Fervent Clinton Asks Swift Health Reform : State of the Union: He also stresses welfare, crime in address that purposely avoids any major new program.

President Clinton, striving to rekindle support for the centerpiece of his domestic agenda, Tuesday night called on Congress to pass his massive health reform plan as he delivered a State of the Union speech strong on passion but deliberately devoid of major new legislative initiatives.

Faced with a lengthy, and still partly unfulfilled, catalogue of promises from his first year in office, Clinton used his 65-minute, nationally televised address to review his successes and to appeal for swift action on the three largest items that remain--health reform, welfare and crime control.

On health care, which occupied by far the longest section of his speech, Clinton again offered to cooperate with Republicans in drafting a bipartisan program, but he bluntly threatened to veto any bill that does not meet his fundamental requirement.

“I want to make this very clear,” he said with studied determination. “If you send me legislation that does not guarantee every American private health insurance that can never be taken away, you will force me to take this pen, veto the legislation, and we’ll come right back here and start all over again.”

The veto threat, a rare moment of drama in a State of the Union Address that for the most part tracked over familiar ground, was part of an effort to stir the sense of urgency that White House strategists believe must be maintained if his plan for a comprehensive overhaul is to win approval.

In the Republican response after the speech, Sen. Bob Dole (R-Kan.), the minority leader, gave little sign of compromise--sharply attacking Clinton’s health plan. The President’s proposal, he said, contained a “massive overdose of federal control” that would “put a mountain of bureaucracy between you and your doctor.”

Clinton also made a lengthy pitch for his welfare reform proposals, promising to submit legislation this spring. Working on the two simultaneously is “inevitable and imperative,” Clinton said, arguing that many people remain on welfare precisely to obtain health benefits.

While he pushed for passage of his agenda, Clinton carefully avoided proposing new programs, as other presidents often have on such occasions. Senior White House advisers believe that voters think the President already has promised more than he can accomplish. In fact, White House officials fear over-promising, seeing it as Clinton’s major vulnerability--one that his Republican opponents already have begun to talk about.

In addition, as Clinton stressed, the constraints of last year’s budget plan have left Congress and the White House virtually no flexibility to propose new spending without cutting existing programs.

So rather than make a raft of new promises, Clinton devoted most of his speech to convincing Americans that he is hard at work on the promises he already has made, and that he can deliver.

“In 1992 the American people demanded that we change,” Clinton said. “A year ago I asked all of you to join me in accepting responsibility for the future of our country. Well, we did. We replaced drift and deadlock with renewal and reform.

“And I want to thank every one of you here who heard the American people, who broke gridlock, who gave them the most successful teamwork between a President and a Congress in 30 years,” Clinton said, referring to a record of legislative action not exceeded since the early years of the Lyndon B. Johnson Administration.

On a second issue of increasing public concern, Clinton said the epidemic of violence across the land must be addressed. But he added--in an acknowledgment that Democrats in the past often have been reluctant to make--that the role of the federal government is limited and that many of the country’s ills can only be handled by family, school, church and community.

“Our problems go way beyond the reach of government. They’re rooted in the loss of values and the disappearance of work and the breakdown of our families and our communities,” Clinton said. “The American people have got to want to change from within if we’re going to bring back work and family and community.”

In particular, Clinton pointed to one of the most controversial issues of social policy--the nation’s rapidly growing rate of out-of-wedlock births. “We cannot renew our country when, within a decade, more than half of the children will be born into families where there has been no marriage,” he said.

At the same time, he endorsed a set of specific steps to reduce crime, beginning with a “three strikes” law that would require life sentences for people convicted of three felonies. He also repeated his call for federal assistance to allow cities and towns to hire 100,000 more police officers.

At the same time, Clinton appealed to gun owners to join him in taking steps to reduce gun violence. “Hunters must always be free to hunt and law-abiding adults should be free to own guns,” Clinton said. But, he added, “there is no sporting purpose on Earth that should stop us from banishing the assault weapons that outgun our police and cut down our children.

“You didn’t create this problem,” Clinton said, addressing those who use guns for sport. “But we need your help to solve it.”

By contrast with the emphasis on domestic policy, only about 10 minutes of the speech focused on foreign affairs. And even those remarks appeared perfunctory--repeating statements Clinton and his top aides have made in the past.

Clinton’s voice was hoarse as the speech started and seemed to fade more as he continued. Twice his voice cracked--once as he referred to violence against children and a second time toward the end of his speech when he referred to his mother, who died earlier this month.

