The idea of requiring employers to pay 80% of workers' health insurance survived its first test in Congress Tuesday in the initial votes on health reform.
If the legislative process is akin to making sausage, the House Ways and Means health subcommittee's action signified the grinding has begun.
For President Clinton and his vision of health-care reform, it was not a pretty sight: Killer amendments from the political left and right had to be deflected by a majority of the 11-member panel. And more will come as the process continues for days.
But coming six months after his plan was unveiled, the sound of roll calls came as something of a relief.
The votes came on a simplified version of Clinton's plan to expand coverage and contain costs proposed by Rep. Fortney "Pete" Stark, D-Calif., subcommittee chairman. Stark's plan would expand Medicare to cover tens of millions without health insurance.
The most-watched vote was on employer mandates, vehemently opposed by small businesses as a threat to jobs and wages. It passed 6-5, with Rep. Michael Andrews, D-Texas, joining four Republicans in opposition. The six supportive Democrats must hang together if a package is to emerge from the panel.
That's likely only if small business gets a break, such as subsidies proposed by Clinton or putting two-earner couples into one employer's plan.
Only two amendments to the Stark plan passed. One would make employers responsible for the costs of providing family coverage. The other would clarify that their 80% share would be based on the lowest-cost plan they offer, if it includes a choice of doctors.
Also Tuesday:
-- First lady Hillary Rodham Clinton, in St. Louis, faced questions from university students about who will foot the bill, but drew approving nods from senior citizens about the plan's cap on prescription costs.
-- The Jackson Hole Group, the academics who kindled interest in "managed competition" as a way to hold down costs, is changing its position on how to achieve reform. The group is backing down from its support of employer mandates, suggesting the requirement be put on hold until 2002 to see if alternatives encourage consumers to save.
Alain Enthoven, father of the managed competition approach to health reform, told the Senate Finance Committee: "Employer-paid health insurance is a myth. Any mandate on employers would be shifted to employees through reduced wages or loss of jobs."
-- President Clinton, in an interview in this week's TV Guide, said he's frustrated he can't fight opponents with TV ads. "We don't have any money," he said. Clinton said his opponents are spending big. The Health Care Reform Project is spending $ 1 million on ads backing Clinton. The insurance industry has spent more than $ 14 million on ads opposing the plan.
