WASHINGTON -- A lot of people in this town, from congressional staffers to senior White House advisers and lobbyists, are now trapped in the punishing heat of August while Congress debates health care.

Congress originally set a recess date of Aug. 13, but members will have to stay well past then if they hope to vote on what President Clinton has set as the centerpiece of his national agenda.

In his press conference last week, Clinton urged members of Congress to stay until they get the job done. House and Senate leaders had already signaled that they are willing to work past the mid-August deadline..

Clinton arguably gave Congress a push when he endorsed the newly introduced health care bill of Senate Majority Leader George Mitchell, D-Maine, which takes a more gradualist approach than the bill offered by House Majority Leader Richard Gephardt, D-Mo.

Mitchell's bill packages a set of medical insurance reforms and subsidies for low-income households while encouraging employers and workers to split the cost of premiums. The goal would be to cover 95% of all Americans by the year 2000. If the goal is not met, a special commission would develop a plan to expand coverage to the uninsured, and Congress would have to vote on it or allow a mandatory insurance plan for employers and workers to take effect in the year 2002.

Gephardt's House bill takes a more direct and mandatory approach by requiring all employers to pay 80% of each worker's health insurance premiums while workers pick up the rest. The plan would take effect in 1997 for large companies and in 1999 for small companies. The bill also offers tax credit subsidies for small businesses, sets federal standards for all insurance plans, and establishes a nationally guaranteed.benefits package.

One problem is that right now no one knows how much the various health care proposals will cost. The Congressional Budget Office is trying to get estimates ready by this week for Mitchell's bill, in time for the beginning of Senate floor debate. More time will be required for Gephardt's bill, but the House is not expected to begin debate until next week.

Clinton's position in all this is somewhat unclear, reflecting the tactical realities of a fluid political situation. In his press conference, the president Urged Congress and the public to avoid missing "this historic opportunity" to pass health care reform. "We dare not pass it up." he said.

But Clinton also said he does not want to dictate to members of Congress what kind of a bill they should pass. While such a, stance may seem presidential," So far there is not much evidence that the White House is mounting a full-court press in Congress the way it did for the budget and the North American Free Trade Agreement.

Clinton and his top aides know that time is running out. Congress is anxious to recess early this year in October so that members can can go back home to the voters and campaign. While many Democrats would like to take a health care bill back to constituents, lawmakers remain hamstrung by time and politics. Whether they will be able to agree on the many complex issues that have to be resolved is no sure bet.

Republicans and some business allies know that the Democrats, want to take a big trophy home in the fall elections. Defeat or procrastination on health care would hurt the Democrats and the president more than the Republicans, who are looking for big gains in the House and Senate.

The election-year skirmishing has begun, and health care is the battlefield.

Subscribe Now

Access to authoritative analysis and perspective and our data-driven report series.

14-Day Free Trial

No credit card required. Complete access to articles, breaking news and industry data.