A whole new ball game - most influential health policy members of Congress - Washington Memo - Column

Business & Health, Feb, 1995 by Steven Findlay

Here's a guide to Congress's major health-policy players, and where they stand on the issues.

In an awesome display of intellectual prowess and willpower, public showmanship, and cunning political tactics, Rep. Newt Gingrich (R-Ga.) has taken Washington by storm, pushing his personal agenda and the "Contract with America" to the front burner.

Gingrich's GOP revolution will likely have a long-lasting impact on health policy and the direction of health reform. Starring roles will be played by the following cast:

* Gingrich himself, Speaker of the House. No health-policy leader, Gingrich helped scuttle reform last year for political purposes. But there's evidence he's giving more serious thought to the issue these days: In testimony last month before the House Ways and Means Committee, Gingrich raised the possibility of transforming the Medicare program along managed-care lines.

* Robert Dole (R-Kan.), Senate Majority Leader. He pushed his own incremental reform bill last year and has pledged to bring similar legislation to the floor of the Senate this year. His leadership could make or break the health-reform effort; if it drops off his radar, it probably won't happen.

* Nancy Kassebaum (R-Kan.), Chairman, Senate Labor and Human Resources Committee. She takes over from Edward M. Kennedy (D-Mass.) after playing a key, if subdued, role in the debate last year. She has proposed handing control of welfare to the states in return for federal control of Medicaid. She joins Dole in having a particular interest in the plight of small business.

* Bob Packwood (R-Ore.), Chairman, Senate Finance Committee. He's a strong believer in managed care but will likely follow Dole's lead. He's a deficit hawk and won't permit tax cuts without spending cuts, but he's unlikely to support big chunks coming out of Medicare too quickly.

* Pete Domenici (R-N.M.), Chairman, Senate Budget Committee. The Budget Committee looms larger, because Congress is expected to make major changes in the way it crafts the federal budget (including a balanced-budget amendment). Domenici hasn't been a leader on health care but has supported more mental-health-care funding. He, too, is leery of big spending cuts in Medicare and Medicaid; he understands the cost-shift problem employers would face if that happened.

* Daniel Patrick Moynihan (D-N.Y.), Senate Finance Committee ranking minority member. Last year's chairman, he strongly supports letting states experiment. He may take the initiative on ERISA waivers, but he won't push that issue if it's dead in the water.

* Thomas Daschle (D-S.D.), Senate Minority Leader. Last month, Daschle introduced the Family Health Insurance Protection Act, the first Democratic initiative of the new Congress. The bill is a much scaled-down version of last year's Democratic proposals.

* Bill Archer (R-Texas), Chairman, House Ways and Means Committee. Committed to tax cuts and entitlement reform, Archer has pledged a bill early this year to restore the self-employed tax deduction of 25 percent for health costs.

* Bill Thomas (R-Calif.), Chairman, House Ways and Means Subcommittee on Health. He favors legislation to reform the insurance market and encourage voluntary small-business purchasing pools. And last month he said he wanted to open a dialogue with state officials about how to resolve the ERISA issue.

* Michael Bilirakis (R-Fla.), Chairman, House Commerce Committee Subcommittee on Health and the Environment. He is expected to push health reform this year. His subcommittee has broad jurisdiction over health programs, including Medicare and Medicaid.

* John Kasich (R-Ohio), Chairman, House Budget Committee. A deficit hawk and a close Gingrich ally, he can press for the major government spending cuts he wants, including reductions in Medicare and Medicaid.