Clinton Hints He May Bend on Health Reform : Legislation: But President appears unwilling to yield on universal coverage. Health alliances may be abandoned.

President Clinton gave new signals of flexibility Monday on many major elements of his health reform plan, but aides warned that on the key question of health coverage for all Americans, the President increasingly appears headed for a collision in the Senate.

“I admit that we needed to make some changes in our original proposal,” Clinton said during a televised interview on NBC’s “Today” show. “I always said we would. We want it now to be less bureaucratic and less regulatory.”

Aides said that statement reflects Clinton’s willingness to abandon several controversial elements of his own plan, including the mandatory insurance purchasing pools, or “health alliances,” to which many businesses had objected.

In addition, while Clinton repeated his insistence that any health plan provide coverage for all Americans, he couched his statement in language aides said was designed to encompass at least some potential compromises that have been the subject of continued behind-the-scenes negotiations between the White House and leading members of Congress.

“The important thing is that we should not walk away from this Congress without a commitment to cover everyone,” Clinton said. That reference to a “commitment” for coverage differs from Clinton’s earlier language, which insisted Congress guarantee coverage to all Americans in one step.

Congress could possibly provide a commitment through one of several proposals to mandate universal coverage only after voluntary efforts had been given a try, officials said. Such non-mandatory mechanisms, known as “triggers,” have circulated on Capitol Hill for weeks, but Clinton has not specifically endorsed them.

Officials said that Clinton could support some of the trigger proposals, but that in private meetings at the White House, including a session of top advisers over the weekend, he had taken a firm stance against any compromises that would not, by some specific date, guarantee health coverage for all Americans.

“The line over here is getting pretty hard now,” said one senior Administration official. “As a result, over on the Senate Finance Committee, they don’t really feel he’s going with them now.”

Finance Committee Chairman Daniel Patrick Moynihan (D-N.Y.) said Sunday that a bill providing coverage for all Americans by mandating that all companies purchase insurance for their employees could not pass Congress.

Clinton’s insistence on having precisely what Moynihan says cannot be delivered sets up a potential collision that, White House officials fear, could end with a defeat of health reform efforts for this Congress.

Administration officials are now largely pinning their chances on progress on the House, where Republican tactics of refusing to consider compromises appear to have backfired and solidified Democratic support. The Administration’s hope is that if the House moves forward with a bill, the movement somehow will break the current Senate deadlock.

Officials hope for a change of heart among at least some of the conservative Democrats and moderate Republicans who say they want to see health reform pass but do not support a requirement that all businesses insure their workers.

Some of the compromise proposals that members of the moderate bloc have supported “just don’t work” on a technical level, said one senior Clinton adviser, expressing the hope that legislators will adopt that conclusion as they continue to analyze rival bills. But, the official conceded, as of now, Clinton and his aides do not see a clear path to a Senate majority.

First Lady Hillary Rodham Clinton reflected that view Monday in a meeting with groups that have supported the Administration on health care, warning them that the proposal is now in severe peril.

Administration officials have been critical of their allies, feeling that they have concentrated too much on the Clinton plan provisions that they dislike at the expense of the broader effort to achieve a health care bill.

“We hoped people would say, ‘I like the overall bill, but I just want to fix one part.’ Instead, all we’ve been hearing is, ‘But,’ ” said one senior Administration aide.

As they try to rally their supporters, Administration officials find themselves caught between two conflicting impulses in Congress. One the one hand, moderate Republicans and conservative Democrats have been probing for signs of compromise. As Sen. Bob Packwood (R-Ore.), the senior Republican on the Finance Committee put it in a speech: “If the President does not wink or nod, then I fear we’re deadlocked.”

At the same time, however, Clinton’s allies in Congress fear that the President, in his search for votes, may lose the support of the liberals who have given the greatest support to health care reform so far.

“On this question of universal coverage, I don’t think we should play semantic games,” said Sen. Paul Wellstone (D-Minn.).

Caught between those two sentiments, Clinton has issued a series of carefully nuanced statements, even as his aides insisted that any bill must include some form of universal coverage. “The signal he is sending is that he is four-square behind universal coverage,” said Clinton adviser George Stephanopoulos.

Also Monday, officials launched a major push to remind legislators of the dangers faced by middle-class voters if Congress attempts only piecemeal reform.

In separate speeches, budget director Leon E. Panetta and Health and Human Services Secretary Donna Shalala presented the argument that halfway reforms will backfire, increasing costs to the middle class.

Without universal coverage, any attempt to control costs will collapse, Panetta said. And without cost controls, he added, both the government’s budget and the finances of many companies will hemorrhage.

Shalala released new statistics on the number of Americans without insurance and urged Congress to take “bold steps.”

“There’s been a lot of talk in recent weeks about some kind of incremental approach to reform,” Shalala said, using a word that Moynihan had used to describe what he thought could pass the Senate.

If universal coverage does not pass, she warned, middle-class families with insurance will continue to be overcharged to cover the costs of the uninsured--costing the average family $600 over the next five years and steadily increasing the percentage of Americans with no insurance at all.

The percentage of uninsured Americans jumped from 12.5% in 1980 to 17.2% in 1992, according to figures released by the government, Shalala said.

The statistics, contained in the department’s annual report on the nation’s health, show that the majority of the uninsured are employed either full time or part time, and that in 1992, 48.8% of those without insurance earned between $14,000 and $50,000 a year.

“These are hard-working, middle-class Americans who get up and go to work every day,” Shalala said. “Yet every day, they must live without the security of health insurance.”

Times staff writers Karen Tumulty and Marlene Cimons contributed to this story.