POLITICS : Democrats Need a Little Help From GOP on Health Care Bill : A bipartisan victory could go a long way on the campaign trail. Trouble is, Republicans know that too.


Woody Hayes, Ohio State University’s legendary football coach, used to complain that throwing a forward pass could have only three possible outcomes and that two of them--an interception or an incompletion--were bad.

Similarly, analysts assessing the health care debate raging on Capitol Hill see three plausible outcomes, but only one would provide an unqualified boost for Democratic incumbents this November: the adoption of reform legislation with some measure of Republican support.

Indeed, developments in the House last week suggest that unless the Democrats can fashion a health care reform bill that wins the votes of GOP lawmakers, along with the backing of conservatives in their own party, they may not be able to pass any bill at all.

This bipartisan approach, some Democrats said, could turn out not only to be a necessity on Capitol Hill but a virtue on the campaign trail.


With bipartisan backing, “everybody will be able to say: ‘We accomplished something,’ ” contended Democratic pollster Mark Mellman, whose clients this fall include House Speaker Thomas S. Foley (D-Wash.), House Majority Leader Richard A. Gephardt (D-Mo.) and House Democratic Caucus Chairman Steny H. Hoyer (D-Md.). “That takes it out of the realm of partisan politics and gives it a sort of Good Housekeeping seal of approval.”

Of course, as most analysts agree, a second possible outcome--health care reform muscled into the statute books solely by Democratic votes--probably would be better for President Clinton and his party than the third outcome: no bill at all.

The last result would represent a dramatic setback for Clinton and other Democrats. It would mean that the President had failed to keep his promise to reform the health care system. It also would call into question his ability to redeem his broader pledge to break the gridlock between Congress and the White House that prevailed during the term of President George Bush.

To avoid such a debacle, some Democrats have talked of pushing health care legislation through with or without Republican votes--and even without the support of some of the more conservative members of their own party.


Nevertheless, even after the $33.2-billion crime bill was defeated on a procedural vote Thursday, some Democrats optimistically recalled that last fall they were able to pass Clinton’s economic plan without any Republican help at all.

“We didn’t have them (the Republicans) on the budget,” pointed out the top aide to one of the Democratic House leaders.

“I think we’ll be able to go to the voters in the fall and say: ‘The economy is going better, and we didn’t have any help from the Republicans. And we passed health care reform, and we didn’t get any help from the Republicans on that either.’ And I think we’ll have a very strong message for the voters.”

But the concerns over health care reform differ markedly from those involved in the federal budget. The various approaches to reform now under consideration would more directly touch the lives of millions of Americans.


“This particular issue impacts everybody,” said David Keene, chairman of the American Conservative Union and an adviser to Senate Minority Leader Bob Dole (R-Kan.). “And while voters may not have a sense of the intricacies, everybody has a sense of what they want and don’t want. And I think that gives Republicans an advantage because as the debate has gone on, voters have soured on the Democratic approach that the government can take care of everything.”

As a result, if Democrats enact health care legislation without at least the appearance of bipartisan support, political professionals say they will face a prolonged and sustained debate over the merits of the bill.

Republicans would certainly attack controversial aspects of the legislation, forecasting either damage to the economy or disruption of the traditional ways that Americans have become accustomed to receiving health care.

Democrats worry that their difficulties in defending health care legislation would be compounded if enactment is accompanied by the deal-making and horse-trading that marked adoption of the North American Free Trade Agreement last fall.


“If people think politicians are trading votes on health care for bridges in their districts, they’re not going to think very well of the institution and the people who make it up,” Mellman said.

For their part, Republicans already are gearing up to campaign against what they brand as Democratic strong-arm tactics.

“The public will be watching the debate,” warned New York Rep. Bill Paxon, chairman of the Republican Campaign Committee in the House. “If the Democrats simply ram through their own bill without bothering to reach out to Republicans, it will result in massive public resentment, and we will elect a Republican speaker of the House next January.”

Democrats are mindful of that danger. “It is always better to have a major reform with bipartisan backing,” said Ed Lazarus, strategy adviser to the Democratic National Committee. “I think the most important thing is to get something that works and get it passed. But it would be better if Republicans join us in that effort.”


But how do Democrats get Republicans to support them in an endeavor most likely to benefit Democrats? One answer is to threaten them with charges of obstructionism if they reject health care reform.

Some Republican strategists dismiss that threat. Their reasoning is summed up by two oft-repeated slogans: “A bad bill is worse than no bill at all,” and “Wait till next year.”

Making the case for delay, Republicans cite a recent Newsweek magazine poll showing that two-thirds of all Americans think Congress should wait until 1995 and begin again.

An advantage of putting off action on health care reform for the GOP is that, if their expectations of significant gains in the House and Senate are borne out by November’s election returns, Republican lawmakers will be well positioned to get health care reform more to their liking in the next Congress.


“Blocking a Democratic health care scheme that threatens the quality of American medicine is in the national interest,” Republican strategist William Kristol argued last week in a memorandum to GOP lawmakers.

Contending that Senate Majority Leader George J. Mitchell (D-Me.), sponsor of the principal Democratic health proposal in the Senate, “is walking a tightrope,” Kristol urged: “Republicans should push him off.”

That would open the way, Kristol argued, for enactment next year of a health care reform measure along the lines of one drafted by Dole, one that is far more modest in its approach than the Democratic proposals. “At which point we will welcome Mr. Clinton to pick up his veto pen--if he dares,” Kristol said.

Despite such tough rhetoric from Kristol and other party professionals, however, some evidence suggests that at least a fair number of GOP lawmakers are interested in finding a health care bill they can vote for this year, even if it means lining up with the Democrats.


In the House last week, moderate Republicans joined with conservative Democrats in introducing an alternative to the bill put forward by Gephardt.

The coalition bill does not include a requirement for employers to provide insurance for their workers, which Clinton has argued is necessary for effective reform. And it would only cover 90% of the population, compared with the 95% claimed for the bill authored by Mitchell. But it offers a package of insurance reforms, subsidies for low-income people and some long-term care.

“We want to pass the kind of reforms that will be supported by responsible Democrats,” Paxon said.

The bipartisan House plan may turn out to be just a token demonstration of GOP interest. But hard political realities underlie such gestures. Even though passing no health care reform at all might be best for the Republican Party, it might not be the best thing for individual GOP incumbents.


“The Republican Party itself probably does not have anything to lose if no health care bill is passed,” said political analyst Cliff Zukin of the Eagleton Institute of Politics. “But individual Republican incumbents may feel pressured to come back to their constituents with something they have passed.”

In the end, Ross Baker, a Rutgers University specialist on Congress, predicted that the lawmakers will fashion a “mild, moderate reform of health care practices” that will include coverage for pre-existing conditions, some subsidies for the poor and job-to-job portability.

Both sides will then claim victory, Baker said. The final legislation, he predicted, will include enough language about promising universal coverage at some future date to allow Clinton to declare that a major step toward health care reform has been achieved.

As for the Republicans, “they will say: ‘We had to deal with this radical proposal by the President and his zealot wife and we managed to hold them down to a modest incremental change,’ ” Baker said. The net result, he said, will be remindful of a quote from “Alice in Wonderland”: ‘Everybody has won and all must have prizes.”