THE NUMBER OF AMERICANS without health insurance jumped from 25 million to 30 million between 1977 and 1984, largely because of the loss of manufacturing jobs and the rising number of divorces. Congress used to set up new social programs to deal with such problems. No more.
Nowadays, lawmakers are looking at proposals that attack health-care problems piecemeal, by forcing companies to provide certain benefits at a time when many companies are cutting back to hold down costs. "We're trying to find low-cost ways of helping people," says a House staffer.
The most popular measure is legislation that would require employers that offer health plans to sell group insurance to, among others, former spouses of employees and unemployed workers, including those who quit. The exception would be people fired for gross misconduct.Companies could charge insurance recipients up to 102% of the average group rate. But overall group rates could rise.
Opponents say that the extended insurance would be most attractive to relatively less healthy people, who find it difficult to obtain coverage on their own -- thus raising group rates.
The measure was unopposed in both the House and Senate, but the bill to which it was attached died for unrelated reasons. Observers expect the measure to be reintroduced successfully this year. Also under consideration are bills that would force employers to include specific benefits, such as coverage of pediatric exams, in any health plans they offer.
Some analysts fear that mandatory benefits will deter employers from offering any coverage. "I'm not saying that plans that currently exist are going to be dropped wholesale," says Deborah Chollet, of the Employee Benefit Research Institute. "But new companies, new jobs, are less likely to have them."