By Edward Walsh and Judith Havemann
Washington Post Staff Writers
Saturday, January 10 1998; Page A10

Confronted with what they acknowledge is a politically popular idea, business groups and other critics of President Clinton's proposal to expand the Medicare health insurance program are waving caution signs, portraying the plan as a risky experiment with a system that is teetering on the brink of financial collapse.

That was the dominant theme yesterday of opponents in the early jockeying for the political high ground on an issue that is likely to be a major legislative battleground in Congress in the coming months.

"Caution must be our watchword," said Pamela G. Bailey, president of the Healthcare Leadership Conference, an association of pharmaceutical companies, hospitals, managed care companies and other health care suppliers.

But even the strongest critics of the Clinton proposal said they recognize its political appeal and acknowledge that it attempts to address a genuine problem that will only grow more serious as the huge baby boom generation approaches the pre-retirement years. The Clinton plan, predicted Sen. Phil Gramm (R-Tex.), will be "very, very popular."

As a result, Medicare promises to be a high-profile issue that could embroil lobbyists and interest groups from business to insurance to the elderly in a battle to win over the sentiments of the public and Capitol Hill.

Under the proposal, uninsured Americans beginning at age 62 could buy into the Medicare program for $300 a month until they qualify as regular Medicare recipients when they turn 65. They would then begin paying an additional fee of $10 to $60 a month depending on how long they benefited from early enrollment in the program. The measure also would allow workers 55 and older who lose their jobs and health insurance to purchase Medicare coverage for $400 a month.

The White House has estimated that about 300,000 people, the bulk of them in the 62 to 64 age category, would take advantage of the program.

Anticipating this as a likely next battleground over the size and shape of the national health care system, the American Association of Retired Persons, the country's largest and most powerful senior citizens lobbying group, conducted a poll last month on the subject. The findings, certain to buoy the White House and congressional Democrats who support the Clinton plan, showed that more than 75 percent of respondents favor the idea even if it led to a modest tax increase.

"Sooner or later there has to be a solution to the problem of people in the latter years before they qualify for Medicare," said Martin Corry, a lobbyist for AARP, which accepts members beginning at age 50. "The baby boomers are approaching those years. They may not be focused on Medicare yet, but they are focused on good health. The notion of being without health insurance may not be acceptable to them."

In the early maneuvering for position, critics of the proposal already are urging a go-slow approach and warning that financing even a modest expansion of Medicare could jeopardize the whole system's shaky financial foundation. Bailey said she feared "legislation by anecdote," with Congress basing its action on the hard luck stories of uninsured Americans just a few years short of qualifying for Medicare.

The critics also argue that there is no rush, and that any Medicare changes should await the recommendations next year of a commission appointed by Clinton to assess the entire Medicare system.

"Our view is this is a little bit too much of a play for votes and kind of unseemly to set up a commission and, before it even meets, willy-nilly go for a huge expansion," said Paul Huard, a senior vice president of the National Association of Manufacturers.

Republicans also have begun to attack the Medicare plan, along with several other recent Clinton proposals, as little more than political posturing.

"What we've seen is a rapid-fire series of politically motivated initiatives," said Mike Collins, a spokesman for the Republican National Committee. "They are not serious and they are clearly aimed at shoring up the Democratic left-wing base for Al Gore's benefit."

Ron Pollack, executive director of Families USA, a liberal group that strongly supports the Clinton plan, said the early opposition of business groups and other critics was based on a "stealth strategy – delay, obfuscation, trying to appear to be doing something while really trying to make nothing happen."

Corry, the AARP lobbyist, predicted that the Clinton plan will be attacked from the right, by those who oppose any expansion of government programs and fear the cost of this one, and from the left, by liberal groups that already are saying a $300 premium would be out of reach to many of the poor.

"The question will be: Will the center be large enough for something to be accomplished?" Corry said.