Massachusetts House Passes Health Bill In Precedent-Setting Boost for Dukakis

BOSTON--The Massachusetts House, brushing aside Republican attempts to stall debate on Gov. Michael S. Dukakis' universal health care bill, gave initial approval last night to the proposal, which is the first of its kind in the nation.

The Democratic-controlled House endorsed the measure by a 99-53 vote after rejecting an amendment that would have removed the heart of the bill--a requirement for most employers to offer health insurance to their workers by 1992.

House Minority Leader Steven D. Pierce (R.-Hampden) introduced the amendment to drop the mandate, saying small business opposed the requirement despite a provision in the bill exempting firms with six employees or less.

Small businesses were opposed "not because they don't believe that health coverage is important to the people who work for them," Pierce said, "but because they believe they should have the right...to work out that choice based on [their] fiscal constraints."

But when House Ways and Means chairman Richard Voke (D.-Chelsea) rose to speak, the stage was set for the critical vote. "This is the whole enchilada," he said. "If you take [the mandate] out, this is it."

The House's Democratic majority responded, defeating the amendment 86-66. Immediately afterward, the House tentatively endorsed the whole bill 99-53. Another vote will be needed in the House, which meets in formal session today, before the measure can move to the Senate.

Passage in the House, which scuttled Dukakis' health care bill in the 1987 session, is the key hurdle for the measure. Late in the 1987 session the Senate passed a bill similar to the one now before the House.

Earlier in the day, Republican State Committee Chairman Ray Shamie and Dukakis exchanged broadsides over the swift schedule the Democratic leadership had plotted for the bill's consideration.

But House Speaker George Keverian (D.-Everett) quelled calls for postponement when he took the podium for a rare floor speech and announced, "I want this bill to pass. I want this week to be one we remember as long as we live--one in which we faced the challenge and won."

Shamie charged before the debate began that the Democratic leadership had put the bill on a fast track to help Dukakis' presidential campaign.

"No one knows how much this bill will cost," Shamie told a news conference. "But Mike Dukakis knows it will help his presidential campaign."

Republicans contend House leaders want to pass the bill in time to give Dukakis a boost for the "Super Tuesday" presidential caucuses and primaries in 20 states next week.

Shamie said more time was needed to study the bill. If that time wasn't granted, the Republicans threatened to run radio ads before the November election claiming, "The Legislature rammed the bill through so Mike Dukakis would have something to crow about in his quest for the White House."

"I don't know that the Republican Party in this state has had a constructive idea in years, and this is another example of it," Dukakis fired back when asked about Shamie's comments. "It's one of the reasons why the Republican Party in this state is in such terrible shape."

Dukakis said it was immaterial whether the bill passed before Super Tuesday. "I have no particular interest in whether or not this bill does or doesn't make it to my desk in the next week," he said, adding his only concern is getting "the best possible bill."

The governor said his main concern is passing legislation that would provide health insurance protection for the 600,000 people currently without such coverage in the state.

"Is there any evidence that the Republican Party in this state and its leadership care about this or has an alternative? I know of none," Dukakis said.

"I think the idea of having every citizen have some sort of insurance to protect them is a good one," Shamie said, but he provided no specific alternatives to the current plan.

Earlier in the day, the influential Massachusetts Hospital Association staged a Statehouse rally for about 300 people and announced its directors voted unanimously to support the governor's bill, which would provide more than $900 million in new revenue to hospitals over the next four years.

A host of amendments were considered yesterday, most of them Republican-sponsored and most of them defeated during debate in a near-empty chamber.

Among those amendments passing was a provision by Voke striking language in the bill that some feared would eliminate a state ban on allowing doctors to bill Blue Shield patients for more than the insurer allowed.

Other approved amendments would require individuals covered by state insurance under the plan to register for the state Employment and Training program, allow individuals getting off welfare to continue to carry Medicaid coverage for two years and to provide for a study into the "flight of physicians" from Massachusetts because of low insurance reimbursements.

Among the amendments that failed was a provision to exempt cities and towns from the insurance mandate. Proponents conceded they did not know of any municipalities not offering health insurance coverage already.