The multitude gathered in the House chamber for the speech included, by tradition, both houses of Congress, the Cabinet, members of the Supreme Court, the Joint Chiefs of Staff and the diplomatic corps.

As has been true in past major Clinton speeches, the White House reserved special symbolic seats flanking First Lady Hillary Rodham Clinton in the House gallery. This time, Mrs. Clinton sat between AFL-CIO President Lane Kirkland and Jack Smith, chairman of General Motors Corp. Organized labor and the auto companies are the Administration’s two biggest allies in the health care battle. Clinton has also been anxious to mend fences with labor after the strains caused by the debate last fall on the North American Free Trade Agreement.

Also seated near Mrs. Clinton were Tommy O’Neill, son of the late House Speaker Thomas P. (Tip) O’Neill Jr. (D-Mass.), and James S. Brady, President Ronald Reagan’s former press secretary who was wounded in the 1981 assassination attempt on his boss.

Clinton cited the gun control measure named after Brady, which requires a waiting period before a handgun can be purchased, on his list of major legislative accomplishments. He also touted the smaller budget deficit, tax cuts for low-income workers, the trade agreement, a program providing young Americans the opportunity to earn money for college by performing public service, family leave and the motor-voter registration bill.

“All passed, all signed into law with not one single veto,” Clinton said. “These accomplishments were all commitments I made when I sought this office and, in fairness, they all had to be passed by you in this Congress. But I am persuaded that the real credit belongs to the people who sent us here, who pay our salaries, who hold our feet to the fire.”

With an eye toward future legislative battles, Clinton took aim at the credibility of his Republican opponents--arguing that they were wrong about his economic plan and, by extension, cannot be trusted to be right about issues such as health care.

Clinton labeled his opponents as “naysayers who said this plan wouldn’t work. But they were wrong.”

The budget deficit, Clinton said, has declined from a projected $300 billion to $180 billion, and inflation and interest rates are at historically low levels.

“If you will stick with this plan,” he said, “we will post three consecutive years of declining deficits for the first time since Harry Truman lived in the White House and once again, the buck stops here.”

White House aides began work on Clinton’s speech shortly before Christmas and Clinton first reviewed a proposed outline for the address over the New Year’s holiday, which he spent at Hilton Head, S.C., at the Renaissance Weekend annual public policy retreat.

Clinton saw a first complete draft of the address just before leaving for Europe in early January but did not devote serious attention to it until last week, as he was flying back from Los Angeles after viewing earthquake damage.

The President worked extensively on the sections on health care and welfare reform and wrote the passages that linked the two, aides said. He worked closely with Mrs. Clinton and senior advisers David Gergen and George Stephanopoulos in honing the message of moral renewal that infused the sections on crime and middle-class values.

Political adviser Paul Begala and pollster Stanley B. Greenberg also contributed ideas for the speech, which was written chiefly by mid-level aides David Dreyer, Robert Boorstin and Jeremy Rosner.

Gergen’s influence could, perhaps, be seen in several instances in which Clinton adopted strategies once used by Gergen’s former boss, Reagan. As Reagan loved to do, Clinton introduced a man in uniform to his audience--a New York City police officer whose community policing efforts had been featured in a New York Times Magazine cover story in December. Clinton also continued his effort to steal for the Democrats themes of family and community that Reagan had used so effectively.

In a final Reaganite line, Clinton loudly vowed to resist cuts in the defense budget. “Many people urged me to cut our defense spending further,” Clinton said. “The budget I send to Congress draws the line against further defense cuts.”

The rhetoric, however, was largely hollow, for the most influential pressure in Congress now is not from liberals seeking to cut defense spending but from conservatives who argue that Clinton already has pared it too much.

On Tuesday, Clinton practiced delivery of the address for almost two hours in the movie theater in the White House residence, as aides wandered in and out to offer suggestions on content and oratorical emphasis. He marked up the ninth draft of the speech Tuesday afternoon and the final version was still being polished a couple of hours before Clinton took the podium in the House chamber.

The absence of new promises, of course, does not mean that Clinton has suddenly changed into a leader with a small agenda. The White House has enough business left unfinished from last year to keep Clinton and Congress busy for months, perhaps years, to come.

At the top of the list--and the centerpiece of Clinton’s speech--is his promise of universal, lifetime health insurance for all Americans.

Both sides in the burgeoning health reform debate have seen this speech as the opening event of the most intensive part of the struggle--a legislative battle certain to last many months.

* GOP RESPONSE: Senate Minority Leader Bob Dole blasts health plan. A18