In New Hampshire and Iowa, nursing home groups lately have been running ads chiding Vice President Gore to commit to increasing reimbursements under Medicare. Yesterday, Gore made clear he has heard the message.
Staking out a position out in front of President Clinton's, Gore said he favors immediately rewriting the 1997 balanced-budget accord to ensure that rural hospitals, teaching hospitals and nursing homes get the money they have been clamoring for.
Gore's new stance, a carefully orchestrated move that he unveiled in Boston--not coincidentally, the home of many teaching hospitals--was the latest instance of him trying to make plain to voters that Clinton's policy priorities are not necessarily his own.
It was also the latest illustration that even relatively obscure policy issues this year have become freighted with heavy political consequences--confronting both Gore and Clinton with awkward challenges in coordinating their policy messages.
Over recent months, the West Wing and the vice president's office team have maneuvered--sometimes at cross-purposes with one another--to stake out politically acceptable positions for Gore on such issues as agricultural relief, veterans spending and encryption technology. None of these are issues that remained long on the front pages or the network news; all are issues of acute concern to key Gore constituencies.
Gore has won some of the increasingly frequent internal policy tussles. His staff persuaded White House Chief of Staff John D. Podesta to intervene with budget director Jacob J. Lew to ensure more money for the Veterans Affairs Department after Gore complained that veterans groups were hammering him on the issue, according to sources familiar with the debate.
But the vice president has lost plenty of times as well. Gore last month personally boasted to environmental groups that the administration would stand firm against attempts by congressional Republicans to weaken environmental laws through amendments to annual spending bills. Despite that pledge, White House sources said Clinton is prepared to ignore Gore's veto recommendation on a pending transportation bill that would strip the federal government's authority to dictate fuel-efficiency standards for light trucks, including sport-utility vehicles.
Even when their positions are at odds, it has become clear in recent weeks that Gore's operation and Clinton's are working in concert more effectively to accommodate the vice president's ambitions--either by shifting policy to his purposes, or letting Gore stake positions different than Clinton's. As recently as a few months ago, stubbed toes were commonplace as Gore focused on 2000, to the resentment of some Clinton aides.
Gore's effort to position himself on Medicare is a good example of the more accommodating approach. The Clinton position is that teaching hospitals and nursing homes need help, but that any fixes should come as part of a broader overhaul of the entitlement program. As a practical matter, White House aides said, officials at the Health and Human Services Department are skeptical that nursing homes deserve a more generous reimbursement rate, and officials at the Office of Management and Budget warn that there is little money for this, in any event.
Meanwhile, Gore was feeling the heat. Exploiting the political calendar, the American Health Care Association and other groups ran ads last month saying, "Al Gore should use his influence to make the Clinton administration restore vital Medicare funding for nursing home patients."
In recent days, White House officials said, Gore's team let Clinton's know that he needed protection on the issue. Clinton aides learned in advance that Gore was going to use an appearance yesterday morning at the Boston Globe to get out in front of Clinton. Gore's new stance, according to aides, is that reimbursement rates for hospitals and nursing homes must be fixed this fall--even if Clinton and Republicans cannot agree on a comprehensive Medicare overhaul.
At times recently, Clinton aides have even helped Gore come up with policy proposals that are at odds in places with Clinton's. White House national economic adviser Gene Sperling, sources said, helped Gore fashion a tax-cut package last July that ignores some of the provisions that Sperling helped Clinton draft several months earlier.
The assistance underlines a paradox of Gore's campaign. Even as he is increasingly trying to establish his own identity--distancing himself from some policies and expressly criticizing Clinton's personal behavior--Gore is also hoping to take full benefit of Clinton's willingness to tilt policy his way at well-timed moments.
Recent weeks have offered a flurry of examples. Gore aides sighed with relief when Clinton approved a change in rules regarding the export of sophisticated encryption technology, which can cloak electronic communications in ways that cannot be broken.
The old policy had put Gore at odds with the high-technology industry--a constituency whose support the vice president has been devoutly seeking. Although Gore backed the change in export rules, senior White House officials said that it was the softening of opposition by national security officials, rather than a wish to help Gore, that proved decisive.
Similarly, the administration last month resolved a longstanding trade dispute over the manufacture and sale of more affordable AIDS drugs in South Africa. Gay activists as well as South Africa supporters had roasted Gore over the issue. U.S. trade officials resolved the issue, with a compromise that allows South Africa to make cheaper versions of U.S.-developed drugs, just days before Gore was to meet with South African President Thabo Mbeki.
White House officials said Podesta has been critical in ensuring that administration officials take Gore's interests into account--on such issues as emergency relief for farmers and limiting high-tech companies' liability for Y2K problems.
Gore advisers are appreciative--to a degree. The $7.4 billion farm relief bill Clinton signed helped the vice president in Iowa but it was still $3 billion less than what Gore had publicly called for. And some Gore advisers fretted that a Podesta-brokered deal over Y2K liability gave too much to computer companies at the expense of another constituency he is courting: trial lawyers.
Podesta said consultation is what he seeks, rather than perfect consensus between Clinton and Gore. Increasingly, Gore domestic policy adviser David Beier is a presence at West Wing debates. "We're in a phase when we're determined to have good coordination," Podesta said. "We've tried to ensure that the vice president is represented in all the critical meetings."
CAPTION: Not always eye to eye: Vice President Gore tries to change some Clinton policies and distance himself from others.