WASHINGTON (AP) — Health care reform — President Barack Obama's top domestic policy priority — heads for a critical but far-from-final congressional vote on Tuesday.
Opposition Republicans are nearly unanimous in fighting the overhaul plans drawn up at Obama's request by Democrats in both the House of Representatives and the Senate.
Republicans believe the Democrats' overhaul measure will unduly increase the national debt and wrongly intrude on the private sector. And some members of the opposition party see it as a chance to score political points by sinking a measure at the core of Obama's presidency.
Most controversial among those issues would be establishment of a government program in competition with the private insurance industry. That, for now, has been written out of the Senate Finance Committee plan that goes to a vote among members of the panel on Tuesday.
The Finance Committee's plan would require nearly all Americans to purchase insurance and usher in a host of other changes to the $2.5 trillion U.S. medical system. The U.S. is the only industrialized country without universal health care coverage, and about 47 million Americans are uninsured.
Much work would lie ahead before a bill could arrive on Obama's desk, but action by the Finance Committee would mark a significant advance, capping numerous delays as Chairman Max Baucus held marathon negotiating sessions — ultimately unsuccessful — aimed at producing a bipartisan bill.
The big question mark is whether moderate Sen. Olympia Snowe will become the first Republican to support a health overhaul bill. The health legislation that passed three House committees and one other Senate panel did so without a single Republican vote.
The four other congressional committees acted before August to pass health legislation, so for months all eyes have been on the Finance Committee, the remaining one. It's also the panel whose moderate makeup most closely resembles the Senate as a whole. And the committee's centrist legislation is seen as the best building block for a compromise plan that could find favor on the Senate floor.
With Finance Committee passage, Obama's top domestic priority will have advanced farther than former President Bill Clinton's effort ever did. The Clinton health plan never made it through all the congressional committees with jurisdiction.
Obama has promised to overhaul the health care system, asserting that all Americans are entitled to insurance coverage, that costs had to be cut significantly to reduce the soaring federal debt and that private insurers must be prevented from denying coverage or dropping it when a person becomes seriously ill.
If the Democratic-controlled Senate Finance Committee passes the proposal Tuesday as expected, the 10-year, $829 billion health care overhaul would move on for debate among all 100 senators. Republicans, while a minority in the Senate, hold sufficient votes to stall passage through a procedure known as a filibuster.
That move is expected and would require majority Democrats to muster all 60 of their votes, not a simple majority of 51, to end debate and bring a bill to a final vote. Some fiscally conservative Democrats are opposed to the bill coming out of the committee, so that gaining the 60 votes to break a filibuster is far from certain.
And even if that happens, the health care bill would then move to what is known as a conference committee to blend the Senate bill with one passed by the House.
The lower house, where the Democrats have a heftier majority and a filibuster is not possible, is considering three versions of the legislation, any one of them assured of passage and far more inclusive of an outcome sought by the White House.
Democrats got a leg up last week when the nonpartisan Congressional Budget Office said the Senate Finance Committee bill would, in fact, cut the federal deficit over 10 years and end up covering 94 percent of Americans.
The private insurance industry hit back, however, on Sunday with a study that claims the bill could end up, over time, adding hundreds, perhaps thousands of dollars to the cost of a typical policy.
Democrats and their allies scrambled Monday to knoc
k it down. "Distorted and flawed," said White House spokeswoman Linda Douglass.
PricewaterhouseCoopers, the accounting firm that did the industry-commissioned analysis, issued a statement late Monday acknowledging it did not look at the entirety of the legislation, only the effects of four provisions that the insurance group wanted analyzed.
Associated Press writers Erica Werner and Ricardo Alonso-Zaldivar contributed