WASHINGTON -- When seven of the most powerful women in Washington got together for the first time yesterday, Sen. Barbara A. Mikulski joked to Hillary Rodham Clinton about how much things have changed.
"I said that if we met this time last year, Sen. [Nancy] Kassebaum and I, we would have had enough room to meet in a telephone both and send out for lunch," said Ms. Mikulski, a Maryland Democrat.
Until last fall's election, there were but two women senators, Ms. Mikulski and Ms. Kassebaum, a Kansas Republican. Now there are six, and yesterday they joined a first lady who is leading an administration task force on health care reform and is radically changing the role of a president's spouse.
They met in a room of the Capitol, and over tea, coffee and cookies talked about health care, particularly women's health care. An issue of long-standing concern to Ms. Mikulski, it will almost certainly receive more attention than in the past with Mrs. Clinton in the White House and more women in the Senate.
After their 50-minute meeting, Ms. Mikulski said the "needs of women" must be addressed in the "core benefits package" the administration wants every American to have. She said that "in the past, health insurance was viewed as gender neutral -- which meant that women were excluded."
In a letter she sent to Mrs. Clinton on Wednesday, Ms. Mikulski said "any basic benefit package must" cover "the full range of family planning, pregnancy-related care, contraceptive drugs and devices."
She said "fertility services, abortion and screening for mammography and osteoporosis" also should be covered.
Although President Clinton supports abortion rights, he has not said whether abortion procedures should be covered in a medical benefits package Americans would get from their employers or from a government-subsidized program.
Mrs. Clinton was not asked about the abortion issue yesterday.
She did, however, comment on a judge's decision Wednesday that placed some restrictions on the ability of the task force to meet in secret. Portraying the decision as a victory, she said, "the judge really gave his stamp of approval."
"The task force has always planned to have a public meeting, to take information from the public," she said, referring narrowly to the Cabinet officials and other top administration officials appointed by the president.
But she made clear that there would not be open meetings of the more than 400 task force staff members, who are laying the groundwork for the decisions the president will make.
Asked about taxes that might be needed to finance health reform, she said, "The president has made it clear that there will not be any general middle-income tax increase to pay for the kind of reform he thinks is necessary.
"Because he has pointed out repeatedly over the last few years that our country already spends 30 percent more money on our health care system than any other country and we don't even cover every American."
"So there are literally billions of dollars in our current system, which is now costing us about $935 billion, that can be utilized differently. And that is the first task we've been assigned.
"How can we get the savings that would come from standardizing forms, eliminating paperwork, from not making every hospital in every community buy its own MRI," she said, referring to the costly magnetic resonance imaging machines used to make diagnoses.
In an interview yesterday with a group of Florida reporters, Mrs. Clinton attacked insurance companies that try to boost profits by covering only healthy people.
Such insurers, she said, "should get out of the insurance business, as far as we're concerned, and let other people get in who want to insure people the old-fashioned way, by making a little bit of money on a whole lot of people."
She also observed that some in the health industry are making more money even as the cost of care rises out of the reach of people.
"You have hospitals in many parts of the country who were actually serving fewer patients than last year but making more money doing it," she said. "Doctors' incomes doubled in the last seven years in this country."