Activist groups try to talk their way onto Bush social agenda. But fire-breathing deficit dragon may preclude any new spending programs

How do you try to influence what a new president does? If you run an organization with a point of view, you put out a timely report making recommendations, preferably well conceived. In other words, you try to push America's new chief executive - politely.

Once every four years many of America's interest groups, liberal and conservative, attempt to influence a new president's policy agenda. That quadrennial season, between election and inauguration, is now under way.

``Anytime there's a new administration coming in, it's an opportunity to help them set an agenda,'' says Stephen Heintz, commissioner of Connecticut's Department of Income maintenance. ``It's a real opportunity.''

Mr. Heintz is also chairman of a project of the American Public Welfare Association. That group has just recommended a number of ways to give America's poor, especially the one child in four who lives below the poverty line, greater access to health care.

Essentially, the association urged a three-part effort to provide health insurance, and thus affordable medical care, to the estimated 37 million Americans who lack it.

The plan would have most businesses provide basic health insurance for employees and their families and require that medicaid be expanded to offer health care to the all unemployed poor and near-poor.

Finally, it would have all but the most poor pay some of the cost.

``No question about it,'' Heintz admits. This new report, on a subject widely agreed to be extremely important, is an effort to influence George Bush's agenda.

It's not the only effort, of course. Both liberals and conservatives do it. Proposals for child care and long-term care for the elderly are expected to be pushed, too, before long.

Sometimes these pre-inauguration efforts actually do influence new presidents.

Heintz and others see an opportunity to have a real impact this year. They recall that during the campaign Mr. Bush promised a ``kinder, gentler'' America.

Yet this year these efforts to influence, no matter how meritorious, may be ``a waste of time,'' says Douglas Besharov, a resident scholar at the American Enterprise Institute.

Mr. Besharov says that the budget deficit will preclude virtually any additional expenditures for social programs for the next few years.

``The overriding advice being given to Bush's people,'' Besharov says, ``is that you've got to cut the $150 billion deficit. ... All this other stuff is going to have a hard time competing with'' the pressure to reduce the deficit.

Just a few days ago, for example, former Presidents Ford and Carter nudged the President-elect on the budget deficit, recommending in their agenda proposal that major efforts be made to trim it.

Heintz admits the importance of the deficit. ``I'm not trying to deny that the costs are going to be the big issue,'' he concedes. But he says that they can be controlled by the elements of the ultimate proposal: the size of benefits and the time over which they are phased in, for instance.

He points out, however, that the costs are not really new: ``We already are paying for these things,'' such as by paying higher costs further down the road for very premature infants whose mothers lacked the resources to obtain prenatal care.

At the same time Besharov sees a glimmer of hope for domestic social programs. There is one way, he says, that some increases in social programs might be provided during the coming four years without a tax hike.

``We may see more and more requirements on business,'' he says, ``to pursue the social agenda.'' Example: Sen. Edward Kennedy's proposal earlier this year that US businesses be required to provide basic health insurance coverage to their employees.

``That's in effect a tax,'' Besharov says. ``But it won't look like a tax.'' And it may result in meeting at least part of some social needs, such as the lack of medical insurance.

Will the American Public Welfare Association's health-care proposal wind up influencing the Bush agenda? It's too early to tell. The President-elect hasn't even named the top officials in his new administration who will be in charge of programs like these.

But one thing is sure. The pressure for deficit cutting, and for adding no new expenditures, will be immense.

Stay tuned.

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