Mitchell Offers 3 Options to Speed Up Health Reform : Legislation: The choices eliminate or cut employer contributions. They are meant to ease the financial burden on small businesses, the plan’s biggest foes.

WASHINGTON —  Senate Majority Leader George J. Mitchell (D-Me.), trying to speed up progress on health care legislation, offered three options Tuesday for easing the financial burdens of reform on small business owners--the most implacable foes of the President’s plan.

His effort marked the second time in the last two weeks that he has undertaken such an exercise, and it underscored the degree to which he is taking control of the course of the legislation.

All three choices were prepared with the help of Administration officials and are designed to stimulate thinking among senators about the single most controversial element in President Clinton’s plan: a requirement that all employers pay up to 80% of the cost of their workers’ health benefits.

Although Clinton would offer discounts to small businesses employing low-paid workers, lawmakers have expressed fear that the requirement could force many firms to lay off workers or close their doors.

One of Mitchell’s alternatives, similar to an approach by House Energy and Commerce Committee Chairman John D. Dingell (D-Mich.), would exempt firms with fewer than 10 workers from any obligation to contribute toward their employees’ health care costs.

To meet Clinton’s goal of coverage for every American, however, that approach would require employees in those firms to pay as much as 3.9% of their income for premiums with government subsidies assisting those who could not afford it. That would cost the federal treasury as much as $55 billion over the next 10 years.

The second option would extend the mandate even to the smallest firms but would lower the share of payroll they would be required to spend. Once again, however, that would require Washington to spend more--as much as $35 billion over 10 years--to assure that all workers are fully covered.

Mitchell’s final option--the least costly--would reduce the ratio of employer-employee contribution for all firms from the 80-20 formula proposed by Clinton to 50-50. That would put a greater burden on individuals, with families paying as much as 6% of their incomes for health benefits, compared to 3.9% under the Clinton plan.

All three efforts to ease the burden on small businesses raise new problems, Mitchell noted in his presentation at the Democratic Caucus weekly luncheon. Among them: encouraging large firms to splinter into smaller ones whose health costs would be lower, increasing the complexity of administering the system and shifting costs and raising the program’s price tag.

Moreover, a massive survey released Tuesday by the U.S. Chamber of Commerce underscored how difficult it will be to persuade businesses to support any government requirement that they pay part of their workers’ health insurance premiums.

Nearly 40,000 employers, 75% of whom are small business owners, responded to the survey and 71.2% said that an employer mandate is “unacceptable.”

As a result, chamber officials said, the organization intends to be “extremely active” in fighting such an employer mandate--a key element in Clinton’s reform agenda as well as in a variety of competing proposals taking shape in Congress.

“We will be pushing hard--opposing mandates,” said Richard L. Lesher, president of the nation’s largest business group, which has 220,000 members. That opposition, he said, would include even a mandate with a 50-50 split between employer and worker.

The survey found that 55.3% of respondents oppose the notion that all Americans should have guaranteed coverage--Clinton’s one non-negotiable goal. As a result, Lesher said, the chamber will continue its current “suspension” of support for universal coverage.