Senate off to a rocky start on health care

WASHINGTON — Hoping to make history, the Senate set off on its major overhaul of the nation's health care system Wednesday, but its first steps were quickly overtaken by fresh cost concerns and partisan anger.

An ambitious timetable that called for completing committee action in early summer seemed in danger of slipping away.

The Senate Health, Education, Labor and Pensions Committee began work on a bill encompassing President Barack Obama's top legislative priority. It marked the first time since President Bill Clinton's ill-starred attempt in the early 1990s that Congress was tackling such a broad overhaul.

But the more important Senate Finance Committee announced it would delay action, as senators sought to retool their proposals to slash the cost by more than one-third, from an intial $1.6 trillion over 10 years, to less than $1 trillion. Of the five major panels working on health care, Finance has the best odds of coming up with a bipartisan proposal that could overcome gathering opposition.

Lobbyists representing every nook and cranny of the economy were on high alert — even if they were on their best behavior.

Majority Democrats running the Finance Committee have told lobbyists that their views will be taken into account as long as their groups don't mount public campaigns against the legislation, numerous lobbyists say. So far, health industry groups have not launched aggressive attacks against Democrats' emerging plans.

"We have a lot of sweat equity in this process," said E. Neil Trautwein, chief health care lobbyist for the National Retail Federation, referring to hundreds of hours his group has spent with lawmakers as they prepared legislation. He predicted the bill would prove too costly and force lawmakers to pare it down — or else.

"We need cost relief," he said. "But if comes to the point where we have to cut and run and build a coalition" to oppose the bill, "we'll take that step."

The American Medical Association backed off from a confrontation with the Obama administration over a government-run plan to compete with private insurance, declining to take a firm position at a Chicago meeting Wednesday.

The health committee, which got to work Wednesday, is chaired by Sen. Edward M. Kennedy, D-Mass., and divided along ideological lines. It's expected to produce a bill that heavily reflects the wishes of Democrats, but may not be able to pass the full Senate. Much of the day was taken up with speech-making.