NEWS ANALYSIS : Clinton Draws His Line in Sand on Health Care

President Clinton, a man who loves compromise, says that he has found his stopping point.

After 17 months in office, during which many have questioned just what it is that Clinton really stands for, the President has taken his stand on the principle that health reform must mean providing coverage for all Americans.

Despite predictions by leading Republicans and Democrats that his position cannot prevail, Clinton told aides over the weekend, and repeated in a speech Tuesday, that “I refuse to declare defeat.”

Clinton has made it clear that he is willing to compromise on almost every other major part of his massive health reform proposal. But his decision to fight over universal coverage amounts to a roll of the dice--with the success of his presidency at stake.

If he prevails--and aides said they believe that despite current gloomy portents he still has a chance to prevail in the House and win narrowly in the Senate--he will have won a huge and highly visible victory on an issue--covering everyone--that polls consistently show the public supports. But should he fail, political strategists warned, the loss could be devastating--reinforcing in the minds of voters the notion that Clinton has been unable to break the Washington gridlock that he campaigned against.

Speaking Tuesday to the Business Roundtable, an organization of big businesses, Clinton drew on his recent trip to Normandy for the anniversary of D-day, saying that just as the World War II generation met its challenges overseas, today’s generation of leaders must meet the challenges of domestic needs.

Figuring out a way to provide health insurance to all Americans “goes to the heart of whether we can get our own economic house in order. It goes to the heart of whether we can make government work for ordinary people. It goes to the heart of whether we can empower people to view change as a friend instead of an enemy,” Clinton told the business leaders. “Unless we can provide coverage for every American in a reformed system which focuses on both quality and control of costs, the deficit will grow, your costs will continue to grow and undermine productivity, and more and more Americans will lose their coverage or be at risk.”

The decision to fight on a point of principle rather than seek a broader compromise won the support of Clinton’s most loyal allies on Capitol Hill.

“Let’s have it out and frankly come to some conclusions. And the sooner the better,” said Sen. Tom Daschle (D-S.D.), a member of the Finance Committee and a protege of Senate Majority Leader George J. Mitchell (D-Me.), who passed up a possible seat on the Supreme Court to lead the fight for health reform. “What you have to compromise away, what a watered-down version of health reform you get to (win) 60 votes (in the Senate), in my view is unacceptable.”

Democratic strategists said they believe that they have a shot at rounding up a 51-vote majority in the Senate for a universal coverage bill--one that they would then, in effect, dare the Republicans to filibuster.

“The American people are not going to permit crass politics to be played with this issue that makes such a difference to them,” said Senate Labor and Human Resources Committee Chairman Edward M. Kennedy (D-Mass.), whose committee has produced a bill that Mitchell could use as a vehicle to get the issue to the Senate floor if the Finance Committee, which is also working on a health bill, remains deadlocked.

“Any political leader or any political party that stands between the Senate of the United States having a full and fair debate and discussion is going to be perceived, I think, as not only an obstructionist but is going to be a politician at risk,” Kennedy added.

Others, however, warned that by insisting on universal coverage and going for 51 votes rather than watering down his plan and seeking a broader majority, Clinton is jeopardizing the best chance Congress has had to make meaningful, if limited, reforms.

Those critics echoed statements made by Finance Chairman Daniel Patrick Moynihan (D-N.Y.) over the weekend that proposals to reform the insurance system but not cover everyone are still “important advances.”

“Government is about the increments by which you move toward goals you desire,” Moynihan said.

“It’s clear that a 51-vote strategy cannot work, in my opinion,” said Sen. John B. Breaux (D-La.), who authored a more conservative health plan that would not guarantee universal coverage. “It’s easier to get to 63 votes” by crafting a bill that wins significant GOP support “than it is to get 51” by appealing to Democrats on party lines, Breaux said.

White House strategists point to last fall’s experience, when Republicans tried to use a filibuster to kill the so-called Brady bill, which authorized a waiting period for the purchase of handguns. The Republicans gave up after the effort proved wildly unpopular with constituents. “The American people don’t like filibusters. They think they’re sneaky,” said one White House aide.

But Republicans, and some Democrats, pointed to the opposite example: early in his Administration when heavy-handed partisan tactics produced a filibuster and Clinton suffered the humiliating defeat of his economic stimulus package.

In the stimulus-bill fight, the White House wrote off moderate Republicans and now may be doing the same on health care, warned Sen. Dave Durenberger (R-Minn.). “I don’t think that’s the way to get health care reform. That’s something that sets off people like me.”

Meanwhile, action--or more properly the lack of it--in Congress illustrated the difficulties ahead.

Moynihan, who had predicted that his committee would complete work on health care by the end of this month, announced that the schedule had slipped until mid-July. And a leading Democratic member of the Finance Committee, Sen. Bill Bradley (D-N.J.), said that he could not support Clinton’s preferred method of achieving universal coverage and proposed yet another entry in what has become a bewildering array of potential compromises. Bradley’s plan rejects the requirement that employers pay for workers’ insurance. It instead mandates that individuals buy insurance if reforms in the health care market fail to produce near-universal coverage.

On the House side, the Ways and Means Committee bogged down amid partisan sniping with Republicans attempting to increase benefits while Democrats charged that GOP lawmakers wanted to grandstand in favor of additional services without supporting revenue-raising measures in the bill.

“Unless we are willing to pay for these add-ons, it makes no sense to add them on,” said Chairman Sam Gibbons (D-Fla.), who threatened to keep the panel in session over the weekend in his effort to complete work on a bill next week.

Clinton has one major political trump on his side in the coming fight. Unlike many parts of his health plan, which have proved controversial, universal coverage enjoys broad popular support. Polls consistently have shown that most Americans favor the idea of universal coverage. Clinton’s proposal that employers be required to cover all their workers also draws strong public support. A highly publicized fight on that issue would be a way of focusing public attention on one of his plan’s stronger points instead of on its weaknesses.

A second major argument in favor of universal coverage is, simply, that most of the alternatives that have been proposed so far do not work, Administration officials said.

Times staff writer William J. Eaton contributed to this story.