HEALTH ACTION MAY BE NEAR Moderate senators offer new plan


WASHINGTON -- New hope for Senate agreement on health care reform was offered yesterday by a bipartisan group of moderates who are developing a plan to require individuals, rather than employers, to buy insurance.

The group, led by Sen. John H. Chafee, a Rhode Island Republican, plans to unveil its compromise proposal tomorrow before the Senate Finance Committee. Other legislators on the deadlocked panel hope that the Chafee plan will provide a basis for formal committee action beginning next week.

"We are reaching some conclusions," Mr. Chafee said yesterday as he and eight centrist colleagues -- most of whom serve on the Finance Committee -- tried to iron out points of contention.

"It is tough."

The new plan falls short of President Clinton's insistence on guaranteed health insurance for all Americans. The Chafee group tentatively decided yesterday to set a goal of 95 percent coverage by 2002. About 85 percent of Americans now have health insurance.

The increase in the percentage of people covered under the Chafee plan is expected to result mostly from cost savings prompted by increased competition and from market reforms that should make health insurance more available.

If the coverage goal of the Chafee group is not reached by the target year, those who lack insurance would be required to buy at least a minimum policy covering catastrophic illness or injuries. Low-income people would be eligible for federal subsidies to buy insurance.

Unlike Mr. Clinton's plan, which would require employers to pay 80 percent of the cost of health insurance premiums for their workers, the new proposal would not put any burden on employers.

Mr. Chafee's staff drafted the new proposal last weekend, and the centrist members have been hashing through it ever since.

The Finance Committee chairman, Sen. Daniel Patrick Moynihan, who on Tuesday had suspended formal debate on health care legislation until next month because he lacked cost estimates necessary to proceed, announced yesterday that he would begin the process Monday. There is no still no consensus in the committee on a health care proposal, Mr. Moynihan said, but the Chafee group's proposal is expected to serve as a starting point.

Mrs. Clinton's hopes

Hillary Rodham Clinton, who came to the Capitol yesterday to light a fire under the dispirited Senate Democrats, declined to comment on the details of the centrist plan. "I am encouraged by what I hear is substantive discussion going on," the first lady told reporters. But in the closed meeting with Democrats, she reportedly urged them to hold the line on Mr. Clinton's demand for universal coverage.

The most encouraging development for the Clinton health care reform drive is that the centrist proposal could bring on board three moderate Republicans who hold swing votes on the health care issue this year: Mr. Chafee, John C. Danforth of Missouri and Dave Durenberger of Minnesota.

There aren't enough Democrats in the Senate to block a #F filibuster if conservative Republicans try to block a health bill. Only one Senate Republican, James M. Jeffords of Vermont, supports a version of the Clinton plan.

The centrist group also includes pivotal Democratic members: Bill Bradley of New Jersey, David Boren of Oklahoma, Kent Conrad of North Dakota, Max Baucus of Montana and Bob Kerrey of Nebraska.

Co-captain of the coalition is Sen. John B. Breaux, a Louisiana Democrat who has been meeting with Mr. Chafee since last fall, in the belief that only moderates would be able to navigate a health care reform bill through the Senate.

Their work sped up in the past week after Mr. Moynihan told Mr. Clinton that he could not get a Clinton-style bill through the Finance Committee because it required employers to buy health insurance.

Packwood's warning

Bob Packwood of Oregon, the senior Republican on the Finance Committee, said yesterday that he might be willing to support the centrist proposal. But he warned that if other Democrats on the committee insisting on taking a partisan line, he and Senate Republican leader Bob Dole of Kansas would back only a package of modest changes in the health care system when the committee debate begins Monday. That represents the GOP party-line position backed by conservatives.

Technically, the Senate does not need a bill from the Finance Committee to act on health care. A Clinton-like proposal has already been approved by the Labor and Human Resources panel. But action in the Finance Committee is considered a more accurate barometer of what kind of legislation has a chance to win full Senate approval.

The change in atmosphere yesterday was dramatic compared with the doldrums the day before.

"I'm frankly kind of pleasantly surprised that it's all beginning thappen," said Sen. David Pryor, an Arkansas Democrat who serves on the Finance Committee and is a close friend of the president. "When this place gets ready to do something, it does it. We're not quite there yet, but we're getting close."

Mr. Chafee still struggled yesterday to win agreement from his group for imposing a heavy tax on high-cost insurance plans. The tax, also proposed by Mr. Bradley, is intended to serve two purposes: to raise money to subsidize insurance for the poor, and to help control costs by discouraging insurance companies from offering high-priced plans.

Senator Baucus complained that plan amounted to "taxing the middle class to pay for the poor."

Who would pay?

The great frustration of the health care reform debate is that while everyone agrees on Mr. Clinton's goal of guaranteed health care for all, many legislators are unwilling to take the difficult steps required to pay for it.

"It is tough, even if you get people of simpatico minds and theyou get one saying, 'Well, I just can't go along with any kind of a tax,' " Mr. Chafee said. Others, he added, say that if employees are obliged to do something, employers should be as well.

In the House, Rep. Sam M. Gibbons, a Florida Democrat who is chairman of the Ways and Means Committee, began yesterday's session by chastising members for working too slowly as they wade through their version of health care reform.

Committee Democrats and moderate Republicans then moved with dispatch, though, to block efforts by conservatives to limit abortion coverage. That battle is expected to be joined later on the House floor, where conservatives in both parties have

greater numbers.

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