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Cherry Blossoms And Health Care Deals?


Washington Outlook

CHERRY BLOSSOMS--AND HEALTH-CARE DEALS?

Washington's first breath of spring is lifting the spirits of health-care reformers. On Capitol Hill, Democrats are starting to break a six-month freeze on action. And despite Whitewater distractions, the White House sees renewed hope of keeping its principles of reform alive.

The health-care thaw comes at a crucial time. With no momentum behind President Clinton's Health Security Act, Congress risked diddling away the year without acting. But after months of closed-door meetings with worried Democrats, key committee chairmen think they have the makings of compromises that will at least get legislation moving.

The first sign of progress came on Mar. 21, when House Energy & Commerce Committee Chairman John D. Dingell (D-Mich.) floated an outline of his version. Dingell would address three of the most troublesome provisions of the Clinton bill: the impact on small business, the mandatory "health alliance" purchasing pools, and the Congressional Budget Office's estimate that the funding is $79 billion short of requirements. In Dingell's version, the cost to the small- est businesses would be limited to 1% of payrolls--down from a 3.5% cap in Clinton's bill--and alliances would be voluntary. He would also trim the cost by making patients pay a larger share of medical bills. "It's not enormously different from what we proposed," says an Administration official of Dingell's draft. "It represents progress."

TO THE HUSTINGS. House Ways & Means Committee Chairman Dan Rostenkowski (D-Ill.) may be readying a breakthrough, too. Storming back to Washington after his Mar. 15 primary victory, Rostenkowski assembled a list of trade-offs needed to win 20 votes among his 24 Democratic members. "Rosty could have a draft ready to shop around within two weeks," says a lobbyist. Rostenkowski's plan won't resemble the Medicare-based version drafted by Ways & Means health subcommittee Chairman Pete Stark (D-Calif.). But it could have higher employer costs and stiffer price controls than Dingell's.

The chairmen aren't sure their compromises will win over conservative Democrats, who hold the balance of power. "There's still too much government: government mandates, government running the system," complains Energy & Commerce member W.J. (Billy) Tauzin (D-La.).

For the next two weeks, however, the battleground shifts from the Hill to the hustings, as Congress takes a break for Easter. Since the Clinton bill was introduced last fall, it has lost momentum during every recess. Lawmakers' election-year town meetings have been dominated by constituents opposed to the package--or just confused by it.

Clintonites hope to improve their record during the spring break. An all-out sales pitch will send virtually every member of the Cabinet into districts of such swing members as Representatives Jim Slattery (D-Kan.) and Lynn Schenk (D-Calif.). Allies in the Health Care Reform Project, a coalition of labor and consumer groups, are recruiting members to bombard meetings and call-in shows with pro-reform messages.

Aides are pressing Clinton to strip down his pitch to its essentials: Reform will produce a Health Security card that promises guaranteed, affordable insurance. When the President stresses those big themes, support for his plan rises. But big themes aren't enough, warns John C. Rother of the American Association of Retired Persons. "People want to know: 'What does this give me, and what does it cost?'" he says.

The same questions have stalled Congress for months. But with the Hill logjam finally breaking, some answers may soon emerge.EDITED BY STEPHEN H. WILDSTROM Mike McNamee and Susan B. Garland


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