The House sponsor of President Clinton's health-care reform package says it may require major surgery to win passage this year.
Majority Leader Richard Gephardt, D-Mo., said Thursday the guts of the plan - mandatory employer payments, mandatory membership in purchasing cooperatives and limits on insurance premium increases - all can be altered or delayed.
But he said such compromises - which could turn the employer mandate and premium cap into options to be used if other means fail - would not compromise Clinton's goals of covering everyone and holding down health-care costs.
"We are interested in the goals being achieved," Gephardt said, not "in all the mechanisms being achieved."
Gephardt's remarks were intended to counter critics' contentions that declining public support has rendered Clinton's plan dead, something the majority leader called "hogwash."
But they also put some meat on the bones of Clinton's pronounced flexibility on all but the key objectives of his 1,342-page proposal.
The president reiterated his stand on CBS Thursday, saying he'll fight for universal coverage "as long as I'm president."
Potential compromises:
-- Delaying the requirement that employers and employees purchase insurance. One idea being considered could push Clinton's goal of universal coverage to the year 2000.
-- Phasing in premium caps only if increased market competition failed to keep costs within prescribed limits.
-- Allowing, rather than requiring, consumers to join purchasing groups designed to ensure rates are competitive.
"I'm not convinced yet that some variant of those mechanisms can't pass," Gephardt said. But he added, "Obviously, you've got to put together different approaches."
The pragmatic analysis follows other developments:
-- Two House panels with initial jurisdiction over health care cannot muster the votes to pass the Clinton plan. One will be passed over; the other will try a new version next week.
-- Republican lawmakers conclude a retreat in Annapolis, Md., today amid indications they are moving further from Clinton's grandiose goals toward less ambitious reforms.
