**President Barack Obama’s attempt to overhaul the US healthcare system is set to enter a new phase with a key Senate panel due to vote on the issue.**The Senate Finance Committee is expected to pass its reform bill.
But all eyes will be on how not only the panel’s Republicans but Democrats vote as the reform plans have divided opinion over their cost and scope.
The committee’s vote could give an indication of how the legislation will fare when it reaches the full Senate.
Reforming the US healthcare system is President Obama’s top domestic priority.
He argues that all Americans are entitled to insurance coverage, rising costs must be tackled and that private insurers must not be able to deny coverage or end it when someone becomes seriously ill.
US HEALTHCARE
- No universal coverage
- Private health insurance available through employer, government or private schemes
- US spends some 16.2% of GDP on healthcare, nearly twice average of other OECD countries
- US Census Bureau estimates some 46m people do not have health insurance - includes 9.2 million non-citizens and 18 million people who earn over $50,000 a year
- Medicaid: federal-state programme for low income groups
- Medicare: for people 65 years old and above and some younger disabled people
On paper, his administration should face few problems, says the BBC’s Kevin Connolly in Montana.
Mr Obama has a strong presidential mandate and his Democratic Party has majorities in the House of Representatives and the Senate.
But, our correspondent says, Democrats come from a very wide political spectrum, including fiscal conservatives who are concerned about any reforms that could increase government spending and borrowing.
That is why the vote in the Senate Finance Committee, a key but far from final step, will be closely watched.
The committee’s bill, which was drafted after weeks of at times bitterly bipartisan debate, sets out a 10-year $829bn (£525bn) plan to cut health costs and provide affordable health insurance to most Americans.
It is expected to pass as the Democrats have a majority of 13 to 10. The key issue is whether any Democrats vote against and whether moderate Republican Senator Olympia Snowe, seen as a pivotal figure, supports the bill.
‘Public option’
After Tuesday’s vote, the finance committee’s bill must be combined with a bill drafted by the Senate Health Committee before going to the full Senate for a vote.
It is not guaranteed to pass, as it needs all the Democrats, two independents and one Republican to vote in favour.
If it does pass the Senate, it will be combined with the House of Representatives’ version and go back before both houses for final approval.
It is still a long congressional slog but correspondents note that Mr Obama’s push for healthcare reform has gone further than attempts in the 1990s by President Bill Clinton, which never got beyond all the committees.
All of the different versions of the bill produced by House of Representative and Senate committees are broadly similar in the scope of their reforms:
- toughen regulations on health insurers
- mandate all Americans to get insurance
- offer subsidies to the less well-off and set up health insurance exchanges for people without employer-sponsored coverage, to help them choose between different options.
Lawmakers are divided, however, over whether there should be a new government-run insurance scheme - the so-called “public option”.
The finance committee’s proposed bill is the only one not to include a public option, an element advocated by Mr Obama and some Democrats as the means of creating competition between insurers.
Last week, the nonpartisan Congressional Budget Office concluded that the finance committee’s bill would result in reducing the federal deficit by $81bn and mean some 94% of eligible Americans would have insurance coverage.
However, Republicans say the final draft which will be voted on is likely to be very different and more expensive than this version. They say the proposed reforms are too costly and represent too much government intrusion into healthcare.
At the weekend, the private insurance industry issued a study that said the plans could mean policies end up costing people hundreds, if not thousands, more dollars.