WASHINGTON (CNN) - A Senate committee debating the only compromise health care bill so far took on the most contentious issue Tuesday - whether to include a government-run public health insurance option that is opposed by Republicans and some moderate Democrats.
Democratic Sen. Jay Rockefeller of West Virginia proposed an amendment to add the public option to the proposal before the Senate Finance Committee. Another Democratic senator, Charles Schumer of New York, also was expected to propose a public option amendment.
The Finance Committee is the last congressional panel to consider health care legislation before debate begins in the full House and Senate. Democratic proposals passed by another Senate committee and three House committees all include the public insurance option.
Republicans unanimously oppose the government-run insurance option, saying it would drive private insurers from the market and eventually bring a government takeover of the health care system. Democratic leaders reject that claim, saying the public option would provide needed competition for private insurers while making health coverage accessible to millions of people currently lacking health insurance.
Finance Committee Chairman Sen. Max Baucus and five other committee members - two fellow Democrats and three Republicans - negotiated the compromise proposal for months before Baucus brought the measure to the full panel. None of the three Republicans in the so-called "Gang of Six" negotiators has backed the proposal before the committee so far.
However, Republican Sen. Olympia Snowe, a moderate from Maine and one of the Gang of Six negotiators, has indicated she could go along with the Finance Committee proposal if changes are made. Snowe voted with Democrats on the panel
to defeat some Republican amendments last week, when the committee began debating the proposal.
Obama and Democratic leaders, aware of a rockier political climate due to mid-term congressional elections in 2010, insist a bill must pass this year to address spiraling health care costs that are threatening economic stability.
Republicans say they agree on the need to reform aspects of the health care system, but oppose the overhaul proposed by Democrats as too comprehensive and costly.
Both parties agree on major aspects of health care reform, including a halt to insurance company practices of denying coverage for pre-existing conditions and capping the annual out-of-pocket expenses of consumers for health care. They also agree on creating incentives for preventive health care to help lower overall costs.
In efforts to bridge differences, the Finance Committee proposal dropped the public insurance option and a mandate for all employers to provide health coverage. It would require individuals to have coverage or face a fine of up to $1,900 for a family of four, but includes subsidies to help low- and middle-income Americans obtain health care plans.
The committee began debating the compromise measure last week, with contentious arguments erupting over Democratic proposals to reduce subsidies for some Medicare coverage while eliminating fraud and waste in the government health care plan for senior citizens.
Republicans argued the changes would reduce benefits for senior citizens, but Democrats say the overall effect would be minor. Some advocacy groups cite reports that the amount of money involved is no more than 5 percent of overall
Medicare spending and therefore won't adversely affect benefits for the elderly.
The non-partisan Congressional Budget Office said the Finance Committee proposal would cost $774 billion over 10 years, but amendments adopted so far have likely increased the overall price tag. By contrast, the CBO said Democratic proposals would cost more than $1 trillion over 10 years.
In the House, Democratic leaders planned a series of meetings beginning Tuesday on merging the three versions passed out of House committees while
bringing down the overall cost by $200 billion. House Speaker Nancy Pelosi said last week she expected a final version for consideration by the full chamber soon, but she was unable to provide a specific timetable.
Fiscally-minded "Blue Dog" Democrats in the House - and conservative Democrats in the Senate - are worried about estimates of how much the plans will cost.
With prospects dim for any Republican support for a health care bill, the Democratic leadership wants to bring liberals, progressives and conservatives in their party together to use its majority in both chambers to pass a bill this year.
In the Senate, Majority Leader Harry Reid of Nevada needs 60 votes to overcome a possible Republican filibuster. There are 60 seats in the Democratic Senate caucus, but some are independents or moderates unlikely to support a public option or some of the most costly reforms.
Reid could implement a legislative option known as reconciliation, which would only require 51 votes to pass a health care bill. However, Republicans warn against such a move as shortsighted legislative warfare that would sow deep and long-lasting division.
Snowe has proposed a possible compromise - a "trigger" mechanism that would create a public option in the future if specific thresholds for expanded coverage and lower costs are not met. The trigger has yet to be included in any
proposal so far.