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Swing Health Reform Vote Feels Heat : Legislation: House Democrat Slattery gets a vivid picture of forces organized for and against Clinton proposal. He sees opposition growing.


TOPEKA, Kan. — Democratic Rep. Jim Slattery scanned the crowd of about 100 assembled for the Lions Club convention here and posed a question: "How many of you believe that everybody should contribute something to our health care delivery system in this country?"

Everyone in the audience immediately raised a hand.

Next, however, came a more telling moment: "How many of you favor either an employer mandate or an employee mandate to pay for it? How many of you would favor a payroll tax, in effect like Social Security, to pay for part of this health care?"

Not one hand was raised. Instead, the group of his Kansas constituents turned combative.

"Who would control it?" one man shouted.

"The government would get it!" another answered.

The mood of the meeting last weekend was not lost on the congressman, who is keenly aware that he holds enormous leverage in the fight over President Clinton's health care plan. "Six months ago, it seemed that people were far more receptive" to the inevitable trade-offs of health care reform, he said afterward.

Slattery is an influential force among moderate Democrats in the House and is one of a handful of swing votes on the Energy and Commerce Committee. A day in Kansas with him provided a vivid picture of how the forces in hundreds of congressional districts are influencing the health care battle on Capitol Hill.

Now that people have begun to understand the components of the Clinton plan and to absorb what the critics have to say about it, Slattery believes that mistrust is growing.

"The country has responded to this barrage of anti-government advertising," he said. "A lot of people are convinced that, if the government gets involved any further, the outcome is going to be worse than what we have now."

In Congress, the proposal is meeting some of its stiffest resistance in the Energy and Commerce Committee. Henry A. Waxman (D-Los Angeles), chairman of the panel's subcommittee on health and the environment, has abandoned his effort to pass the bill at that level. The legislation is being considered, instead, by the full committee--an extraordinary step.

Waxman described Slattery as "a bellwether for the committee, the kind of vote that's going to be essential if we're going to get a bill out of committee."

"He's a constructive member and a thoughtful person," Waxman added. "He has a lot of concerns that other members are expressing as well. It's got to be on his mind how his votes on health care are going to be reflected back home."

Slattery's vote on health care is likely to be his last major decision--and his most important one--as a congressman. After six terms, he is giving up his House seat to run for governor and is favored to become the Democratic nominee in the August primary.

The 45-year-old lawmaker bears a passing resemblance to the late Robert F. Kennedy and favors cowboy boots with his pin-striped suits. With roots in the farming community of Good Intent, Kan., he espouses a fiscal conservatism that has made him a favorite in a congressional district that generally votes Republican.

The health care debate in Washington has diverted a good deal of Slattery's energy from his gubernatorial race. His calendar is jammed with meetings on the issue--sometimes with national organizations, and sometimes with their Kansas affiliates. Various groups with an interest in the health reform also are spending heavily to advertise in his district.

Late last month, Slattery's staff was startled when dozens of elderly people stormed an annual open house at his district office intent on winning his support for coverage of long-term care. The outpouring was generated by a newspaper ad, paid for by the American Assn. of Retired Persons.

"He wasn't too happy (but) an open house is an open house," said Deborah Dion of Families USA, an organization that supports the Clinton plan and which called a news conference outside Slattery's office to publicize the event.

If Slattery's comments are any indication of how he will vote, it is unlikely that those organizations will be completely satisfied.

He is openly skeptical of the affordability of the benefits package Clinton has proposed--particularly in such costly areas as long-term care and prescription drugs.

"I favor us shaping a very cautious benefits package so that we know how much it's going to cost, we know that it is affordable," he told the Lions. "One of the principles that I am deeply committed to--and I will not compromise on--is that I do not want to see us borrow one dime from our kids and grandkids to pay for our current health care."

Unless the benefits package is scaled back, he said, Congress might have to sacrifice Clinton's central goal of universal coverage, aiming instead for a narrower bill that makes health insurance more accessible.

Such comments anger groups that support the Clinton plan. "We are not going to settle for universal access and a package that doesn't include the benefits we need," said Kelly Jennings, field representative of the Kansas Assn. of Public Employees.

Business interests also grumble about the response they have gotten from Slattery. Members of the Kansas chapter of the National Federation of Independent Business, which staunchly opposes much of Clinton's plan, met with the lawmaker last week to plead with him to oppose the proposal to require employers to pay 80% of their workers' health insurance costs. The federation contends that the employer mandate could cost Kansas as many as 155,000 jobs.

"When it came to the issue of the mandate, he indicated he didn't have a better idea of how to make universal coverage available to people," said Hal Hudson, who heads the Kansas chapter.

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