Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: THURSDAY, August 11, 1994 TAG: 9408110079
SECTION: NATIONAL/INTERNATIONAL PAGE: A-1 EDITION: METRO
SOURCE: Associated Press
DATELINE: WASHINGTON LENGTH: Medium
And the outcome of that vote - expected late this week or early next - could go a long way toward determining the fate of the most ambitious piece of legislation to reach Congress in years.
A show of support would give George Mitchell a big boost in his drive to fashion a Democratic majority behind legislation approaching President Clinton's goal of coverage for all.
In the House, it would strengthen the hand of Democratic leaders who are pushing a straightforward universal coverage bill that requires businesses to pay 80 percent of worker insurance costs. Moderate and conservative Democrats who hold the balance of power ``want to have an answer'' from the Senate ``before people walk the plank over here'' and vote on an unpopular provision, says Rep. Phil Sharp, D-Ind., retiring after 10 terms.
Should Mitchell, the Senate's Democratic leader, lose that early test, it could ultimately cause the White House's monumental election-year reform effort to collapse into more limited measures, including subsidies for the poor and changes in insurance company practices that most lawmakers favor.
With midterm elections just three months distant, and the lobbying intense, the outcome seems uncertain. Democratic senators and aides whisper that the Republicans would push for an early showdown if they could be certain of succeeding.
Republicans say the issue has become overshadowed slightly in the past two days, as the full extent of Mitchell's proposal becomes known. Some of the most prominent critics have been moderates who have spent all year trying to fashion a bipartisan approach.
Turning their attention instead to taxes and government control, Republicans issued a thick document Wednesday entitled ``New Bureaucracies, New Mandates and New Federal Powers.''
It ran to 81 pages, most of them small type.
Mitchell says not all senators have decided how to vote on the core issue of mandatory employer contributions.
In his bill, these provisions would take effect beginning in 2002, but only if the country fell short of 95 percent insurance coverage, and after Congress refused to implement other measures to bring coverage to the remaining uninsured. Even then, Mitchell's plan would have businesses and workers split the cost of insurance 50-50, with small firms as well as companies in states with 95 percent coverage exempt.
A victory on this one test doesn't mean Democrats could be certain of prevailing on health reform.
The obstacles are prodigious - from thorny questions of medical malpractice reform to whether abortion should be part of the government-mandated standard health benefits to the House bill's proposed expansion of Medicare for workers at small firms, for the unemployed and for part-time workers.
In one relatively minor issue, Mitchell's bill creates a trust fund for medical schools and academic health centers, funded with a 1.5 percent tax on insurance premiums. One analysis shows more than 50 percent would go to facilities in eight states. In the Senate, that's an invitation to the other 42 states to try to change the formula.
In the House, leadership allies are heartened by late difficulties encountered by lawmakers attempting to come up with a bipartisan approach. Republicans won't consider tax increases, and Democrats won't agree to spending cuts outside health programs. The result may be a package that falls well short of even the 95 percent target in Mitchell's bill, and forces enough Democrats to swallow hard and vote for the leadership bill.
by CNB