Waxman Viewed as Key Player in Health Plan : Politics: Administration considers Democrat’s strong support essential. GOP Rep. Moorhead will also play a role.

As Clinton Administration officials hammer out their proposal to overhaul the nation’s health care system, Rep. Henry A. Waxman (D-Los Angeles)--a champion of expanded medical coverage for the poor, disabled and elderly--is very much on their minds.

“He’s one of those people everybody presumes will be a player and everyone presumes will be looking out for those who have less,” said an Administration official involved in the process. “People would say: ‘Waxman won’t like that. Or Waxman will like that.’ ”

Though not as influential as Waxman, Rep. Carlos J. Moorhead (R-Glendale) nonetheless has potential clout on health care as the ranking Republican on the Energy and Commerce Committee--one of various House panels that will handle the legislation.

“We’re very interested in winning Republican support,” said a White House official who is involved in selling the sweeping reform package to Congress. “He’ll be important in trying to promote that positive dialogue.”

Waxman, a major force on health care for 15 years, and Moorhead, a relative newcomer to the issue, are two of many who will determine how Clinton’s plan fares on Capitol Hill. Waxman is expected to help shape the final legislation, and his strong support is considered essential; Moorhead is poised to participate in behind-the-scenes negotiations and to influence how much bipartisan backing the Administration wins.

The two Valley-area lawmakers reflect the challenge ahead for President Bill Clinton and First Lady Hillary Rodham Clinton as they steer the enormously complex, high-stakes plan through the legislative labyrinth: keeping Waxman, one of the House’s most liberal members, firmly on board while reaching out to Moorhead, one of the House’s most conservative, pro-business members.

At this point, Waxman is upbeat about the proposal and its prospects--despite his concern that proposed reductions in Medicare and Medicaid spending may curtail medical care for the poor and the elderly.

“I am optimistic,” he said as he sat at his desk in his expansive Rayburn Building office framed by the white-domed Capitol behind him. “I don’t think it’s going to be easy. But I think there’s a good chance.”

Moorhead is more circumspect. Though less leery of the Clintons’ intent than he was after November’s election, he backs a more gradualist House Republican alternative that he helped devise. The plan would require employers to make health insurance available for workers to buy at their own expense.

“Everyone seems to want some kind of health program,” Moorhead said Wednesday shortly before joining other congressional leaders at a White House meeting with the President and Mrs. Clinton.

“And I think there is a lot of room for compromise. If there is a willingness to move forward, I think you’re going to find a lot of give and take, and perhaps we’ll get a bill that is not as harsh on the American people as the Clinton plan looks at first glance and gives greater options but keeps the costs at a reasonable level.”

Clinton’s blueprint for so-called managed competition would provide all Americans--including the 37 million who lack health insurance--with a generous insurance policy through regional purchasing cooperatives. Employers would be required to provide insurance and pay 80% of the cost. Low-income families would receive subsidies to buy insurance.

The package is expected to cost the federal government an additional $350 billion over five years. The White House proposes to meet the expense through a combination of new “sin” taxes, reductions in Medicare and Medicaid and other health cost controls. Medicare is the government-financed health care program for the elderly; Medicaid is the program for the poor.

The Administration maintains that the health care plan would reduce federal deficits by $91 billion over seven years, but critics call the estimate wildly optimistic.

The President’s projected savings of $238 billion for Medicare and Medicaid, in part from reduced waste and profligacy, has been called particularly unrealistic.

“I’m concerned and a little skeptical whether they can achieve the level of savings from Medicare and Medicaid,” said Waxman, who was responsible for extending coverage in the two programs in the 1980s. “I very much want health care reform, but I don’t want us to make things worse for the elderly, disabled and poor.”

Waxman, one of the shrewdest strategists in Congress, is positioned to put his stamp on the legislation as chairman of the Energy and Commerce subcommittee on health and environment, which will hold hearings on the bill.

His staff has consulted regularly with the Administration, and he has had several meetings with Mrs. Clinton and Ira C. Magaziner, her chief health care adviser, including private sessions in his office and at the White House.

Throughout, Waxman says, he has emphasized the necessity of universal coverage--a longtime personal goal--sensitivity to the needs of the poor and the imperative of allowing choice of coverage. He says the Administration has “made changes to accommodate me,” though concerns remain.

Waxman’s level of enthusiasm for the final product will be closely watched by Democratic colleagues and various interest groups.

“Low-income groups and the elderly look to him a great deal and therefore his approval is critical to winning their support,” said a White House aide who helped formulate the plan. “And a lot of traditional liberal Democratic groups will look for his reaction. While one thinks they will ultimately be with us regardless, the enthusiasm they bring to the cause will be critical.”

In contrast to Waxman, Moorhead views his involvement with the issue in the past eight months as largely “a learning experience.” He has attended weekly meetings as a member of the Republican Task Force on Health Issues as well as sessions with Mrs. Clinton. He expects to be part of the behind-the-scenes negotiations as the bill moves through the Energy and Commerce Committee.

The low-key lawmaker says the Clinton plan “has many solid parts to it” but that “nobody believes that the figures on money are anywhere near accurate.” He expresses concern that the reform not “go so far it will weaken the quality of health care in America or increase the costs that many people will have to pay.”

Moorhead said that his goals--which would be met by the GOP House plan--are “to keep our health system the best in the world” and “make medical insurance more readily available to the American people, including those who don’t have it.”

“I don’t think we could live with the Clinton bill as it is now because it’s so vague on costs.”