HOUSE RULES CMTE. EXPECTS TO WIELD SIGNIFICANT POWER IN HEALTH DEBATE

HOUSE RULES CMTE. EXPECTS TO WIELD SIGNIFICANT POWER IN HEALTH DEBATE given the fact that the three & House committees with principal jurisdiction over the President's Health Security Act will report out separate versions of the legislation, House Energy & Commerce Committee Chairman Dingell (D-Mich.) predicted at a Nov. 16 health reporters breakfast in Washington, D.C. "We will see major impacts on the legislation occurring at every stage of the process," Dingell said, "including the very strong possibility that the Rules Committee will be used by the [House Democratic] leadership to lay out a sensible and rational course of the handling of the legislation on the floor." The Health Security Act was expected to be introduced in the House and Senate on Nov. 20. Noting that House Speaker Foley (D-Wash.) has decided on simultaneously referring the bill to the Energy & Commerce, Ways & Means, and Education & Labor Committees, Dingell explained that "I'm hearing that it will be done jointly." Assuming each committee amends and reports out legislative language by a "practical, unwritten deadline," he added, Foley then will direct Rules Committee Chairman Rep. Moakley (D-Mass.) to come up with a "roughly agreed upon" version of the bill. The Rules panel has "to do a certain amount of rewriting in order to give a focus on the issues in a way in which they can be resolved." Before sending the bill to the floor, Rules will enter into a "process of negotiation" with House leadership and committee chairmen, Dingell said. Members then will be presented with a "range of options," including the possibility that competing committee versions might be allowed on the floor for a vote. Acknowledging the political implications of the process, Dingell deadpanned: "You may see a rule...almost as thick as the [President's 1,342-page] bill itself." Made up of nine Democrats and four Republicans, the House Rules Committee determines floor voting procedures and has the power to reject specific amendments. In the Senate, on the other hand, "time agreements" for floor procedures are established through unanimous consent and all legislation is amendable. Majority Leader Mitchell (D-Maine) and Minority Leader Dole (R- Kan.) have significant control over time agreements. An advocate of single-payer, Dingell reiterated his support as a cosponsor of the White House bill because it is the "most workable" and "most possible." He noted that passage of the deficit-reduction package proposed by Reps. Penny (D-Minn.) and Kasich (R-Ohio) would "adversely affect, very significantly, the economic assumptions on which the bill is bottomed." The Penny/Kasich amendment, which targets $46 bil. in Medicare and Medicaid savings over five years for deficit reduction, "changes the politics by changing the economics" of health reform, Dingell complained. "It sucks out a lot of money...that the Administration had earmarked" for the Health Security Act. The effect of the Penny/Kasich amendment on health reform was echoed by Treasury Secretary Lloyd Bentsen at a same-day hearing before the House Ways & Means Committee. Bentsen remarked that the measure's Medicare cuts would create "a huge shortfall in the financing of the health care reform plan" that would have to be made up either by additional cuts in Medicare, tax increases, slowing the phase-in of universal coverage, or scaling back the scope of benefits in the President's plan. However, Dingell later acknowledged that the Clinton bill contains $57 bil. set aside for deficit reduction that could balance the effects of the budget-cutting initiative. "If that $57 bil. is a good number, and if all the other figures in the bill are good, Penny/Kasich can get $46 bil....without impairing chances of the legislation," he said. Asserting that the financing of the Administration's proposal is economically sound, Dingell reported that the Congressional Budget Office already has tacitly "signed off on the substance of those figures...They do not quarrel with the numbers that the White House has attached to the bill or the economic assumptions." Although CBO says it has yet to conclude its official analysis of the Health Security Act, Dingell maintained that Administration officials waited for CBO "to effectively bless their numbers" before sending the plan to Congress. "The White House withheld the bill until they completed their negotiations and discussions with CBO," he said. The Energy & Commerce chairman also acknowledged the possibility that Congress might not pass health reform in 1994 and the possible political repercussions. "I'd say on a scale of 10, the odds are nine to nine-and-one-half that we will" pass a bill, he forecast. "If we don't, I think this is a splendid subject for an election." If the Clinton plan were to fail, he added, "I think single-payer is going, as a result of this debate, to achieve a much higher level of both prominence and probability."