Despite the gloomy legal and political prospects for the chairman of the House Ways and Means Committee, Capitol Hill Democrats were talking optimistically about their chances for approving a healthcare reform bill this year.
Such talk occurred amid reports that Rep. Dan Rostenkowski (D-Ill.), chairman of the tax-writing Ways and Means Committee, was weighing a plea-bargain agreement with federal prosecutors on wide-ranging charges of corruption.
Prosecutors were said to have given Mr. Rostenkowski until early this week to either accept a pact or face indictment. The agreement would include relinquishing the Ways and Means chairmanship, which he has held since 1981.
The Chicago lawmaker has been under criminal investigation for alleged abuse of House of Representatives Post Office and other official funds. Absent a plea bargain, Mr. Rostenkowski could face indictment on felony charges, which under House rules also would force him to resign his post. Rep. Sam Gibbons (D-Fla.) is in line to fill in as acting chairman.
The Clinton administration has viewed Mr. Rostenkowski, one of Congress' consummate wheelers and dealers, as a key ally and vital to passage of any reform measure.
First lady Hillary Rodham Clinton last week acknowledged that Mr. Rostenkowski's resignation would be a "great loss to Congress," but she said "healthcare reform and the need for it is bigger than any one person in the country."
To maintain momentum on reform, President Clinton traveled to Capitol Hill last week for a series of three meetings in which he gave congressional leaders, a bipartisan group of senators and more than 200 members of the House Democratic Caucus a pep talk.
While Mr. Clinton expressed an interest in bipartisanship in two of the meetings, his message to the caucus was anything but conciliatory.
"He gave us a rallying cry," said Rep. Henry Waxman (D-Calif.), chairman of the House Energy and Commerce health subcommittee. Mr. Waxman said Mr. Clinton told caucus members that "Democrats should stand for getting something done on healthcare reform. Those other guys stand for gridlock."
Democrats on the Ways and Means Committee predicted that with or without Mr. Rostenkowski, the panel would produce a bill. When the committee begins its bill-writing effort in earnest next month, it likely will work from a plan approved in March by the panel's health subcommittee. That plan would mandate employer health insurance coverage, cap health spending and set government rates in the event caps were breached, and create a new "Part C" in the Medicare program for the poor and unemployed.
Rep. Benjamin Cardin (D-Md.), a Ways and Means member, told reporters last week that a majority of his colleagues on the committee support an employer mandate. He said the issue of private-sector cost containment would be the toughest to settle.
Rep. Fortney "Pete" Stark (D-Calif.), chairman of the Ways and Means health subcommittee, described Mr. Rostenkowski as "irreplaceable," but said he'd leave behind a strong, well-organized committee capable of tackling reform.
Progress on reform was slow but steady last week, with a variety of committee and party developments:
The House Education and Labor subcommittee on labor-management relations approved on a 17-10 party-line vote a modified version of Mr. Clinton's health reform plan. Early next month, the panel will resume deliberations on a single-payer proposal, sponsored by Rep. George Miller (D-Calif.), which also is expected to win approval.
After an early lurch toward bipartisanship, in which the Senate Labor and Human Resources Committee unanimously approved an amendment that would curb benefits in the event the cost of reform exceeded its savings and revenues, the panel last week defeated several Republican amendments, largely on party-line votes.
One, sponsored by Sen. Nancy Landon Kassebaum (R-Kan.), the ranking minority member, would have created an independent commission on graduate medical education to study whether and how to limit the number of training slots for specialists and the redistribution of funds for medical education.
The committee is working on a bill drafted by its chairman, Sen. Edward Kennedy (D-Mass.), that is similar to the president's.
Late in the week, Democrats also defeated an amendment by Sen. Orrin Hatch (R-Utah) that would cap punitive damages in medical malpractice awards at $250,000 and require states to cap non-economic damages.
The panel will take up the contentious issues of employer mandates and cost controls early next month.
However, Sen. Jeff Bingaman (D-N.M.) said he would introduce an amendment that would soften the burden on small employers to provide health coverage. Those with one to five workers would pay a 1% payroll tax. Those with six to 10 employees would pay a 2% payroll tax. Under Mr. Kennedy's bill, all employers with 10 or fewer workers would pay a 2% payroll tax.
The Senate Finance Committee continued meeting behind closed doors and was expected to begin drafting a bill soon. Sen. Dave Durenberger (R-Minn.) said he doubted the panel would approve a reform plan with an employer mandate, which many Democrats have viewed as the only viable way to achieve universal coverage. But last week, some of those Democrats indicated a willingness to consider a so-called "trigger" mechanism under which Congress would attempt more limited reforms. If those changes failed to achieve universal coverage, action would be taken later automatically to reach that goal.
Sen. John D. Rockefeller (D-W.Va.) predicted that employer mandates would be part of the final health reform bill, but he said they could be combined with mandates that individuals obtain insurance or that they could, alternatively, be a "soft-trigger or hard-trigger" mandate.
In his meeting with House Democrats, Mr. Clinton indicated that a trigger was "an idea worth considering," said Rep. Steny Hoyer (D-Md.).
Senate Minority Leader Robert Dole (R-Kan.) drafted an outline of a reform plan that merged initiatives from a variety of Republican reform plans, many of which are also part of Democratic bills.
Mr. Dole said he wanted to reach out to "like-minded Democrats."
The plan included: private-market insurance reforms; a mandate for employers to offer, but not pay for, health insurance; unspecified low-income subsidies; medical savings accounts; malpractice reforms; an unspecified mechanism for limiting federal exposure to health spending increases; an advisory commission on graduate medical education; a cap on federal Medicaid spending; and a basic benefits package for private health insurers.