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Health bill aims to build consensus

With President Clinton's ambitious health care reform plan dividing Congress and the nation, a group of 30 conservative Democrats and Republicans on Thursday proposed a set of incremental steps that most everyone supports.

The legislation, sponsored by Republican Rep. Michael Bilirakis of Palm Harbor and Democratic Rep. J. Roy Rowland of Georgia, would help workers obtain and keep health insurance but would do little to extend coverage to the 37-million Americans who don't have it.

The plan, called the "Health Reform Consensus Act of 1994," would prevent insurance companies from refusing coverage because of pre-existing illness. It also would allow workers to bring their insurance with them if they switched jobs.

Bilirakis said the provisions were taken from the many bills that have been filed in Congress. Making the point that his bill could pass the House, he said 297 lawmakers have supported one or more of the various provisions he has pulled together.

"In this fractious situation, we've got to seek common ground," Bilirakis said.

In effect, Bilirakis and Rowland want to test President Clinton's threat to veto any bill that doesn't meet his goal of providing universal coverage. They acknowledge that their bill falls far short of that goal, but Rowland believes a veto by Clinton would be a "tragic political mistake" that the president is likely to avoid.

White House spokeswoman Lorrie McHugh welcomed the lawmakers' contributions to the debate, but she stuck to Clinton's call for universal coverage. The president's health plan would require employers to pay up to 80 percent of their workers' insurance and would place controls on health costs. Coverage would come from private insurance companies, with oversight from regional health alliances.

But the Clinton approach has been assailed for its cost and complexity. Senate Republican leader Bob Dole of Kansas proclaimed it dead this week, and public opinion polls show the plan dropping in popularity.

The alternatives aren't doing so well, either. Rumors spread through Congress on Thursday that the Congressional Budget Office was prepared to estimate that a rival plan, called "Clinton Lite," would cost taxpayers much more than previously thought.

Meantime, congressional committees are beginning to craft their own health legislation.

Rep. Pete Stark, the California Democrat who heads the House Ways and Means subcommittee on health, expects his panel to pass what he calls Medicare part C. That would extend the government-run coverage of Medicare to the nation's 37-million uninsured, with the financing provided by employers and employees.

Stark's program is one of the more liberal approaches in Congress, and it seems unlikely it would pass the entire House.

Clinton's allies on another panel, the House Energy and Commerce Committee, decided to bypass one of their subcommittees this week because they could not muster the Democratic voters for the president's plan.

That's just the sort of trouble that Bilirakis and Rowland point to in trying to sell their plan. "The way it is right now, everything is so splintered we're just going to look like fools up here," Bilirakis said.

Their plan allows states to form purchasing groups for companies with between two and 50 workers. Currently, some states are blocked from forming the groups, which are designed to band companies together so they can bargain for lower rates.

The bill's prohibition on insurance companies' "pre-existing condition" requirements would apply to those plans offered by employers. Self-insured workers could enjoy protection from this practice if they joined a purchasing cooperative.

Under the bill, self-employed people would win the right to fully deduct the cost of their health coverage from their taxes. To pay for that $8-billion provision, the bill proposes a bookkeeping change that would have the Postal Service and other government agencies pay more for the health coverage of future retirees. That, in turn, might bump the cost of a postage stamp up two cents.

In a nod to doctors complaining about malpractice insurance costs, the bill aims to discourage lawsuits by steering complaining patients into a non-court procedure called alternative dispute resolution. If the case ends up in court, the bill puts a $250,000 limit on awards for pain and suffering.

Rowland said the bill doesn't spend any new federal money. He hopes it will encourage the use of community health centers, which would receive more Medicaid money, but sponsors do not spell out the number of new centers.

While small businesses and a restaurant group praised the bill, Ralph Nader and other consumer advocates blasted it for stripping "injured patients of important legal rights."