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Clinton Won't Back Down on Universal Heath Care Plan

By David Lauter
and Karen Tumulty
Los Angeles Times
WASHINGTON

Bill Clinton, the man who loves compromise, says he has found his stopping point.

After 17 months in office during which many questioned just what it was that Clinton really stood for, the president has taken his stand on the principle that health reform must mean providing coverage to all Americans.

Despite predictions by leading Republicans and Democrats that his position cannot prevail, Clinton told aides over the weekend, and repeated in a speech Tuesday, that "I refuse to declare defeat.''

Clinton has made it clear that he is willing to compromise on almost every other major part of his massive health reform proposal, but his decision to fight over universal coverage amounts to a roll of the dice with the success of his presidency at stake.

If he prevails -- and aides believe that despite current gloomy portents he still has a chance to prevail in the House and win narrowly in the Senate -- he will have won a huge and highly visible victory on an issue -- covering everyone -- on which polls consistently show the public supports. But should he fail, political strategists warn, the loss could be devastating -- reinforcing in the minds of voters the notion that Clinton has proven unable to break the Washington gridlock he ran against.

Democratic strategists believe they have a shot at rounding up a 51-vote majority in the Senate for a universal coverage bill -- one that they would then, in effect, dare the Republicans to filibuster.

Others, however, warned that by insisting on universal coverage and going for 51 votes rather than watering down his plan and seeking a broader majority, Clinton was jeopardizing the best chance Congress has had to make meaningful, if limited, reforms.

Those critics echoed statements made by Finance Committee chairman Daniel P. Moynihan, D-N.Y., over the weekend that proposals to reform the insurance system but not cover everyone were still "important advances.''

Meanwhile, action -- or more properly the lack of it -- in Congress illustrates the difficulties ahead.

Moynihan, who had predicted his committee would complete work on health care by the end of this month, announced that the schedule had slipped until mid-July. And a leading Democratic member of the Finance panel, Sen. Bill Bradley, D-N.J., said he could not support Clinton's preferred method of achieving universal coverage and proposed yet another entry in what has become a bewildering array of potential compromise ideas. Bradley's plan rejects requiring employers to pay for their workers insurance, and instead would mandate that individuals themselves buy insurance if reforms in the health care market were unsuccessful in producing near-universal coverage.

On the House side, the Ways and Means committee bogged down amid partisan sniping with Republicans attempting to increase benefits while Democrats charged that GOP lawmakers wanted to grandstand in favor of additional services without supporting revenue-raising measures in the bill.

Clinton has one major political trump on his side in the coming fight. Unlike many parts of his health plan, which have proven controversial, universal coverage enjoys broad popular support. Polls consistently show that most Americans favor the idea of universal coverage. Clinton's proposal that employers be required to cover all their workers also draws strong public support. A highly publicized fight on that issue would be a way of focusing public attention on one of his plan's stronger points, instead of on its weaknesses.

A second major argument in favor of universal coverage is, simply, that most of the alternatives that have been proposed so far do not work, administration officials say.

Because the many pieces of the health care system are so closely intertwined, piecemeal reform could simply end up making things worse. For example, Republicans support the extremely popular idea of telling insurance companies that they no longer can refuse coverage or charge much higher rates to people who already have health problems--the so-called pre-existing conditions clause found in most health policies.

Insurers point out, however, that if the pre-existing condition exclusion disappears but insurance coverage remains voluntary, only the sick will buy insurance. Healthy people would simply go uninsured, knowing they could always buy insurance later if they get sick.