Clinton may settle on health

August 27, 1994|By Karen Hosler and Carl M. Cannon | Karen Hosler and Carl M. Cannon,Washington Bureau of The Sun

WASHINGTON -- President Clinton would sign a health care bill that makes only modest changes, despite his earlier threat to veto any legislation that fails to guarantee health care coverage for all Americans, White House Chief of Staff Leon E. Panetta hinted yesterday.

Mr. Panetta stressed that the president would not participate in a charade by Congress to enact a halfway measure and try to pass it off as "broad health care reform."

But if lawmakers produce legislation that claims to be no more than a "minimal approach to health care, obviously that's a whole different ballgame," Mr. Panetta told a luncheon gathering of reporters. "The president would look at it."

Coming at a time when prospects for the sort of sweeping reform legislation President Clinton once envisioned now seem doomed by lack of time on the congressional clock, the White House staff chief's remarks were a clear signal that Mr. Clinton would settle for much less.

Further, Mr. Panetta's comments offered encouragement to lawmakers already working informally to find some means to salvage nearly two years of effort at overhauling the nation's health care system and prevent a political fiasco in November for the Democrats.

Mr. Panetta's message is also being conveyed privately by close Clinton allies on Capitol Hill, who say the president is now willing to acknowledge that he may have tried to accomplish too much too fast and would not take an all-or-nothing stance.

In fact, House Speaker Thomas S. Foley, a Washington state Democrat, and other congressional leaders have been helping Mr. Clinton ease into this minimalist position by acknowledging earlier this week that they cannot produce the votes for a more sweeping effort.

The Senate's failure to act on health care reform before it left town Thursday night for a two-week recess was the equivalent of a neon sign announcing that Clinton-style health reform is dead for the year.

House members, who had already given up for the summer on trying to pass a version of the Clinton bill and left last weekend, had planned to return to Washington on Sept. 8 for a three-day weekend marathon session if progress had been made in the Senate.

Now, neither body is scheduled to return until Sept. 12 for a three-day week abbreviated by the Jewish holiday of Yom Kippur. As a practical matter, no serious legislative work can begin on either the House or Senate floor until Sept. 19, leaving only seven weeks until the November midterm elections.

Mr. Panetta noted that the administration is still hopeful that talks between Senate Majority Leader George J. Mitchell and a bipartisan group of Senate moderates led by John H. Chafee, a Rhode Island Republican, and John B. Breaux, a Louisiana Democrat, can produce a genuine reform bill.

But Mr. Mitchell said yesterday that such a compromise would not result in a bill that meets Mr. Clinton's goal of extending health insurance to the 37 million Americans who are not covered today.

"It clearly will not be a bill as comprehensive as I would prefer, but there's much that can be done that would represent #F progress," Mr. Mitchell said yesterday before meeting with leaders of the so-called "mainstream" group, which is pushing a modest package of subsidies and insurance reforms.

The "mainstream" proposal itself seems unlikely to provide the basis for a reform bill because it is widely opposed by advocacy groups on both the left and the right.

The new White House test for acceptable legislation appears to include two criteria: It must result in real progress without causing harm. And it must pave the way toward future improvements.

Rep. Benjamin L. Cardin, a Baltimore Democrat who has been active in the health care debate and is a strong supporter of comprehensive reform, said he has been working with senators and House members on a fallback proposal he thinks would meet that test.

But it's not as easy as it sounds, he said, because even small steps such as banning insurance discrimination against people with pre-existing medical conditions could have the effect of driving up premiums on the young and healthy, who could then be forced out of the system. So insurance reforms without a mandate requiring employer-paid universal coverage would have to be very limited and phased-in to avoid major upheaval, Mr. Cardin said.

A more central feature of Mr. Cardin's proposal will be to provide incentives to states to advance their own health care reforms, as Maryland and many other states are already doing. Those incentives might include relief from some federal regulation, and changes in the Medicare and Medicaid programs, which are jointly run by the states and the federal government, he said.

Mr. Cardin predicted that even these limited approaches would draw fire from Republican leaders, who will try to make political hay out of reminding voters that President Clinton waved his veto pen at Congress last winter in a challenge he has apparently lost.

"But we'll get some Republicans," he added. "I'm sure there's going to be a bill of some kind."

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