Key House Panel to Vote on Health Plan : Congress: Ways and Means Committee is expected to narrowly approve proposal with universal coverage, employer mandate.

The House Ways and Means Committee neared final approval Wednesday of a health care bill that would achieve President Clinton’s goal of universal coverage by requiring employers to pay 80% of medical insurance costs while employees put up the other 20%.

The bill would cover all Americans except illegal immigrants and prisoners, beginning in 1998. The panel is expected to pass the measure today by a narrow margin, with all Republicans and at least three Democrats opposed. Approval would set the stage for the full House to vote on a health care bill after Congress returns from its July 4 recess.

“We’ve finished a historic piece of legislation,” Rep. Sam Gibbons (D-Fla.), acting chairman of the committee, said after he and other Democrats had added a few more sweeteners to preserve the fragile majority for the bill on the 38-member committee.

“This is a good bill for moderates,” said Rep. Benjamin L. Cardin (D-Md.), one of 20 (or possibly 21) Democrats who favor the legislation. “This is a product that is capable of developing a lot of support on the floor.”

The House Education and Labor Committee had previously approved a similar bill. Democratic leaders are expected to combine the products of the Ways and Means Committee and the more liberal Education and Labor panel into a single measure that will be sent to the House floor.

In the Senate, all eyes were on the sharply divided Senate Finance Committee, where votes are expected today on key parts of Clinton’s plan. The Senate Labor and Human Resources Committee had previously approved a bill along the lines of the President’s proposal.

Thirty-nine Senate Republicans, led by Minority Leader Bob Dole (R-Kan.), finally introduced their own proposal on Wednesday. It offered universal access without any attempt to provide health insurance for everyone.

Dole’s plan contains “no price controls, no mandates and no taxes,” he said. It calls for $100 billion in subsidies for low-income families to buy private coverage as well as changes in insurance laws to make coverage available to millions who now go without.

“This is not offered as a ‘partisan Republican plan.’ This is offered as another option, and we think the right option,” Dole said.

In the Ways and Means Committee, the 14 Republican members, who have passionately opposed the so-called employer mandate and the cost-containment provisions of the bill, tried without success to amend the legislation to curb medical malpractice awards. They lost on a vote of 23 to 15 after opponents argued that the provision was out of the committee’s jurisdiction and would thus delay the bill for weeks while the Judiciary Committee reviewed it.

A proposed 45-cent increase in tobacco taxes was retained despite competing efforts to raise it to $1.25 and to eliminate it altogether.

“Tobacco is a killer,” said Rep. Michael A. Andrews (D-Tex.), who sought to raise the tobacco levy. Many Democrats agreed, including Rep. Pete Stark (D-Hayward), who charged that tobacco company chief executives are “worse than murderers.” But the amendment lost, 31 to 7.

The panel then voted, 26 to 12, against a proposal by Rep. Jim Bunning (R-Ky.) to knock the tax out of the bill.

In other decisions Wednesday, the committee:

* Doubled the proposed tax on health insurance premiums from 1% to 2% to pay for programs to reduce lead paint hazards to children, to earmark more funds for biomedical research and to expand chiropractic benefits. Insurance companies would pay the tax, but they likely would pass it on to those they insure.

* Reduced the proposed deduction for health insurance bought by the self-employed from 100% of cost to 80% in order to finance tax incentives for doctors, nurses and midwives in rural areas and to channel more aid to medical education and academic health centers.

In the Senate, the Finance Committee officially began its public drafting of health care legislation with an opening session devoted to lofty speeches and an explanation of the first draft of Chairman Daniel Patrick Moynihan (D-N.Y.).

The panel’s critical votes are expected to begin today, with the most important test being whether to require the employer mandate.

Clinton included that proposal as the way to reach his goal of guaranteeing health coverage for all Americans. Moynihan modified it, making the mandate a fallback that would be used only if other reforms fail to expand coverage to virtually the entire population.

Although five congressional committees were given the job of writing health care bills, none has been so closely watched as the Senate Finance Committee. Because its moderate-leaning membership so closely reflects the Senate as a whole, it is considered the most likely indicator of where Congress ultimately will end up on the matter.