Health care reform begins to fizzle

August 24, 1994|By Karen Hosler | Karen Hosler,Washington Bureau of The Sun

WASHINGTON -- Democratic congressional leaders tacitly acknowledged yesterday that it will probably be impossible to achieve President Clinton's goal of sweeping health care reform this year and said that they would settle for only modest improvements.

With no consensus in either the House or Senate for a Clinton-style overhaul and with time running out, Democratic leaders appear to be setting the stage for an alternative strategy.

Instead of insisting on Mr. Clinton's universal coverage, the leaders are discussing smaller steps to allow the president and Congress to claim some progress -- without the major changes that have aroused opposition among special interests and wariness among voters.

House Speaker Thomas S. Foley, D-Wash., told reporters yesterday that his "bottom line" would be "real progress on one or more issues" in the Clinton bill, such as expanding coverage, or adopting cost controls and insurance-market reforms.

"If a bill could be found that deals with one or more of those issues in a significant way and doesn't bar future improvements, I think that would be worth doing," Mr. Foley said.

In the Senate, Thomas A. Daschle, D-S.D., also took a conciliatory tack yesterday. "Let's not be captive of rhetorical goals we've laid down," Mr. Daschle said. "If there are ways to make discernible progress, let's look at them."

An ally of Senate Majority Leader George J. Mitchell, Mr. Daschle has been among the leading advocates of the Maine Democrat's version of the Clinton reform bill.

His conciliatory comments come at a time when the last hope of any major reform this year seems to rest with negotiations under way between the more liberal Mr. Mitchell and a bipartisan group of moderates that last week produced its own health care plan.

Their so-called "mainstream" plan is a much less ambitious effort than the Mitchell proposal. It would expand health insurance coverage to about a third of the 37 million Americans who lack it now, mostly through market reforms and modest subsidies.

If senators in the Mitchell and mainstream groups could agree on a package, they would have enough votes to easily pass a bill and perhaps crack the health care stalemate in the House.

But prospects for such an agreement aren't good. The moderates' proposal has been attacked by most of the dedicated advocates of reform: labor unions and organizations representing the elderly and consumers.

Yet many in that mainstream group of senators will reject any new deal with Mr. Mitchell that moves too far from their goals of controlling costs and cutting the deficit.

Sen. John B. Breaux, a moderate Louisiana Democrat who is active in the negotiations with Senator Mitchell, said yesterday that the best he could say about the prognosis for health care reform this year is: "We are not on life support."

Congress lacks will

Democratic congressional leaders are beginning to publicly acknowledge that Congress lacks the will to overhaul what amounts to one-seventh of the nation's economy.

Public demand for health reform began to dissipate last fall almost as soon as the details of Mr. Clinton's proposal became known and were subject to a barrage of attacks from special-interest groups.

Polls showed that voters supported the goals of the Clinton plan, notably universal coverage and the requirement that employers buy health insurance for their workers. But the same polls also show voters opposing the Clinton plan itself.

Recently, many voters have adopted the refrain sounded by congressional Republicans that the whole effort is too complicated and should be put off for further study.

"I don't think health care reform is, at this juncture, the absolute requirement," Mr. Foley said.

There is no sense among voters, he said, that "this must be done or we're going to burn down the Congress."

Voters fear overhaul

Voters fear a major overhaul of the health care system, said Celinda Lake, a Democratic pollster. But she warned that congressional incumbents of both parties will probably suffer in the midterm elections this fall if no action on health care is taken.

"If Congress fails to act, voters believe 2-to-1 that it will be because of special interests and politics," she said. "That hurts us because voters know Democrats are in charge, but it also hurts the Republicans, too."

"I think the feeling is the voters want us to do something," said Rep. Steny H. Hoyer of Maryland, who chairs the House Democratic Caucus. "They just don't know what it is."

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