Senate to Debate $848 Billion Health-Care Overhaul

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A vote for the bill would support "the spending binge that is leading to a massive and unsustainable long-term debt that will shackle our children to a future they can't afford," said Senate Republican leader Mitch McConnell of Kentucky. Still, McConnell sounded doubtful Republicans will offer an alternative. "What we don't think the American people want is another 2,000-page bill," he said on CNN.

"Senator Reid's claim that the cost is $848 billion is the ultimate Washington gimmick, at taxpayers' expense," said Senator Charles Grassley of Iowa, the top Republican on the Finance Committee.

Government-Run Program

In debating the 2,074-page bill, senators will focus on issues including how to pay for the legislation and how to prohibit the use of federal money to fund abortions.

One key sticking point: the Senate bill would create a government-run insurance program, the so-called public option, to compete against private insurers such as Hartford, Connecticut-based Aetna Inc. The measure would let individual states choose not to offer it.

Senator Joe Lieberman, a Connecticut independent who caucuses with Democrats, said on NBC's "Meet the Press" program that the public option may be more expensive than private insurance and that one thing he's sure of is that "it's going to run a deficit, and it's only the taxpayers who are going to pay for it."

Another issue is whether to help finance the plan with a 40 percent tax on high-value insurance policies. Labor unions object to the tax, saying their members would be hit too hard.

Senate Democrats Ben Nelson of Nebraska, Lincoln and Landrieu oppose the public option and also want adjustments in the abortion language and more aid for small businesses.

Snowe's Position

Lieberman has said he won't support a bill that includes the government-run plan, as has the only Republican who supported a health bill in a committee vote, Olympia Snowe of Maine.

She said she hasn't decided whether to offer an amendment, supported by some Democratic centrists, to create a public option only if private insurers aren't offering enough affordable policies.

Reid said Landrieu told him she is working with other Democrats, including Tom Carper of Delaware and Charles Schumer of New York, to try to find a compromise on the public option issue.

On "Meet the Press," Dick Durbin, an Illinois Democrat and the Senate majority whip, said the public option remains negotiable. "There are many variations on the theme," he said. "At the end of the day, we want insurance to be more affordable."

Abortion Issue

In a sign that abortion remains a stumbling block, the U.S. Conference of Catholic Bishops sent a letter two days ago calling the Senate measure an "enormous disappointment" that did not "live up to Obama's pledge to bar the use of federal dollars for abortion."

Senate Democratic leaders say the measure keeps existing restrictions on the use of taxpayer money for abortion services. It requires state insurance purchasing exchanges to offer at least one policy with abortion coverage and one that doesn't.

The House legislation goes further, barring the public plan from covering abortions and banning use of federal money on the exchange to buy a private policy that covers abortion.

If the Senate passes a bill, it would work toward a compromise with the House that would be voted on in both chambers before a measure could go to Obama.

To contact the reporter on this story: Laura Litvan in Washington at llitvan@bloomberg.net .