WASHINGTON -- The House Ways and Means Committee began work on health care reform legislation yesterday, with its chairman predicting a protracted debate as there is no consensus among panel members on what approach to take.

Under the schedule laid out by Chairman Dan Rostenkowski, D-Ill., members will spend the next two weeks debating various alternatives. They will not even begin taking votes to shape the package until after June 7, when Congress returns from its Memorial Day recess.

Rostenkowski said the committee's starting point is a bill approved by the panel's health subcommittee in March. The measure includes a provision that would permit federally guaranteed tax-exempt bonds to be issued for health care institutions serving urban areas with inadequate access to medical services.

Rostenkowski conceded that no strong base of support has formed behind the subcommittee plan or any of the alternatives being floated by other committee members.

At this point, Rostenkowski said he would not offer his own plan and try to force members to support it. Rather, he will open the floor over the next two weeks to an open debate on how to proceed with health care reform.

"It is important to me that each of you have an opportunity to express your views," Rostenkowski said.

"Never in my thirteen years of chairing this committee [have I seen] so many different alternatives" for a public policy initiative, he said. "It would be useful to offer the proponents of each of these major alternatives an opportunity to present their proposals and respond to questions."

The wide-open nature of the process leaves open the possibility of adding to the bill a trio of bond provisions backed by the Public Securities Association and a group of 501(cX3) issuers.

The provisions are designed to help health care institutions make the transition to a new health care system. They would ease limits on health care advance refundings, hank deductibility, and the amount of bonds that individual health care institutions may have outstanding.

Rostenkowski said he realized the two weeks of talk may mean that "some will be tempted to conclude that the real work of the committee has not yet begun." But "they would be wrong" because "education of ourselves and the American people is an important part of our job," he said.

For the time being, Rostenkowski wants Republican committee members to participate in the process, but if too much rancor develops, he said he would retreat behind closed doors with Democrats and fashion a partisan bill.

"Everyone in this room knows I prefer a bipartisan approach to this legislation," Rostenkowski said. If that is unworkable, "I will do whatever I need to to get at least 20 votes in this committee," the number needed for a majority, he said.

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