Panel OKs Clinton Health Care Goals : Legislation: Committee is first in House to back plan that hews to the President’s key objective of guaranteed universal coverage. Approval assures a floor vote.

President Clinton’s beleaguered effort to overhaul the nation’s health care system took a step forward in Congress on Thursday when the House Education and Labor Committee became the first committee in the House to approve a health plan that closely resembles the Administration’s proposal.

Elsewhere on Capitol Hill, however, the fate of health legislation remained in question. In the Senate, a bipartisan group of moderate Finance Committee members encountered stiff resistance from both the left and the right as they attempted to fashion a bill that could require uninsured individuals to buy health coverage.

Passage of a bill similar to Clinton’s was never in question in the Education and Labor Committee, the most liberal of the three House panels considering health legislation. Indeed, the committee also narrowly approved Thursday the most radical of the health care options before Congress: a Canadian-style, government-financed health care system known as “single payer.”

But the committee’s 27-17 vote in favor of a plan that hews to Clinton’s goal of guaranteeing coverage for every American nonetheless marked a milestone and assured that health legislation can reach the House floor. The vote, generally along party lines, with two Democrats defecting, followed similar action earlier this month by the Senate Labor and Human Resources Committee.

“With today’s action, for the first time ever, a committee in each house of Congress has reported a bill that guarantees universal coverage,” Clinton said in a statement issued by the White House after the vote. “They have broken the chokehold of special interests, and by choosing to cover everyone, have stood up instead for millions of hard-working, middle-class Americans.”

Added Chairman William D. Ford (D-Mich.): “It’s going to be on the floor in a matter of weeks. . . . Everyone’s going to get the chance to put up or shut up.”

The Education and Labor Committee bill is significantly more generous than Clinton’s. Over five years, it would add an extra $30 billion in health benefits and subsidies for the poor and small businesses.

Meanwhile, the House Ways and Means Committee plodded through a series of minor amendments to its health bill but Chairman Sam Gibbons (D-Fla.) called the lawmakers into unusual weekend sessions in a drive to finish work by Tuesday.

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So far, with a single exception, the Ways and Means panel has kept to its chairman’s call to match spending on benefits with new revenues to pay for them. The biggest challenge ahead appears to be the financing provisions, coming up for votes early next week.

The third House committee considering health legislation--Energy and Commerce--appears hopelessly deadlocked and perhaps unable to produce legislation.

Ultimately, House leaders will have the task of melding the committee bills into a single piece of legislation that they hope could come to a vote this summer. They also have promised advocates of a single-payer system, who number more than 90 in the 435-member House, that they will get a separate vote on their proposal.

House Majority Leader Richard A. Gephardt (D-Mo.), who will be leading the effort to meld differing versions of health care legislation, said he is now spending at least two-thirds of his time preparing the way for the House vote.

And while the going is slow, he insisted that he remains optimistic. “We are winning this fight in little bitty steps in little bitty ways every day,” Gephardt said.

Many in the House are watching the Senate--and specifically its Finance Committee--with a wary eye. They are reluctant to take a dangerous political stand on health care until they are confident that the Senate will not undercut them by insisting on something more conservative.

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Hopes for a compromise in the Finance Committee are riding on the group of moderates, who have said they are close to agreement. Their plan would first put into place a set of changes in insurance practices that are aimed at making health coverage more affordable.

Presumably, those measures alone would expand the number of people who have health coverage--now about 85% of all Americans. But if that figure did not reach 95% by the year 2002, a so-called “individual mandate” would kick in, forcing people to buy health coverage, just as state law now requires them to buy insurance for their cars.

The moderates’ approach is an effort to reach Clinton’s goal of universal coverage without his proposal to require businesses to pay for 80% of their workers’ insurance. That has proved to be the single most controversial provision of the Clinton plan, with business groups warning that the additional cost would force many small firms to lay off workers or shut down.

However, it is far from certain that there would be any more support for a bill that could force middle-class families to spend thousands of dollars a year on health coverage. Moreover, it is unclear whether such a requirement could be enforced.

Poor and low-income people would receive government subsidies to help them afford the coverage. However, paying for those subsidies could mean hundreds of billions of dollars in new taxes over a decade.

Conservatives already had expressed opposition to the individual mandate. On Thursday, liberal groups chimed in as well.

“The Senate Finance Committee is moving toward abandoning millions of American health care consumers,” said Robert Carolla, legislative counsel to Consumers Union.

In a letter to each member of the Finance Committee, the Health Care Reform Project--a coalition of 56 organizations that support the President’s plan--also said that it opposes the alternative being crafted by the moderates.

“We strongly urge you to reject this approach or any others that fail to meet the test of guaranteeing all Americans affordable comprehensive coverage,” the groups wrote.

Meanwhile, First Lady Hillary Rodham Clinton continued her effort to rally the President’s supporters, telling a lunch-time audience a story about a young girl who died of meningitis after her parents, who did not have health insurance, were sent away from a hospital with a bottle of Tylenol for their child’s fever.

“I want to live in a country where the care of children is not determined on whether or not their parents have health insurance,” Mrs. Clinton told her audience at a luncheon sponsored by the Women’s Legal Defense Fund. “This is an issue that has an ethical dimension, a moral dimension. It says a lot about what kind of people we are, what our values are, what we care about.

“The only way for all of us to be secure, and particularly for those among us who already are vulnerable or are more likely to become vulnerable--women and their children--to be taken care of is to absolutely commit ourselves to giving health care coverage to every single American.”

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Times staff writer David Lauter contributed to this story.