Panel Backs Health Bill in Boost to Clinton

WASHINGTON — Giving President Clinton’s health reform effort some badly needed momentum, the Senate Labor and Human Resources Committee on Thursday became the first full committee in Congress to vote for a bill that meets the President’s basic goal of guaranteeing health coverage for everyone.

The outlook elsewhere on Capitol Hill remained muddled, however, as Senate Finance Committee Chairman Daniel Patrick Moynihan (D-N.Y.) presented his committee with a Clinton-like bill that its members promptly said they would rewrite. And in a symbolic gesture a House subcommittee endorsed a government-financed health care system, known as single-payer, that is similar to Canada’s.

In all, five congressional committees--three in the House and two in the Senate--are charged with producing health legislation. The various bills will be melded by the House and Senate leadership into two that they will present to their respective chambers.

All five are running weeks behind schedule. Before the Labor Committee action Thursday, only a subcommittee--the House Ways and Means health subcommittee--had finished its work.

Labor Committee Chairman Edward M. Kennedy (D-Mass.) and his solidly Democratic majority retained, in slightly altered form, both of Clinton’s most controversial provisions--a requirement that most companies pay 80% of the cost of their workers’ health benefits and a mechanism under which the government would control premium costs.

The Kennedy committee bill is somewhat less regulatory than Clinton’s, and abandons its requirement that most Americans be forced to join government-organized health purchasing cooperatives. It also exempts businesses with 10 or fewer workers from the requirement that they purchase health insurance for their employees, although those opting out would be required to pay a payroll tax of as much as 2%.

Kennedy has championed health reform for more than two decades. His committee’s bill also includes richer benefits than Clinton proposed, particularly for women and children. The bill would give everyone the right to join the widely praised health insurance program now available to federal employees, including members of Congress.

Only one Republican, Sen. James M. Jeffords of Vermont, joined the committee Democrats in voting, 11 to 6, for the bill. Although Kennedy had started the two weeks of deliberation with a declaration that he hoped to find significant bipartisan support, it never emerged, except on issues that have been at the periphery of the bitter health care debate.

As his committee prepared to approve the bill, Kennedy said that he has not given up hope of ultimately winning more Republican support before the issue reaches the Senate floor, probably this summer.

“This process is moving,” Kennedy said, noting that votes historically have swung from one side to the other as important legislation, such as that establishing the Medicare system, has neared its final test.

“This is an issue where the American people will want action and demand action and I think politicians will understand that very clearly before they call the roll,” he added.

Republicans insisted, however, that they never could support a bill that includes the so-called employer mandate, which they contend would decimate small business. “The bill will cost hundreds of thousands of jobs with a huge payroll tax, yet fail to achieve any of its goals,” said Minnesota Sen. Dave Durenberger, a moderate Republican who is on both Senate committees with jurisdiction over health care.

The Finance Committee is considered a more crucial testing ground for health care legislation, because its Democratic majority is far more fragile and its membership more representative of the Senate at large.

Moynihan, who repeatedly has expressed his skepticism about the Clinton approach and his belief that any bill needs GOP votes to pass, surprised many on Capitol Hill by producing a bill that hews closely to Clinton’s proposals. He presented a nine-page draft to committee members at a closed session.

Moynihan’s bill includes Clinton’s proposed requirement that companies pay 80% of their workers’ premiums, although it adds a temporary exclusion for firms that employ 20 or fewer. If those smaller firms did not reach specified targets for coverage--97% of their workers by the end of 1998, and 98.5% by the end of the year 2000--the government would order them to provide coverage.

Moynihan also added several taxes. He would raise the cigarette tax, now 24 cents a pack, to $2 a pack--compared with 99 cents under the Clinton plan. His proposal also would boost the excise tax to 50% on handgun ammunition, excluding .22 caliber bullets.

Republicans and conservative Democrats on the Finance Committee declared that it would not survive unless drastically altered.

But all sides said that the important thing was to get a proposal on the table so that negotiations could begin in earnest.

“It’s a beginning. That’s what we need. We need a place to start,” said Sen. Thomas A. Daschle (D-S.D.), a member of the committee.

Meanwhile, on the House side of the Capitol, the Education and Labor Committee’s labor-management relations subcommittee approved legislation that would establish a single-payer system.

The vote had little meaning, however. The same panel had passed a bill similar to Clinton’s last month.

More than 90 House members are on record favoring a single-payer approach, but it appears to have no chance of passing, because it would require a massive tax increase.

Rep. Sam Gibbons (D-Fla.), the new acting chairman of the House Ways and Means Committee, began his first public meeting of the panel by offering a hasty revision of the proposed legislation that was only made public Wednesday.

Gibbons said a recalculation of the costs of the measure required changes in the bill and he blamed the Congressional Budget Office for delaying production of the final figures that will be needed before the committee can begin voting on parts of the bill.

Times staff writer William J. Eaton contributed to this story.