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On eve of holiday recess, Senate panel slaps together weak health reform bill


WASHINGTON -- Senate Democratic leaders, determined to complete Finance Committee work on President Clinton's health care overhaul before the July 4th recess, were trying to jam a hastily crafted version through so fast last night that the senators barely had time to see it.

Despite protests from Republicans, the committee action will end nine months of preliminary work in both the House and Senate on Mr. Clinton's sweeping proposal and set the stage for floor votes on the legislation later this summer.

The Finance Committee version -- expected to be voted on this afternoon -- is based largely on a bipartisan compromise reached by a small group of moderate senators.

Mr. Clinton's controversial proposal to require employers to buy health insurance for their workers has been eliminated, and his ,, goal of insurance for all Americans is not guaranteed.

Instead, the Finance Committee measure depends largely on greater competition in the marketplace and subsidies for low-income people to bridge the gap that has left 15 percent of Americans without insurance.

Of the four House and Senate committees that have acted on Mr. Clinton's proposal, the Finance Committee took the most conservative approach.

But the White House was sure to rejoice at the bill's passage, because it provides momentum to a legislative process that just a week ago seemed stalled.

President Clinton expects to get a proposal more to his liking when the Finance Committee measure is merged with a separate bill passed by the Labor and Human Resources Committee. The latter bill more closely resembles Mr. Clinton's original legislation.

"We can make history in the month ahead if we listen to the American people," Mr. Clinton wrote yesterday to members of the House in a pitch for their votes on health care reform.

Mr. Clinton was elated Thursday after the House Ways and Means Committee gave his reform program a huge boost by endorsing all its major elements, including the requirement that employers provide health insurance for their workers.

Sen. Bob Dole of Kansas, the Senate Republican leader, is expected to fiercely oppose the health care reform proposal later this summer when it reaches the Senate floor.

Mr. Dole complained yesterday that the Finance Committee was being asked to act too quickly.

Committee aides were cobbling together a draft proposal that didn't reach the senators until early yesterday evening. No cost estimates will be available for at least two weeks.

"We're being asked to ignore our responsibilities because somebody wants to get [the bill] out before the July 4 recess," said Mr. Dole, charging that the bill before the panel would add $200 billion in new taxes.

Sen. John B. Breaux, D-La., countered that the panel had had months of debates, hearings and private discussions on the issues.

The committee plan drops Mr. Clinton's proposal to require employers to pay 80 percent of their workers' coverage by 1998.

Instead, the bill creates a commission to recommend steps Congress should take if market reforms and insurance law changes fail to expanded health insurance coverage to 95 percent of Americans by 2002. Congress would have to act on the recommendations.

The Finance Committee bill also eliminates Mr. Clinton's proposal to cap insurance premiums as a way to control costs.

The substitute cost control measure in the Finance bill is a tax on the most expensive insurance policies, intended to encourage insurers to lower their costs.

During its session yesterday, the committee also voted 13-7 to drop a 1 percent payroll tax on companies with more than 500 employers that was intended to help subsidize insurance for low-income people.

The payroll tax was expected to raise $100 million over 10 years, but Sen. Orrin G. Hatch, R-Utah, warned that it would lead to layoffs.

Much of the committee debate last night focused on abortion, a sleeper issue that many fear has the potential to torpedo the entire health care reform effort.

The panel narrowly defeated an attempt to exclude abortion coverage from the standard benefit package available to everyone.

But it affirmed states' rights to set limitations such as waiting periods or requirements for parental consent.

The committee also wrote into the bill a stipulation that health insurance plans do not have to provide abortion facilities in states where they do not already exist.

In other votes yesterday, the committee:

* Approved a $1 per pack increase in the federal cigarette tax, which is now 24 cents. Mr. Clinton had proposed a 75 cent per pack increase.

* Endorsed a limit of $250,000 on non-economic damages in medical malpractice cases. In current law, there is no limit. Mr. Clinton proposed no change.

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