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Conference Panel OKs Plan To Expand Health Coverage to Uninsured

By Robert A. Rosenblatt and Janet Hook

Senate and House budget negotiators agreed on a plan Thursday that could lead to the biggest expansion in decades of government funding and tax breaks designed to provide health insurance to the 43 million Americans lacking such coverage.

The provision, included in the compromise budget resolution the negotiators have been working on this week, reflects bipartisan enthusiasm for trying to significantly reduce the ranks of people without health coverage. Extending coverage has proved a stubbornly persistent problem despite the recent years of strong economic growth.

Thursday’s agreement would make available an additional $28 billion over the next decade in federal money to cover the uninsured. Proponents advocate using it to extend health insurance to parents of children already covered by a federal program for low- and moderate-income households.

This aid would be added to President Bush’s proposal to give tax credits worth $71 billion over 10 years to low-income families to help them buy health insurance.

If the final legislative process produces the $99 billion in total outlays and credits, it would represent the biggest boost in the government effort to help the uninsured since Medicare was created in 1965.

The ultimate fate of the proposals remain uncertain. The budget resolution containing the health insurance initiatives does not actually implement the policies; it simply sets broad spending parameters for spending and tax legislation that Congress will enact later this year. That means separate legislation will have to be passed to actually accomplish the expansion of health coverage for the uninsured.

The proposal to directly appropriate an additional $28 billion for such coverage is sure to be opposed by some Republican lawmakers who want to keep government spending growth in check. And some Democrats in the closely divided Congress can be expected to question whether Bush’s tax credit plan would go far enough in helping low-income families obtain health insurance.

Still, many lawmakers have indicated strong support for both proposals. And the White House, along with pushing its tax credit plan, has not signaled objections to the $28 billion spending proposal.

A sense of cooperation among unlikely political allies is helping move the issue of the uninsured to a higher prominence than at any time since 1994, when the Clinton administration’s sweeping proposal for universal coverage collapsed. Oregon’s two senators -- Gordon Smith, a generally conservative Republican, and Ron Wyden, a generally liberal Democrat -- joined forces to include the $28 billion spending proposal in the budget resolution that Senate passed last month. The House, which did not have a similar section in its budget plan, accepted the Senate proposal during Thursday’s final negotiations on a compromise budget resolution.

“Oregon has a long and noble tradition of taking care of those who have been left behind,” Smith said Thursday. “I think that tradition is one the rest of the nation would do well to follow. In a time of surpluses and tax cuts, the U.S. Congress can find a bit extra to help those who work hard, play by the rules, but simply cannot afford health insurance for themselves and their families.”