CLINTON SEEKS TO EXPAND MEDICARE.

Byline: John M. Broder The New York Times

President Clinton proposed a significant expansion of Medicare on Tuesday, to allow hundreds of thousands of early retirees, laid-off workers and uninsured Americans between the ages of 55 and 64 to enroll in the federal health-care program for the elderly.

The proposal addresses the problem of a growing group of Americans who are at high risk of losing their health insurance through layoffs or reductions in corporate benefits.

The 3 million uninsured people in this group, known by insurance statisticians as the ``near elderly,'' are too young for Medicare and not poor enough for Medicaid, the insurance program for the poor and disabled.

Although the program was immediately criticized by many Republicans, the president said it would pay for itself and, for the first time, make health care coverage available for hundreds of thousands of people who could not otherwise find or afford it.

``This is an entirely new way of adapting a program that has worked in the past to the needs of the future,'' Clinton said at a morning ceremony at the White House. ``For many Americans, access to quality health care can mean the difference between a secure, healthy and productive life, and the enormous burden of illness and worry and enormous financial strain.''

Individuals who choose to buy into the expanded Medicare program would pay between $3,600 and $5,000 a year, depending on their ages.

The proposal represents another incremental step toward providing health insurance for the 41 million Americans who currently lack it. Since the administration's universal health care initiative was rejected by Congress in 1994, Clinton has tried in less ambitious ways to extend health benefits to the uninsured, most recently in the 1997 budget agreement that extends government-financed medical care to an estimated 5 million low-income children.

But enactment of the administration's new Medicare proposal is by no means certain and the plan is likely to become a political issue in congressional elections this year. Even before it was announced Tuesday, Republican leaders in Congress complained that the proposal would create a new Medicare entitlement at a time when the program already faces long-term financial strains.

``Before Congress considers expansion of a program that is already going bankrupt, several important concerns must be addressed,'' said Rep. Bill Thomas, R-Bakersfield, chairman of health panel of the House Ways and Means Committee. ``I'm cautious because every time Washington promises something for free, the taxpayers end up footing a bigger and bigger bill. In this case, the cost of the proposed expansion puts taxpayers at risk of seeing their taxes hiked and Medicare beneficiaries are at risk of having their benefits reduced.''

Rep. John Kasich, R-Ohio, chairman of the House Budget Committee, predicted flatly that the Republican-led Congress would reject the Clinton plan.

Administration officials said the proposal was designed to aid those who had lost jobs and health benefits in the corporate downsizing of the past decade. Private insurance for the healthiest people ages 55 through 64 costs $5,000 a year or more, while those with chronic illnesses like diabetes, high blood pressure, ulcers and kidney ailments often find they cannot purchase private insurance at any price.

There are 22 million Americans ages 55 through 64; roughly 3 million of them now have no health insurance. Administration officials estimate that 300,000 people in this age group will take advantage of the Medicare proposal.