The fate of the administration's health care reform bill seems inextricably linked to the outcome of the budget reconciliation bill, which at this writing is pending in the Senate.
The linkage is principally due to the fact that the only way the federal deficit can be reduced in the long run is to enact health care reform that significantly slows rising costs.
Contributing to the anxiety about the outcome of health care reform and the budget reconciliation bill are the recent political and public relations faux pas emanating from the White House.
'The President is going to have to recover substantially in the polls before he offers his health care proposal,' according to Gordon Wheeler, the Health Insurance Association of America's director of political affairs.
Mr. Wheeler said the President's withdrawal of his nomination of Lani Guinier as chief of the Justice Department's civil rights division 'has severely weakened him on Capitol Hill.'
President Clinton will have to do considerable fence-mending with members of the Congressional Black Caucus where 40 votes could be lost over a vote on budget reconciliation or health care, Mr. Wheeler noted.
The Guinier nomination was 'essentially, a Catch 22' situation for the President, he observed. 'All in all, it doesn't bode well for timely action on health care,' he said. However, he added that the President should be protected by his staff from having to read 'every piece of paper' before making a decision.
In going all-out to win House passage of the reconciliation bill by a narrow margin, President Clinton went to Capitol Hill and met with the House Democratic caucus and a joint meeting of House and Senate Democratic leaders. He argued against caps on entitlements, such as Medicare and Medicaid.
The President opposed a proposal offered by Rep. Charles Stenholm, D-Texas, to impose caps on entitlements. The Stenholm provision, the 'Entitlement Discipline Agreement,' was passed as part of the budget reconciliation measure.
The Stenholm provision creates a mechanism to monitor total costs of entitlement programs and, if costs exceeded target levels set by the Office of Management and Budget, the President and Congress would be held accountable and be required to take action each year.
If the targets were exceeded by more than one-half of one percent, the President would have to recommend to Congress spending cuts, tax increases, or both to wipe out the overage, or to make no changes and raise the targets.
On the morning President Clinton went to Capitol Hill, he had lunch with a group of Chief Executive Officers to persuade them to support the budget reconciliation bill. He told them the energy tax is a good tax that would get interest rates down and have 'credibility in the markets.'
He pointed out that the bill has $100 billion in entitlement cuts. A reporter then asked the President during a photo opportunity with the business leaders, 'what about an entitlement cap, as some people on the Hill want? Wouldn't that help?'
President Clinton replied that he was not opposed to a cap on health care spending, but it should be done in the context of health care.
Noting that 'this is a good place to discuss this,' he said that 'the United States government has already contributed to the rising costs of health care for employers by squeezing Medicare and Medicaid and forcing those costs off onto private employers...
'If we did it now,' he said, 'it would run the risk of two or three years from now having another big increase in their costs, undermining their ability to hire American workers and to keep American competitive.
'So if we're going to have a health care cap, let's do it with health care. That's the way it should be done,' the President said.
It seems like common sense.
