House approves health care bill Flurry of activity in Congress covers welfare, wages, taxes

August 02, 1996|By Karen Hosler | Karen Hosler,SUN NATIONAL STAFF

WASHINGTON -- A bill to expand access to health insurance for millions of Americans won nearly unanimous approval in the House last night even as the Senate completed action on Congress' landmark overhaul of the welfare system.

Legislation to raise the minimum wage and reduce taxes on small businesses, meanwhile, awaited expected approval in both the House and Senate by tomorrow.

All those measures, and several others on the crowded election-season agenda, are headed for certain approval by President Clinton.

The flurry of action, after months of gridlock, came as the Republican-led Congress prepared to adjourn this weekend for a monthlong recess in which the lawmakers will go home to make their cases for re-election. The raft of popular bills expected to win final approval by week's end could help their campaigns.

"Our system worked this week, and that's what Americans want," said Rep. Bill Archer, a Texas Republican who chairs the House Ways and Means Committee.

Republican and Democratic leaders rushed to take credit for the imminent enactment of legislation that had been bottled up for months or years. But the measures were all the result of considerable compromises by both sides.

"This legislation is a genuine bipartisan achievement," said Sen. Edward M. Kennedy, a Massachusetts Democrat, referring specifically to the health insurance bill of which he was a leading sponsor.

The health insurance bill, which allows employees to keep their coverage when they change or lose jobs and which bars insurers from discriminating against people with medical conditions, sailed through the House on a vote of 421 to 2. All eight Maryland delegation members voted in favor of it.

Senate passage expected

Senate approval is expected today for the health care measure, which would also grant new tax benefits for the purchase of health insurance and would provide tax breaks for buying long-term-care insurance.

The bill represents the culmination of four years' work by Clinton and members of both parties to expand the availability of health insurance and to control its cost.

But it is far less ambitious than Clinton's 1993 proposal to replace the entire American health insurance system. The current bill takes only a few small steps toward correcting what is seen as the most glaring deficiency: that nearly 40 million Americans have no health insurance at all.

"We knew you needed to start with a more incremental approach," said Robert H. Michel, the former House Republican leader who appointed a task force in 1991, two years before Clinton's own health care proposal, to try to produce a solution to the insurance crisis.

In the seesaw battle over the health insurance bill in this Congress, the disagreements centered on a Republican-backed provision to create tax-free medical savings accounts for people who buy low-premium, high-deductible insurance policies for catastrophic illnesses.

Critics said medical savings accounts would benefit mostly the healthy and the affluent, at the expense of the poor.

The final compromise bill calls for a four-year pilot test of those medical accounts, involving up to 750,000 policies.

While yesterday's debate on the bill was taken up mostly by those applauding the legislation and claiming credit for it, some Democrats complained that it fell far short of what is needed to make sure all Americans have health insurance coverage. One especially bitter complaint was that House and Senate negotiators dropped a Senate provision that would have assured that health coverage for mental illness would be as generous as coverage for physical ailments.

But Rep. Dennis Hastert, an Illinois Republican, argued that requiring such mental health coverage would "increase insurance costs astronomically." As a result, he warned, premiums would rise for everyone or employers would drop health coverage for their employees entirely.

Welfare system overhaul

In the Senate yesterday, the bill to end the six-decade-old federal guarantee of welfare aid for the poor aroused small but vociferous opposition. The measure passed with a bipartisan majority of 78 in favor, including Maryland Democrat Barbara A. Mikulski.

Though she had "great reservations" about the measure, Mikulski said in a statement: "The alternative is to do nothing, and that is unacceptable."

But 21 senators -- all Democrats -- voted against the bill.

Among the opponents was Paul S. Sarbanes, a Maryland Democrat, who said he was particularly concerned that the measure includes only "a fig leaf" protection against the danger that the need for welfare assistance would swell during a recession.

"There was a 35 percent increase in the number of children in poverty" when the unemployment rate rose to 7.7 percent from 5.3 percent during the Bush administration, Sarbanes said. "That caused a 40 percent increase in welfare payments.

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