Republicans Seek to Be Included In Crafting Health-Care Reform

GOP lawmakers aim to avoid looking simply obstructionist on an issue with broad support

THE word of the day is bipartisanship.

That's Washingtonese for Republicans and Democrats on their best behavior, particularly after the bruising budget battle, as the Clinton administration gears up to present its proposal for health-care reform.

Even Sen. Robert Dole (R) of Kansas, not one to go lightly on Democrats, was conciliatory in a speech Tuesday at the National Governors' Association conference in Tulsa, Okla. Though Republicans oppose President Clinton's plan to require employers to provide health insurance for employees, Senator Dole indicated his party's willingness to deal on the issue. (Business opposition to mandates, Page 2.)

"Employer mandates would damage the economy and hurt those who need help the most - new hires, small businesses, and low-income workers," Dole said. "Certainly we're going to talk to the president about any issue. We have flexibility if the president has flexibility."

Dole also said that an Aug. 3 letter to Mr. Clinton signed by 41 of the Senate's 44 Republicans was changed to soften its opposition to employer mandates. Originally the letter said that "under no circumstances" would they accept such mandates. The letter as sent said they were "strongly opposed" to mandates.

The spirit of bipartisanship is not just a political nicety, it's essential. The Democrats' ability to eke out a budget victory on Democratic votes alone was possible only because a filibuster wasn't allowed.

But beyond that, health-care reform is just too important for Republicans not to play a role. Americans care deeply about the issue, and Republicans need to show they are engaged. The health-care industry accounts for 14 percent of the American economy; reining in the costs of Medicare and Medicaid is key to controlling the budget deficit.

"This is the most significant legislation since Social Security," says Ed Quinlan, spokesman for Sen. John Chafee (R) of Rhode Island, head of the Senate Republican Health Care Task Force.

Senator Chafee, one of the Senate's more liberal Republicans, is putting together a package that can be introduced when Clinton presents his next month. Indications are that the Chafee plan will bear some resemblance to Clinton's. Both are heading toward establishment of insurance-buying cooperatives, and both aim to cover every citizen.

Republicans differ with Democrats on employer mandates and on the establishment of ceilings to control costs. But, unlike on the budget plan, the White House has kept in close touch with Chafee's task force.

Mr. Quinlan says Chafee has met six times with Hillary Rodham Clinton, head of the president's task force, and has met with Ira Magaziner, a top Clinton adviser on health care.

From the perspective of a small faction of Republican senators who have their own plan - to introduce "medical IRAs" or savings accounts that provide an incentive to cut costs - Chafee's plan is moving in parallel to Clinton's, only slower. When the time comes, Clinton will shop for votes from among the 24 Senate Republicans who signed the task force's seven-page statement of principles issued Aug. 6.

Among House Republicans, Clinton's job will be harder. The House Republican plan, organized by House minority leader Robert Michel of Illinois, is not expected to include universal coverage. And House members will have a harder time imposing taxes to pay for the plan. So far, Clinton has said cost-saving measures in the early going will help pay for the cost of covering all Americans; the administration is also considering higher taxes on cigarettes and liquor to pay for long-term care for the elderly.

Last week Representative Michel said his plan would include no new taxes.

"If the Democrats go the course of new taxes, partisanship will remain," says Joe Isaacs, president of the National Health Council.

At Tulsa, partisan sentiment has at times broken through the surface. Republicans were put out when Democratic governors held a private meeting with Mr. Magaziner. A White House spokesman said that if Republican governors invited Magaziner to a meeting, he's sure Magaziner would oblige.

Republicans have also complained that the administration circulated its briefing book on health-care reform to Democratic members of Congress only. The White House spokesman says that was just the first run of copies, and that Republicans will be getting theirs soon.

In an Aug. 16 statement, Republican National Committee chairman Haley Barbour warned against the Democrats' starting a "phony debate" between Clinton's plan and doing nothing. But while the Democrats have revived a "war room" on health care to issue rapid responses to criticism, Republicans have yet to set up an analogous operation.

"We want to be bipartisan," said a Republican spokeswoman.