Health Care's Rosty Troubles

May 08, 1994

If House Ways and Means Committee chairman Dan Rostenkowski should be indicted soon for financial irregularities, this would be a grievous blow to President Clinton's top legislative objective: health care reform. While Mr. Rostenkowski did the Clinton cause no good with his assertion April 22 that reform would require tens of billions of dollars in higher taxes on virtually all citizens, he remains a crucial administration player in the fierce health care battle on Capitol Hill.

An indictment, possibly even before Memorial Day, couldn't come at a worse time for reform advocates. The chairman, despite the distractions of his legal troubles, has been energetically communing with members of his committee, trying give them the arguments and psychological boosting they need to support the bill emerging from his panel. Without his support, influence and presence, lawmakers under pressure from small businesses and the medical community might bolt.

Under House rules, Mr. Rostenkowski would have to surrender his chairmanship if he is indicted on charges of misusing congressional and campaign funds. He would be replaced by Rep. Sam Gibbons, D-Fla., who would loyally carry the ball for the administration but is far from expert on the intricacies of health care legislation.

The Ways and Means Committee is expected to approve a bill that would retain some kind of a mandate requiring all employers to offer health insurance to their workers, but it will contain breaks for small business that were missing from the initial administration proposal. It will also have the private sector, rather than government, impose restraints on soaring medical costs. And it will enlarge Medicare as the primary vehicle for providing universal coverage.

Though these provisions substantially moderate the Clinton bill,

more drastic revisions could come in House debate and, even more, during Senate deliberations. Prospects for Clinton-style health reform are dimming by the day. The president may have to settle for incremental changes, holding out hope for eventual universal coverage rather than bold reforms if any legislation at all is to emerge.

Mr. Rostenkowski's remarks about a broad tax increase, which were contrary to White House assurances that only a cigarette tax was needed, came as a bad jolt to health care. If the Chicago congressman should be indicted, the odds will lengthen against legislation designed to define the Clinton presidency.

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