Clinton’s Handoff to Congress Finds Forces Eager to Pounce : Lawmakers: Many analysts predict that after months of wrangling and debate, what emerges will be fairly close to the President’s original plan.

Now the real battle begins. With his speech Wednesday night, President Clinton officially handed off his health care proposal to Congress, where dozens of committees and factions stand ready to pounce.

By making it clear that he will compromise on any detail of his plan so long as the final product meets the basic goals of reform--providing health coverage for all Americans and bringing medical costs under control--Clinton has signaled his acceptance of the fact that Congress will insist on having its say.

And say it will--for the rest of this year and much of 1994.

Rarely has every lawmaker been so deeply engaged in a single piece of legislation. Health care reform is not only the most sweeping overhaul of social spending in decades but an issue that legislators are well aware will have a significant effect on the lives of virtually every one of their constituents.

Moreover, many in Congress already have spent more than a decade studying the health care problem. They have developed definite ideas about how it should be fixed.

“I made my first speech on this in 1973 to the Young Democrats. This is not an issue that I discovered yesterday,” said Rep. Jim McDermott (D-Wash.), whose proposal for a government-financed, Canadian-style health care system has 89 supporters in the House.

“This is not something that will go quickly,” McDermott said of the reform effort. “You just can’t ram this through.”

Yet the seemingly endless legislative wrangling is part of the time-honored process by which America makes major policy decisions. And tedious as it may seem, the process serves at least three vital purposes:

* First, the design and policy engineering of the Clinton plan will be mercilessly tested. What begins now is an adversarial trial by combat. Weaknesses and unforeseen side-effects may be uncovered.

* Second, over the next 10 months or so, the public--both consumers of health care and those who provide it--will gain a better understanding of what the new system would mean to them as individuals.

* Third and potentially most important to those who must put their political careers on the line, as the public learns more about the plan and its implications, it will become clearer what the majority of people want, how badly they want it and how willing they are to accept the unpleasant side-effects of reform.

Even as they fill the air with their own words, members of Congress will be listening carefully for the almost-inaudible sound of public opinion beginning to jell.

In the end, many analysts predict, unless it backs away from significant health care reform entirely, Congress may come out fairly close to Clinton’s original plan. Hundreds of details may be rejiggered and some major features could be redesigned. But political and economic realities make it hard to stray far from the Administration’s position on most of the basics if care is to be universal and a serious assault on costs is to be made.

Clinton is expected to submit the actual health care legislation next month and congressional committees are scheduling hearings to begin within days. However, most on Capitol Hill believe that the earliest the legislation will come to a vote in both houses will be mid-1994.

Particularly in the House, virtually every committee is laying claim to at least part of the many-tentacled plan.

Agriculture Committee Chairman E. (Kika) de la Garza (D-Tex.), for instance, has asserted that because diet and nutrition are primary components of health care, his committee is entitled to a say. “Veterans, Post Office, Armed Services--you name it,” sighed one House leadership aide, ticking off the panels that have expressed interest in reviewing the plan. “I imagine that every committee that can get it will get it.”

“Even the Ethics Committee will have a part of it,” joked Sen. John B. Breaux (D-La.).

In the end, however, primary responsibility will fall upon four panels. Issues of financing will be handled by the Senate Finance and House Ways and Means committees, while broad policy questions will be weighed by the Senate Labor and Human Resources and House Energy and Commerce committees.

Most of the key Democratic players on those committees have vowed to aid the Clinton effort. “I intend, if it is humanly possible, to support this and do nothing else,” said Energy and Commerce Chairman John D. Dingell (D-Mich.), who in the past has been allied with the forces supporting McDermott’s bill.

However, one of the President’s hardiest foot soldiers, Ways and Means Chairman Dan Rostenkowski (D-Ill.), is under the cloud of an ethics investigation that could take him out of the action. If he is indicted, the vacuum could be filled in part by Ways and Means health subcommittee Chairman Pete Stark (D-Oakland), who has publicly ridiculed Clinton’s untested concept of “managed competition” as “a unicorn, . . . a beautiful animal in fairyland.”

Backers of competing health care proposals will insist that their plans be examined as well.

Clinton tried in his plan to accommodate many of their demands. Indeed, in the view of some, he was too obliging. Louisiana’s Breaux called it “the gumbo approach, where you put in a little of everything and stir it up and hope it comes out well.”

Yet advocates of other systems are far from satisfied. McDermott, for one, already has been promised a vote on his “single-payer” proposal, which would turn the management of the health care system over to the government.

Ultimately, however, congressional leaders believe that Congress’ single-payer faction--largely liberal Democrats--can be persuaded to support some version of the President’s plan.

Said Rep. Henry A. Waxman (D-Los Angeles), chairman of Energy and Commerce’s health and environment subcommittee and a supporter of the single-payer concept:

“When all is said and done, some time next year, the alternatives are going to be pretty much the Clinton proposal and the goals it presents, or the status quo. . . . I can’t believe those of us who say they’d prefer single payer will say they would rather see no reform” than the Clinton plan.

More in question are the votes of Senate Republicans. Under Senate rules, their numbers give them the potential power to block legislation so both parties believe that Clinton cannot prevail without the support of at least a handful of GOP senators.

As a result, many believe, the ultimate plan passed by Congress will be a compromise between the version laid out by the President and that of a group of Senate moderates, led by Sen. John H. Chafee (R-R.I.).

The Chafee plan contains many of the elements of the Clinton plan but rejects its requirement that all employers provide health care to their workers and its government controls on health care premium increases.

And even those who have promised to support the Clinton approach are far from comfortable with some aspects of the plan.

Waxman, for example, said he is “concerned and a little skeptical” of Clinton’s claim that he can squeeze $238 billion from projected spending in Medicare and Medicaid without harming the beneficiaries of those programs.

Senate Finance Committee Chairman Daniel Patrick Moynihan (D-N.Y.) has gone so far as to call the financing scheme “fantasy.”

The political equation will be complicated, too, by the fact that Congress could be forced to vote on the plan during the height of its campaign season--not a time when lawmakers are generally given to boldness.

Yet congressional scholar Norman J. Ornstein, noting the public’s general disaffection with Congress, said that election-year jitters actually could play into the hands of those seeking dramatic change--just as it did with tax overhaul in 1986.

Now as then, lawmakers believe that their jobs depend on proving to voters that they are capable of acting when the public has cried for change.

“In the end, for members of Congress in 1986, the only thing worse than voting for that package was to vote against it and go home empty-handed,” Ornstein said.