WASHINGTON -- Promising health-care reform with less government interference, nearly four dozen House Democrats and Republicans yesterday introduced a bipartisan bill that would help most low-income Americans get insurance.
The measure, which the White House immediately criticized, falls short of guaranteeing coverage for all.
The House bill is significant because it is the work of moderates and conservatives whose votes will be pivotal in reshaping the $940 billion health care system, which the government says leaves 37 million people uninsured.
Other comprehensive proposals include President Clinton's plan, a Senate Republican bill drafted by John H. Chafee of Rhode Island and legislation by Rep. Jim McDermott, D-Wash., calling for a government-financed system like Canada's.
"We feel [this] will work better back home and may be the best chance of breaking the partisan gridlock in Washington," said Rep. Jim Cooper of Tennessee, a leader of a group of conservative Democrats and co-author of the bill.
Rep. Fred Grandy, R-Iowa, another co-author, said, "This is not a Democratic bill with Republican support -- this is a true merger."
Although it is not the first bipartisan effort, the Cooper-Grandy bill has attracted the most support. Nineteen Republicans and 27 Democrats signed on to the measure. A companion bill will be introduced later in the Senate.
Based on a health care reform strategy called "managed competition," the Cooper-Grandy bill would create purchasing co-operatives to help small businesses get a better deal on insurance.
Unlike the president's plan, the Cooper-Grandy bill would not require employers to pay a share of their workers' health insurance.
The White House reacted critically to the new legislation, and administration officials said privately that they prefer the Senate Republican bill because it would guarantee health insurance for all.
However, the White House was having problems defending its own plan against charges that requiring employers to provide health insurance would lead to layoffs. Administration officials told reporters yesterday that no one could really say what the job impact would be.
"To give a number is to provide false precision," said Mr. Clinton's chief economic adviser, Laura D'Andrea Tyson.
Ms. Tyson said that the net effect would be "small . . . less than one-half of 1 percent of employment, up or down" -- about 630,000 jobs.
The Cooper-Grandy bill differs from Mr. Clinton's plan in other major ways:
* It would not create a federal long-term care program, provide outpatient prescription drug coverage for Medicare beneficiaries, or have the government assume the health-care costs of people who retire early.
* It would not establish a national budget for health-care spending and would have no mechanism other than market pressure for holding costs in check.
* It would leave the job of establishing a basic benefits package to a national commission.
The bill would abolish the Medicaid program, which serves about 40 percent of the poor, and guarantee coverage for all the poor through the new purchasing co-ops, with the government paying the premiums.
In addition, the government would subsidize some of the premiums for families and individuals with incomes up to twice the poverty level.
The Cooper-Grandy bill, which would cost about $25 billion a year in additional federal spending, would be financed primarily by limiting the tax deduction employers can take for providing health insurance.