Capitol Hill Split over Health-Care Bills Key Subcommittee Takes Up One Proposed Plan, Though Not the President's, While Both Parties Scramble to Find Consensus

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SPARKS are flying this week in a House health subcommittee that is debating one plan to reform the nation's health system.

Despite the proximity of this vote - the first one on health reform - Republican lawmakers, like Democrats, are divided over the issue. "We're not there yet," said Senate minority leader Bob Dole (R) of Kansas.

Although in the minority, Republicans are flexing their political muscle. They have helped shift the entire health-reform debate by being vocal critics of some of the main tenets of President Clinton's health-reform plan. Support among Democrats for these aspects - some of which are also contained in a bill introduced by Rep. Jim Cooper (D) of Tennesee - has weakened in the last few weeks.

Falling fast is Mr. Clinton's backup plan to use price controls to bring down costs, his requirement that employers pay 80 percent of the cost of health care for workers, and the mandate that people buy health coverage as a group, based on where they live.

"Everyone recognizes the president's plan is, I won't say, dead, but certainly on life support," said Rep. Richard Armey (R) of Texas, chairman of the House Republican Conference. Control vs. freedom

Mr. Armey said he hopes the Clinton plan will drop out of the center of the debate, leaving the major Republican plan to square off with the single-payer plan, in which government would raise taxes to pay for health care. "This debate, at bottom, has really always been about bureaucratic control versus individual freedom," Armey said.

In the House, where Democrats dominate by a wide margin, it will, nevertheless, be virtually impossible for the Republicans to pass a plan on health reform.

The Senate, however, with 56 Democrats and 44 Republicans, is where the real fight - and possible compromise - will take place. Most are relieved that Senate committees are not expected to begin voting on health reform until at least the late spring.

While generally allied in their opposition to the Clinton bill, Republicans do not have agreement on a plan within their own ranks. They are no less solid than the Democrats, whose plans also are all over the map.

"No doubt, everybody will remain as loyal as possible to their product for as long as possible," Armey said.

"The middle ground exists. We've chosen to ignore it {for now}," a Republican aide said. Seeking consensus

In hopes of moving the party closer to consensus, Sen. John Chafee (R) of Rhode Island organized a two-day Republican retreat in Annapolis, Md., early this month. No compromise occurred. "There was a fair amount of discussion but not a single proposal," a Republican aide noted.

The Republican Party is particularly challenged by the health-reform issue. Traditionally, it has opposed government intervention as a solution to economic or social problems. "Whenever the government gets involved, costs go way beyond what you originally anticipated. You have to be terribly cautious," said Mr. Chafee, considered a moderate Republican.

Some of the broad issues that divide Republicans include whether people should be required to buy coverage and whether benefits should be mandated by the government and what they should include. Another concerns coverage for the poor - if it should be mandated, how it would be paid for, and when the coverage would begin.

"Abortion is likely to surface after an approach is agreed upon," said Chafee aide Doug Sloane.

The Chafee plan is considered the most liberal of the Republican plans because it contains an individual mandate and would eventually cover the poor; the Gramm bill is viewed as the most conservative, the Michel bill, the most moderate. …


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