Newspaper article The Christian Science Monitor

Pioneer Plan Offers Lessons Washington State's Health-Care Reforms Run into Political Backlash

Newspaper article The Christian Science Monitor

Pioneer Plan Offers Lessons Washington State's Health-Care Reforms Run into Political Backlash

Article excerpt

THIS is a model health-care plan that is going to be one of the finest things ever to happen to the people of this state," Washington Gov. Mike Lowry (D) tells voters in a town meeting. But, even though the reforms have already been signed into law, the statement is met with groans of "No" from the audience.

Scrambling to recover, Mr. Lowry says the Health Services Act means that people will not be denied insurance because of an existing health problem. The audience applauds.

The seeming ambivalence shows how much people want an upgraded system but how skeptical they are of government doing the job.

This state's experience with health-care reform also holds lessons for the other Washington, where President Clinton is preparing a public-relations blitz to sell a similar package of national reforms.

In May, Lowry and a Democratic-controlled state Legislature passed one of the nation's most radical health-insurance overhauls. The reforms, praised by the White House, fall under the "managed competition" label, in which insurers compete for clients but face more regulation than previously.

The law requires employers to insure all workers and sets up a commission to put a cap on premiums - two measures that members of the Clinton administration would like to see in the president's managed-competition plan when it is unveiled this fall. Plan created an outcry

Claiming a mandate on the issue from fall election victories, lawmakers here enacted the plan despite an outcry from businesses and insurers, who opposed the price cap and the requirement on all employers.

Although Mr. Clinton claims a similar mandate for reform and has a Democratic Congress, he appears to face a longer, tougher fight, says John O'Donnell, health-care-policy director at Buck Consultants, a New York City-based firm. Conservative Democrats and Republicans in Congress are leery of making insurance mandatory or tampering with market forces.

Yet one lesson Mr. O'Donnell draws from Washington State is that "you can't count anything out in politics." Clinton "may have staked his entire presidency on health reform, on his ability to get this program through.... What we're going to see is something very similar to a presidential campaign in terms of the media, the public advertising."

Clinton's plan is likely to offer a framework that states can experiment with and fine-tune.

O'Donnell, who opposes White House aims such as mandatory employer coverage and "global budgets" on the money each state spends on health care, worries that Clinton's campaign could create a groundswell of support by appealing to emotion more than reason. Reforms' future is uncertain

Another lesson from Washington State is that even if sweeping reforms are passed, their future is uncertain. The most visible groundswell of opinion here lately has been support for ballot initiatives that would roll back tax hikes, including ones to fund the health program. …

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