WASHINGTON (AFP) –
The bitterly divided US Senate on Monday formally launched a historic debate on sweeping legislation to overhaul the US health care system, President Barack Obama's top domestic priority.
Obama's Republican foes appeared united against the plan, forcing his Democratic allies to hold difficult behind-the-scenes negotiations to bridge internal divisions and try and rally the 60 votes needed to ensure passage.
The White House-backed bill aims to extend coverage to some 31 million Americans out of the roughly 36 million who currently lack it, while curbing soaring costs and improving the quality of care.
"We have before us an historic occasion," Democratic Senate Majority Harry Reid said on the Senate floor. "We have the opportunity to allay the suffering of many and prevent worse pain in the future."
Reid needed to unite all 58 Democrats and two independents who often side with the party to overcome any Republican parliamentary delaying tactics that could derail the bill.
Reid's main challenge came from three possible Democratic defectors, Senators Mary Landrieu, Blanche Lincoln, and Ben Nelson, and from former Democrat turned independent Senator Joe Lieberman.
Landrieu, Lieberman and Lincoln have signaled they will help Republicans block a final vote on the bill if it includes a government-backed "public option" for health care coverage to compete with private insurers.
Nelson has said he will oppose the bill unless it includes tough new restrictions on even indirect government funding for abortions -- mimicking a last-minute deal that paved the way for House passage of the legislation.
"While we will disagree at times, let us at least agree that doing nothing is not an option," pleaded Reid, who warned his colleagues of possible weekend sessions in a bid to meet a self-imposed Christmas deadline for a vote.
Republican Senate Minority Leader Mitch McConnell assailed the plan as an "experiment" that would eventually lead to "government-run health care" and said Democrats and the White House were wrong to say that "history is calling."
"Someone is calling, all right, but it's not history. It's the American worker, wondering where the jobs are," he said.
With senators expected to push dozens of amendments, the debate was expected to take weeks.
The measure includes a government-backed insurance "public option," tough new restrictions on dropping care for pre-existing ailments, and an end on lifetime caps for coverage.
It is estimated to cost 848 billion dollars through 2019 but cut the sky-high US budget deficit by 130 billion dollars over the same period, according to the non-partisan Congressional Budget Office.
Senate approval of the measure would force the Senate and House of Representatives to reconcile their rival versions of the bill and vote again on whether to send it to Obama.
The United States is the world's richest nation but the only industrialized democracy that does not provide health care coverage to all of its citizens, about 36 million of whom are uninsured.
Washington spends more than double what Britain, France and Germany do per person on health care, but lags behind other countries in life expectancy and infant mortality, according to the Organization for Economic Cooperation and Development (OECD).
