White House officials last week downplayed the significance of a vote by a group of top corporate executives to reject President Clinton's health plan and endorse a less regulatory alternative sponsored by Rep. Jim Cooper (D-Tenn.).
At a meeting with reporters, Ira Magaziner, senior White House policy adviser, characterized the policy statement approved by the Business Roundtable (Feb. 7, p. 2), a group of 200 executives of large corporations, as a reflection of the organization's "negotiating position" and not a flat rejection of the Clinton plan.
He stressed that the executives objected to the cap on the tax deductibility of health benefits in the Cooper plan. And while the group took issue with major features of the president's plan, it also opposed the tax cap, a central portion of Mr. Cooper's proposal, Mr. Magaziner said.
"I don't think it's a very serious matter," he said, despite the furious lobbying that had gone on by the White House to avert the roundtable vote.
Many health policy experts agreed that the Business Roundtable decision will focus more attention on the Cooper bill, but its long-term significance is far from clear.
"Votes and resolutions are not effective in themselves unless they are followed up with lobbying," said Michael Bromberg, executive director of the Federation of American Health Systems. Without a lobbying push from individual members of the business group, its vote will amount to no more than a week of "bad PR" for the administration, Mr. Bromberg said.
Mr. Bromberg, along with many other observers, said the White House itself elevated the importance of the roundtable vote by lobbying feverishly against it.
"The White House should have ignored it," he said. "There are a lot of thinned-skinned people in the administration. If you criticize one part of the bill, they think you're an enemy."
Arnold Bennett, spokesman for Families USA, a consumer group with close ties to the White House, saw the vote as a reflection of sheer partisanship.
"I can't understand how anyone would be surprised that a bunch of Republicans decided not to give full and enthusiastic support to a Democratic president," he said.
The group's endorsement of the Cooper plan, which would encourage managed competition and provide expanded coverage for the poor without requiring employers or individuals to purchase insurance, will give the Clinton administration a "political advantage," Mr. Bennett said.
The greater scrutiny that the plan now will receive will reveal that the measure would "raise taxes for ordinary Americans," Mr. Bennett said. He referred to the Cooper plan's proposed cap on the tax deductibility of insurance benefits, a provision that promises to be a lightening rod for opponents, who will paint it as a tax increase.
Specifically, the plan would limit the tax deductibility of health insurance to the lowest-cost plan available to employers and individuals. The proposal depends heavily on this measure for financing, estimating it would raise $16 billion over five years.
"I don't know where (Mr. Cooper) will be when he finds out he won't be able to pass his bill with that tax change," Rep. Henry Waxman (D-Calif.), chairman of the House Energy and Commerce subcommittee on health and the environment, recently told reporters. "There's not a majority of support for that. None of us can go home and tell people you're going to pay more for health insurance."
Mr. Clinton himself started campaigning against the tax cap in back-to-back speeches the day before the Business Roundtable vote.
At a meeting of the National Governors' Association, which endorsed a healthcare reform policy that included a tax cap, Mr. Clinton railed against taxing "the benefits of middle-class workers who have generous healthcare packages" in a system that spends more than any other country on administrative expenses.
"Why take something away from hard-working people before you squeeze the system and its unconscionable (administrative) burdens on hospitals, doctors, nurses and the American people themselves?" he said in a similar appeal at an American Hospital Association meeting the same day.