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Health reform revived

Too many American workers have been held hostage by their health insurance. Fearing a loss of benefits, some have missed opportunities to pursue better jobs. Others have been devastated financially after being fired and subsequently stripped of benefits.

That is why members of Congress should be commended for reaching an agreement on Thursday to revive important insurance reforms that have been stalled for months. The legislation, known as the Kennedy-Kassebaum bill, centers on portability, a concept that allows workers in employer-sponsored health plans to keep their benefits if they change or lose a job _ even if they have existing health problems. Though it is far less dramatic than the health plan proposed by the Clinton administration in 1994, the legislation may well represent the most significant reform in the last three decades.

The bill passed both houses of Congress but has been held up because of a feud over medical savings accounts _ a new form of insurance some Republicans want included in the legislation. The accounts would allow workers to save money to pay for their own routine medical care. In exchange, the government would offer tax incentives. Traditional insurance would cover only catastrophic illness or injury.

Supporters say the accounts would give patients more choices. Critics contend the accounts will be of little value to the seriously ill, whose medical expenses will preclude saving any money. Instead, the accounts could amount to little more than a tax shelter for people who are wealthy and in relatively good health. That could drive up health care costs for everyone.

There is no question the legislation would have been stronger without this addendum. But Republicans would have held it up indefinitely had savings accounts been omitted, along with a separate bill to increase the minimum wage, which has been stalled because of the health insurance impasse. In that sense, the deal lawmakers struck _ allowing savings accounts only as a four-year pilot program _ was probably the best they could make.

The reforms included in the measure are only a first step to making health insurance available to all Americans. They do nothing to help the 40-million people who lack insurance altogether, but the changes still represent movement in the right direction.

A lingering dispute over health insurance for the mentally ill should be shelved until after this package becomes law. It is a complex issue that could result in further delays and ought to be debated separately. Americans have waited long enough for meaningful health care reform.