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GOP Crafts Compromise Health Plan, but Democrats Oppose It


WASHINGTON — Scurrying to revive their dying health reform bill on the eve of Majority Leader Bob Dole's departure from the Senate, congressional Republicans hashed out a compromise Monday--but the plan ran smack into Democratic opposition and its chances of becoming law remain slim.

The bill would make health coverage "portable," enabling millions of working Americans to take their health insurance with them when they switch jobs, even if they have preexisting health conditions.

If passed, it would become the most sweeping health reform legislation in 30 years, although it is a mere shadow of the massive reforms proposed by President Clinton in 1993.

But the landmark legislation has become mired in debate over a provision that would allow Americans to set aside money in tax-exempt medical savings accounts, a feature that critics, including Clinton, say would benefit only the healthy or wealthy, drawing them out of traditional insurance pools at the expense of the needy and sick.

The White House has threatened to veto any bill that includes the medical savings account--which would give Americans a tax-break on money they save to pay doctor's bills--on a broad scale. In March, the House adopted a bill that offers the accounts to all Americans; the Senate version, approved in April, excludes them entirely.

On Monday, Sen. Nancy Landon Kassebaum (R-Kan.), a key sponsor of the legislation, brokered a deal that would allow medical accounts for companies with 50 or fewer employees and for the self-employed. After an independent study, the program would be expanded to all Americans in 2000 unless Congress voted otherwise.

The initial phase would cover an estimated 20% of the population, according to Kassebaum's office. The Kansas senator said she hoped the plan would be small enough in scope to be approved by Clinton and the Democrats, who have said they would accept a small pilot project to test the medical-account concept.

But the bill's chances of passing appear slim. A top White House health aide expressed skepticism Monday, saying the proposal "sounds like a step forward, but not a step far enough."

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