election year. But unless the House accepts the Senate bill as written, or the president caves on medical savings accounts, it appears that another stalemate is shaping up. The record of the last few months would indicate that the president won't give in and that if the sides can't agree, the Republicans will take the rap. President Clinton can be expected to milk that for all it's worth.

Unless House Republicans or the president gives in, another stalemate may be shaping up.