Democrats vowed to return next year to work on health reform. So did Republicans.
But whatever is proposed in the next Congress is likely to be a smaller, more conservative approach than bills offered this year.
The last nail was hammered into the health-care reform coffin Monday by retiring Senate Majority Leader George Mitchell, D-Maine. But Mitchell and other Democrats say the fight is not over.
"I believe something will happen inevitably on health-care reform," Mitchell said. "Action is inevitable."
Not wanting to be blamed for the collapse of reform, Republicans said they would work on ways to provide coverage for more Americans, too.
"For all the right reasons, health care didn't make it this year," said Senate Minority Leader Robert Dole, R-Kan. "The American people said, `Go slow. Get it right.' "
But any thought of a sweeping overhaul of the system, like the plan proposed by President Clinton, is dead - and everybody knows it.
And with the prospect that November elections may produce big Republican gains in the House and Senate, creating a more conservative Congress, it's inevitable that all sides will be looking to fix the problems with smaller solutions. Among them:
-- Congress will try to pass rules barring insurance companies from denying coverage to those with pre-existing conditions and guaranteeing that workers keep insurance when they change jobs. That could be opposed by insurers and employers, who say it would cost them money.
-- Democrats will push to get coverage for uninsured children and pregnant women but will have trouble finding the money to pay for it.
-- Conservatives will try to establish tax-free medical savings accounts so consumers are more likely to buy coverage.
-- States are ready to march ahead with their own plans to cut Medicaid costs and find innovative programs to make insurance affordable.
-- Private companies, already trying to hold down rising health costs, are likely to move in increasing numbers to managed-care plans - offering their employees coverage in health maintenance organizations and other networks, with a more limited choice of doctors and a tighter rein on services and budgets.
"It is clear relief is no longer in sight," said Sen. John Rockefeller, D-W.Va. But it "will come eventually."
"The important thing is that there is a bipartisan way to do health-care reform, and if the public says nothing more during this election they ought to say . . . `Come on back here in January and February and do it right,' " said retiring Sen. David Durenberger, R-Minn., a member of the bipartisan coalition that wanted insurance-market reforms and subsidies to help the poor buy insurance.
"American consumers are going to find that there's bad news in the months and years ahead as many of the problems with our health-care system not only continue but in some cases get worse. We're all going to be back here fighting again," said Bob Carolla of Consumers Union.
Bob McGlotten of the AFL-CIO said health-care reform "is an enormous problem that may have to be dealt with incrementally."
But the political fallout from the reform battle this year has left people weary and skeptical.
"Everybody has their level of awareness raised and their education or understanding of the problems and the benefits. . . . It really led to a bunch of people running around looking for magic bullets that could resolve this thing without anybody having to pay for anything," said Rep. Fortney "Pete" Stark, D-Calif.
Many lawmakers are still looking to the self-styled "mainstream" group of senators who drew up a plan to increase coverage to 94% of Americans and provide subsidies to the poor by raising the tobacco tax.
"I hope next year we can start from the center on health reform instead of starting so far over from the left or the right," said Sen. John Chafee, R-R.I., who led the group.
Bill Gradison, president of the Health Insurance Association of America, which ran a successful ad campaign against the Clinton plan, warned: "This issue isn't going to move forward if all the major players come into 1995 with the same ideas they had in 1993 and 1994."
But there's one thing the White House learned from the exhausting debate: "It's going to take a little longer," said Pat Griffin, the White House legislative affairs director.
