He's known by the quaint nickname "Rosty," but in his 32 years on Capitol Hill, he's built a reputation for being about as quaint as a pit bull.
As chairman of the House Ways and Means Committee-the most powerful committee in the House, with primary jurisdiction over all tax bills-the White House was counting on the Chicago Democrat to muscle through healthcare reform legislation this year.
But in the wake of a 17-count federal grand jury indictment on charges of wide-ranging corruption, Rep. Dan Rostenkowski was automatically forced out of his chairmanship last week, leaving President Clinton and House Democrats to face the challenge of enacting healthcare reform without his legendary political brawn.
Sitting in as acting chairman for the duration of this year's healthcare reform activities will be 74-year-old Rep. Sam M. Gibbons (D-Fla.), whose expertise is trade, not healthcare (See profile box, p. 3). While he's viewed as a competent legislator, neither his skills nor power base put him in the same league as "Rosty," who after more than a decade at the helm of Ways and Means could have doled out promises and cashed in IOUs in exchange for votes on a healthcare bill.
Mr. Gibbons has been a strong supporter of a single-payer approach to reform and is a co-sponsor of the single-payer bill introduced by Rep. Jim McDermott (D-Wash.). But he's also signed onto Mr. Clinton's proposal, and, since assuming the Ways and Means chairmanship, has publicly distanced himself from the single-payer plan.
Stunned House Democrats, particularly those on the Ways and Means Committee, rallied last week to put the best face on a grim situation, proclaiming their ability to produce a healthcare bill, irrespective of this latest setback.
"We've been hurt. We've been hit hard. We've got the wind knocked out of us," acknowledged Rep. Charles Rangel (D-N.Y.), in a televised interview. "But I just don't see how we can tell the American people that we cannot give them universal coverage because we've had a personal political tragedy on our committee."
The president, in reaction to the May 31 indictment, said, "Chairman Rostenkowski and others have helped create real momentum for healthcare reform, and I am confident that legislation will pass this year." Two days before the indictment was announced, House Majority Leader Richard Gephardt (D-Mo.) declared on an ABC news program that Ways and Means would "get a bill out no matter what happens, and we're going to have it on the floor in July."
Rep. Fortney "Pete" Stark (D-Calif.), chairman of the Ways and Means health subcommittee, meanwhile, said he was "confident the committee under Rep. Sam Gibbons will produce legislation which will implement President Clinton's goals."
But according to Henry Aaron, director of economic studies at the Brookings Institution, a Washington research organization, such intraparty bravado reflected a predictable closing of ranks in the midst of a crisis and failed to capture the gravity of the situation.
If Democrats were more critical of the prospects for healthcare reform, their statements would be tantamount to treason and "viewed as a rebellion against the new chairman," Mr. Aaron said. The members want to help Mr. Gibbons succeed "because it will help the party succeed," he added.
Most health policy experts and Capitol Hill watchers last week weren't prepared to write the obituary for reform this year. But they agreed that a difficult legislative task just got much, much tougher.
"We'll never know exactly what did or didn't happen because a different chairman was in place," Mr. Aaron said. "The debate on healthcare reform is chaotic and confused, and the way in which compromises might go is unpredictable. What you want is people who can make deals, make them stick and bring along supporters with them. Rostenkowski had a well-established reputation of being able to do just those two things."
The gap means other congressional leaders, as well as Mr. Clinton, will have to work harder to make healthcare reform succeed, experts said. In addition, senior members such as Mr. Stark are expected to play a larger role in committee deliberations.
"There's no question that the situation will slow down the process and make it more challenging to produce a bill out of Ways and Means," said Richard Pollack, executive vice president of federal relations at the American Hospital Association. At the same time, the administration will have other allies, such as Mr. Rangel, Mr. Gephardt, Senate Majority Leader George Mitchell (D-Maine) and others who are committed to producing a healthcare bill.
"There are so many other people equally committed to getting something done that it's not as severe a setback," he added.
Behind the scenes, House Democratic leaders were bracing for the worst. According to sources familiar with negotiations, the full House Labor and Education Committee has been urged to keep its bill within the mainstream, in case it's the only committee able to produce a bill this year. The panel's subcommittee on labor-management relations already has approved a Clinton-like reform plan and is expected to also vote favorably on a single-payer bill later this month.
With the Energy and Commerce Committee hopelessly stalled on reform and Ways and Means facing a leadership vacuum, it's possible that the Labor and Education Committee's bill will be the one that heads to the floor. House leaders want to make sure it's moderate enough to attract strong support.
In addition, the path is being paved for as smooth a transition as possible on Ways and Means. According to congressional aides, Mr. Gibbons plans to use the same legislation Mr. Rostenkowski would have as the starting point for a committee bill.
That measure, called the "chairman's mark," will be a slightly modified version of a proposal approved in March by Mr. Stark's health subcommittee. The plan would require employers to finance at least 80% of workers' health coverage, create a new Medicare program to cover the poor, and impose global budgets on health spending enforced with price limits on providers.
Over the past several weeks, Mr. Rostenkowski did much of the legwork to gather votes for the plan, although the panel is still short of the 20 votes needed for approval. The White House has applauded the committee's work, but so far is sticking by its own proposal.
"Mr. Gibbons will benefit greatly from the work that Rostenkowski did ahead of him," said Ronald Pollack, executive director of Families USA. "The issues that needed to be resolved among committee Democrats have narrowed."
Many observers predicted that Mr. Rostenkowski, who will retain his seat in Congress and on the committee as he carries on his legal battles, would also retain much of his influence over healthcare reform proceedings. That, along with other factors, would work in favor of committee Democrats producing a bill.
"I think what you'll have until a final resolution of the charges (against Mr. Rostenkowski) is a co-chairmanship" of the Ways and Means Committee, said Lee Bechtel, president of the lobbying and consulting firm Bechtel & Associates, Silver Spring, Md., and chairman of the American League of Lobbyists healthcare group. While Mr. Gibbons will be the official chairman, "he'll need the assistance of the leadership, like Gephardt and Rostenkowski, to help pull people together."
John Rother, chief lobbyist for the American Association of Retired Persons, even suggested that Mr. Rostenkowski's demise could have a galvanizing effect on committee Democrats. "No one wants to be seen as ineffectual or gridlocked just because the chairman has left."
But according to Cynthia Brown, manager of the Washington office of the American College of Surgeons, Mr. Gibbons may be able to get a bill through the committee, but he wouldn't begin to rival Mr. Rostenkowski's influence in the full House.
In the end, "it's going to be the president, not Dan Rostenkowski" who exercises the leverage on the healthcare reform vote in Congress, predicted Stephen Wayne, a government professor at Georgetown University.
"Congress has changed so much that there is no one person who could get a program through for the president or kill a program," Mr. Wayne said. But ultimately, Democrats' "fear of the anti-incumbency mood" of the public during an election year will make it more likely that they'll coalesce behind the president and vote for a scaled-back healthcare bill.
Back in Mr. Rostenkowski's home base of Chicago, some healthcare executives said they believe the congressman will remain a force for their concerns and any healthcare reform bill that passes.
"The indictment doesn't impress me," said Ruth Rothstein, chief of the Cook County Bureau of Health Services and director of 932-bed Cook County Hospital. "He still has the ability to lead and focus on the issues, and he is still a member of that committee. He will make a major contribution to healthcare."
Other Chicago executives were unsure what, if any, impact Mr. Rostenkowski's new role would have.
"Healthcare is in such a state of flux that it's difficult to say what's going to happen," said Lee Domanico, chief executive officer at Columbus-Cabrini Medical Center, located in Mr. Rostenkowski's congressional district.