Divided Panel Presents $66-Billion Medical-Care Plan : Health: It would provide insurance coverage for all Americans. But key lawmakers say it has no chance to pass.

A bitterly divided congressional commission called Friday for an ambitious $66-billion expansion of federal spending to provide health insurance coverage for all Americans.

But the plan, approved by an 8-7 margin, failed to receive a single vote from the four Republican legislators on the commission. And it was pronounced dead on arrival by lawmakers who would play key roles in steering health legislation through the House.

“It is wrong, outrageous and morally repugnant” for Americans to be denied health care because they cannot afford it, Sen. John D. (Jay) Rockefeller IV (D-W.Va.), chairman of the Pepper Commission, told a news conference.

Other members of the commission, named for its first chairman, the late Rep. Claude Pepper (D-Fla.), agreed with Rockefeller that the estimated 37 million Americans who currently lack health insurance must be given access to affordable health care.

But they split over the contentious issue of financing, with the panel’s Republican members and one Democrat objecting to the program’s huge price tag and the absence of a specific plan for raising the money.

The failure to obtain bipartisan approval removes much of the potential political momentum from the long-awaited commission report, which had been seen as a possible vehicle for major reforms in the health care system.

As a result, the commission’s final product will be viewed as essentially a Democratic document. The eight-member majority included six Democratic members of Congress and two public members picked by former President Ronald Reagan.

The Bush Administration is strongly opposed to any health care plan that would require significant new spending and tax increases.

Despite the commission’s failure to reach a bipartisan agreement, its proposal is likely to intensify a growing national debate over the need for health care reform.

The plan approved by a majority of the Pepper Commission calls for:

--Mandatory health insurance coverage for all businesses with 100 or more workers. Companies would be given three years to offer insurance to their employees or begin paying money into a public plan that would cover all those without private insurance.

--Tax credits and subsidies for companies with fewer than 100 employees to encourage them to purchase insurance for their workers. After five years, any remaining uninsured would be covered under the public plan.

--Free coverage under the public plan for uninsured pregnant women and children up to the age of 6 in families with income below 185% of the federal poverty level (currently $6,314 for a single person and $12,675 for a family of four). Other participants would pay premiums based on their income.

--Free care for the first three months spent in a nursing home, regardless of age or income level.

--Home care and assistance, such as bathing, dressing, and grocery shopping, for severely disabled persons.

Under the commission plan, the federal government would require a basic package of medical and surgical benefits, including prenatal care, well-child exams and preventive care, to be offered under all private and public insurance plans.

The yearly deductible would be $250 for a single person and $500 for a family. Patients would pay 20% of the cost of all services, with a maximum out-of-pocket limit of $3,000 a year.

Companies currently offering health insurance to their workers could maintain their programs, but they would be required to match the new federal standards for benefits and costs.

The proposed universal health program, which would expand coverage to the 37 million Americans now lacking health insurance, would cost the federal government $66 billion a year and private businesses $20 billion, Rockefeller said.

The commission plan did not discuss how the money would be raised other than calling for a “progressive tax package, requiring a higher contribution from those most able to bear increased tax burdens.”

Rockefeller said the 8-7 vote for his plan was a sufficient mandate. “World Series (games) are won by 8 to 7,” he said.

“Well folks, we have done it,” Rockefeller declared as he opened the news conference. “(Our) recommendations will begin to transform the nature of the American health care system (which is) . . . in total crisis.”

But the absence of details about financing drew stinging and scornful dissents from a key pair of commission members, Rep. Pete Stark (D-Oakland) and Rep. Willis D. Gradison Jr. (R-Ohio).

“It’s a hoax,” Stark said at the news conference. “The commission is stone silent on how they will pay for it or how much it will cost each person. Without a way to pay for it, it is legislatively dead before it starts.”

Gradison said $66 billion in annual expenses would cost every taxpaying household $750. “My constituents don’t feel they are under-taxed,” he noted.

Gradison also criticized the universal nursing home benefit proposed by the commission. “Donald Trump, God forbid, if he needed it, could spend three months in a nursing home . . . at the expense of taxpayers,” he said.

The Pepper Commission plan would take effect only if enacted by Congress. Stark is the chairman and Gradison the ranking Republican on the health subcommittee of the House Ways and Means Committee, which would handle the legislation, and their opposition makes favorable consideration appear unlikely.

Rep. Dan Rostenkowski (D-Ill.), chairman of the parent committee, also summarily rejected the plan, issuing a statement indicating that he was “seriously disappointed” with the final product.

The commission “worked hard,” said Rostenkowski, “but when the question of financing arose, it ducked. That sort of evasion is unacceptable in today’s budget climate.”

The long-term care program, providing for home-based services and 90 free days of nursing home care, was approved by an 11-4 vote. Both Stark and Gradison voted against it.

HIGHLIGHTS OF PEPPER PLAN

The Pepper Commission, a bipartisan panel of legislators and presidential appointees, proposed that Congress enact an ambitious program to provide health insurance coverage for all Americans. The price tag would be $66 billion a year in federal funds and $20 billion financed by private businesses.

Highlights of the plan include:

Mandatory health insurance coverage for all firms with 100 or more workers.

Subsidies and tax credits to encourage smaller firms to provide insurance.

Coverage under a public plan for all persons without private health insurance.

Free public insurance for pregnant women and children up to 6 in poor families.

Government-paid home care services for the severely disabled.

Free care for the first 90 days spent in a nursing home.