Reagan Likely to Defer Action on AIDS Policy

WASHINGTON —  President Reagan is expected to defer acting upon the two most important recommendations of his own AIDS commission: that he endorse expanded federal anti-discrimination rules and back confidentiality legislation, to protect the ill and the infected.

Instead, he is likely to call on federal agencies and the public to voluntarily adopt policies of anti-discrimination, according to White House sources.

Reagan met last Thursday with Dr. Donald Ian Macdonald, his special assistant for drug policy, whom he directed last month to devise a plan of action in response to the commission’s nearly 600 recommendations.

Approval Expected

The President, who has not made a final decision regarding Macdonald’s proposals, is expected to approve them, according to officials who asked to remain anonymous. A public announcement by the White House may come sometime this week, the sources said.

The 13-member commission was appointed by Reagan last summer to create a national strategy to combat the deadly epidemic and presented its report to him June 27. The document has been almost universally praised for its public health recommendations and for its sensitivity and compassion.

Macdonald did not recommend that the President support the panel’s centerpiece proposals: that the federal anti-discrimination disability law be expanded to include the private sector, and that federal legislation be enacted to protect the confidentiality of medical records, with strong sanctions against violators.

Currently the federal disability law, which prohibits discrimination on the basis of handicap--including infectious diseases--applies only to institutions receiving federal money.

Instead, Macdonald urged the President to order the attorney general to study the legislative proposals further and report back to him as quickly as possible, “definitely before he (Reagan) leaves office,” according to the sources.

Adm. James D. Watkins, chairman of the AIDS commission, was out of the country and could not be reached for comment. But sources close to Watkins described him as “extremely upset” at the prospect that the White House would not immediately support new federal anti-discrimination legislation.

The White House response to the commission will almost certainly be attacked by many public health and medical groups, as well as by civil and gay rights organizations, all of whom have called for new and expanded federal anti-discrimination and confidentiality statutes, saying they are critical to curbing the deadly epidemic.

In past statements, the Reagan Administration has opposed federal anti-discrimination legislation to protect AIDS patients and those who are infected, saying such measures were the province of the states.

Macdonald also failed to endorse another major commission recommendation: that Reagan issue an executive order forbidding discrimination against ill or infected workers in the executive branch.

Similar to Guidelines

However, Macdonald proposed that the President direct every federal agency to adopt a policy based on guidelines recently issued by the Office of Personnel Management, the sources said. Those guidelines urge that AIDS-infected employees be permitted to work as long as they are able and allows managers to take disciplinary action against individuals who refuse to work with AIDS-infected colleagues. Although the guidelines technically do not have the force of law, a presidential directive is generally considered binding. Thus far, 22 federal agencies have already implemented the guidelines, the sources said.

Macdonald recommended that the President call upon every citizen, business, school and labor union in the nation to follow the Office of Personnel Management guidelines and those issued several years ago by the Centers For Disease Control, according to White House sources. The CDC guidelines emphasize that there is no danger of casual transmission of the disease, and those who are ill or infected should not be barred from their jobs or from the classroom.

‘Not Necessary’

“It is not necessary for the President to come out and support federal legislation right now,” said one White House source. “It’s much more important for him to come out and articulate that there must be a national policy of anti-discrimination. The President is trying to make the whole nation--indeed the world--aware that there is a need for compassion, that this is a disease and should be handled as such.”

But congressional sources involved in AIDS legislation, informed of the pending White House response to the AIDS commission, said that federal anti-discrimination and confidentiality legislation already has been advocated by numerous health, medical and legal organizations, including the American Medical Assn., the National Academy of Sciences and the American Bar Assn.

“We don’t need another study--it’s been studied enough,” said one Capitol Hill source. “The reason we are after anti-discrimination legislation is because we want to put together an effective testing and counseling program. We want to get everyone who is afraid to be tested unafraid. The President appointed a commission that conducted a year’s worth of hearings and gave him a very strong mandate about what should be done--and he’s still doing exactly what he wants. Why did he bother having a commission?”

Vehement Opposition

The legislation has been vehemently opposed by conservative lawmakers and some White House officials, who view it as a “hidden gay rights” bill, since homosexual men have been the hardest hit by the epidemic. Further, at least one of the more conservative members of the AIDS commission itself, who opposed the recommendation, has reportedly lobbied against it at the White House.

Federal anti-discrimination and confidentiality legislation, such as that advocated by the commission, may have an increased chance for passage after Reagan leaves office, since both presidential candidates--Democrat Michael S. Dukakis and presumed Republican nominee Vice President George Bush--have endorsed the commission recommendations.

“But that still means at least another six months--another six months of people getting infected, getting sick, and dying,” one Capitol Hill source said.

In this country, AIDS has primarily afflicted homosexual and bisexual men, intravenous drug users and their sexual partners. As of July 25, a total of 69,085 Americans had contracted AIDS, of whom 38,897 had died.