WASHINGTON (CNN) - A Senate committee began the arduous work Thursday of debating and amending the first comprehensive health care bill to come before Congress this year.
The measure before the Senate Health, Education, Labor and Pensions (HELP) Committee is one of at least four expected proposals for overhauling America's ailing health care system.
At issue is how to best reduce the cost and increase the reach of the current health care system, which officials say is increasingly draining personal, corporate and government budgets while leaving 46 million Americans without health insurance.
President Barack Obama has made the issue a top priority, warning that failure to act now would bring far worse economic difficulties than the costs of plans under discussion.
Both parties in Congress agree on the need to slow the increase in health care costs while ensuring that all Americans can get health insurance, but they differ sharply on how to proceed.
Democrats generally favor a government-funded public option to compete with private insurers. Republicans say such a step would lead to a government takeover of health care, which they would oppose.
The parties agree on several principles, including an emphasis on preventive care, cost-cutting measures in the existing Medicare and Medicaid programs, and a halt to denials of coverage because of pre-existing medical conditions.
While the Senate HELP Committee began its work, the Senate Finance Committee has delayed its consideration of a similar measure because of uncertainties over the overall costs.
A Congressional Budget Office preliminary analysis this week said portions of the Senate HELP committee bill it has reviewed would cost $1 trillion over the next 10 years while reducing the number of the uninsured - currently 46 million - by just 16 million.
Meanwhile, a bipartisan group made up of former Senate Majority Leaders Tom Daschle, Howard Baker and Bob Dole has offered an outline for an alternative plan intended to overcome the deep party divisions.
The proposal by the Bipartisan Policy Center called for a budget-neutral plan that would include taxing some employer-provided health care benefits for workers.
The plan stopped short of an outright government-funded public health care option, but called for various forms of government assistance to help make coverage more affordable and available. It also called for requiring all Americans to have health care.
Both taxing health care benefits and the lack of a public option go against stated Democratic positions, while the mandate for individual coverage is opposed by Republicans.