Health bill sets up historic debate

WASHINGTON — Setting up a historic year-end debate, Senate Democratic leader Harry Reid unveiled his long-awaited version of legislation to reshape the nation's health care system Wednesday night, a measure designed to extend coverage to 94 percent of eligible Americans and bar private industry from denying insurance because of pre-existing medical conditions.

"Tonight begins the last leg of this journey," said the Nevada Democrat, less than two weeks after the House approved its version — and nearly 10 months after President Barack Obama's Inauguration Day summons to action.

Reid's Senate measure would require most Americans to carry health insurance and would provide hundreds of billions of dollars in subsidies to help those at lower incomes afford it. It also would mandate that large companies provide coverage to their workers.

At its core, it would set up new insurance marketplaces — called exchanges — primarily for those who now have a hard time getting or keeping coverage. Consumers would have the choice of purchasing government-sold insurance, an attempt to hold down prices charged by private insurers.

Initial maneuvering on the Senate floor was expected later in the week on the measure, bitterly opposed by Republicans eager to deny Obama a victory on his top domestic priority.

After weeks of secretive drafting, Reid outlined the legislation to rank-and-file Democratic senators at a closed-door meeting. "Everyone was positive," said Sen. Amy Klobuchar, D-Minn.

That didn't mean there weren't problems — far from it. At his news conference, Reid pointedly refrained from saying he had the 60 votes necessary to propel the bill over its first hurdle.

Reid met privately earlier in the day with Sens. Ben Nelson of Nebraska, Mary Landrieu of Louisiana and Blanche Lincoln of Arkansas, moderate Democrats who have expressed concerns about the measure.

With the support of two independents, Democrats have 60 seats, the precise number needed to choke off any delaying tactics by the 40 Republicans who appear united in opposition to the bill in its current form.

"This bill has been behind closed doors for weeks," said Sen. Mitch McConnell of Kentucky, the Republican leader. "Now, it's America's turn, and this will not be a short debate. Higher premiums, tax increases and Medicare cuts to pay for more government. The American people know that is not reform."