Congress rolls up its sleeves on health care reform

March 09, 1994|By R. A. Zaldivar | R. A. Zaldivar,Knight-Ridder News Service

WASHINGTON -- The health care reform crowd lined a block-long corridor an hour before the bill drafting session. Paid place-holders held spots for high-priced lobbyists.

The wheels of Congress finally began turning on health care reform yesterday as the House Ways and Means subcommittee on health held its first session to draft a bill. At the end of the day, no one quite knew where the lumbering legislative machine was headed.

"It's really interesting," said Cindy Sherwood, a dentist from Augusta, Kan., who had come to lobby her delegation to include dental coverage in any national benefits package. "The process is formidable, but it's slow."

Subcommittee Chairman Pete Stark, D-Calif., a maverick who ditched President Clinton's plan and substituted a simpler proposal to provide insurance for everyone, acknowledged up front that he doesn't yet have the votes.

"Perhaps the best thing I can say about it is that this bill will give everyone something to complain about," Mr. Stark said. "In fact, if there aren't complaints from all sides, I will start thinking about changing the bill."

A staff member began a page-by-page "walk-through" of Mr. Stark's bill. The sound of rustling paper filled the huge Ways and Means hearing room as hundreds of people turned pages in unison. Although the outcome was far from certain, everybody seemed happy to be getting down to business.

"It gets the institutional juices flowing," a lobbyist said. "Other chairmen will be able to say to their committees: 'Look guys, we have to get the process moving.' "

Mr. Stark has about two weeks to find agreement on his panel. He probably needs the votes of five of the six other Democrats on the panel, because none of the four Republicans is likely to go along. The full Ways and Means Committee is expected to begin work in early April, along with two other House panels. Two Senate committees will go to work later.

It's too early to tell whether any of Mr. Stark's plan will survive. Yet some of its main points could have lasting appeal: less bureaucracy than Mr. Clinton's plan and a more affordable benefits package.

"I want a bill I can defend," said Rep. Sander M. Levin, D-Mich. "I want to have a product that's good enough that it doesn't die the minute it leaves the subcommittee."

Like Mr. Clinton's plan, the Stark proposal would guarantee coverage for all and require every employer to pay for its workers' health care coverage. But, unlike the president's proposal, the Stark plan would not oblige people to obtain their coverage through huge insurance purchasing co-ops called health alliances.

The Stark plan would create a new government program -- Medicare Part C -- for low-income people and those now uninsured. Benefits would not be as generous as under Mr. Clinton's proposal. For example, Mr. Stark's plan would not create a new long-term care program.

Mr. Stark would pay for his plan through higher tobacco taxes and an 0.8 percent payroll tax on all employers. His program would provide coverage for all by 1997, a year ahead of Mr. Clinton's.

Among features that could lead to objections to Mr. Stark's plan: government price controls for privately insured patients, having the IRS collect premiums for Medicare Part C, and a formula that would require employers who don't offer insurance now to pay only for employee -- not family -- coverage.

Though Mr. Stark snubbed Mr. Clinton's plan, administration officials were upbeat. "It's really exciting to see the process go forward," said Judith Feder, the top health policy specialist in the Department of Health and Human Services.

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