Update at bottom: Reid plan ups pressure on moderate Dems

US Senate Democrats unveiled a historic plan to extend health coverage to more than 30 million Americans who lack it now and set the stage for a key test vote as early as this weekend.

US President Barack Obama, who has made such an overhaul his top domestic priority, hailed the new legislation as "a critical milestone" that brought the United States "closer than ever" to a better health care system.

"The challenges facing our health care system aren't new -- but if we fail to act they?ll surely get even worse," said Obama, who had sent Vice President Joe Biden and other top aides to lobby wavering senators throughout the day.

The non-partisan Congressional Budget Office says the plan will cost 849 billion dollars over ten years, while extending coverage to 31 million Americans who currently lack health coverage, said a Democratic aide.

CBO's preliminary estimate was that it would also cut the federal budget deficit by 127 billion dollars over the next decade, and 650 billion the 10 years after that, the aide said on condition of anonymity.

Democrats on paper have the 60 votes needed to win on a procedural vote, as early as Saturday, to formally launch the debate but must keep two independents and a handful of waverers in their own party to do so.

"We have traveled a long ways to where we are, and tonight begins the last leg of this journey," Democratic Senate Majority Leader Harry Reid said with guarded optimism. "The finish line is really in sight."

"Absolutely," Democratic Senator Tom Harkin, who became chairman of the Senate Health, Labor and Pensions Committee after Democratic icon Ted Kennedy died in August, said when asked whether Democrats would prevail this weekend.

Republicans seemed united in opposition to the measure, with Senate Minority Leader Mitch McConnell condemning it as "another trillion-dollar experiment" and warning "the American people know that is not reform."

The House of Representatives approved its own trillion-dollar version of the legislation on November 7, squeaking through on a 220-215 margin only after toughening restrictions on federal funds subsidising abortions.

The Senate version allows a government-backed "public option" health insurance plan to provide abortion but bars federal monies from paying for the procedure, a Democratic aide said.

If, as expected, the House and Senate approve different versions, they would need to work out their differences and approve the same legislation to send to Obama to sign into law.

"I look forward to working with the Senate and House to get a finished bill to my desk as soon as possible," said the US president.

"From day one, our goal has been to enact legislation that offers stability and security to those who have insurance and affordable coverage to those who don?t, and that lowers costs for families, businesses and governments across the country," he said, stressing the bill "meets those principles."

The United States is the world's richest nation but the only industrialized democracy that does not ensure that all of its citizens have health care coverage, with an estimated 36 million Americans uninsured.

And Washington spends vastly more on health care -- both per person and as a share of national income as measured by Gross Domestic Product -- than other industrialized democracies, according to the Organization for Economic Cooperation and Development.

The United States spent about 7,290 dollars per person in 2007, more than double what Britain, France and Germany spent, with no meaningful edge in the quality of care, and lags behind OECD averages in key indicators like life expectancy and infant mortality.

Politico reports that Reid's plan increases pressure on moderate Democrats.

Carrie Budoff Brown writes that the Senate Majority Leader's "move quickly turned up the pressure on the last few wavering moderates to support the plan, which includes a sizable chunk of deficit cutting."

“Tonight begins the last leg of this journey” to bring health reform to the nation, Reid said in announcing the bill.

But Reid’s plan contains considerable differences from House legislation passed earlier this month — with a more limited public option and different ways to pay for the bill. Reid included an excise tax on insurers who offer “Cadillac” health plans, not the “millionaire’s tax” that’s in the House bill.

And one of the biggest differences between the bills – on language restricting federal funding for abortion – could prove problematic for Reid. His bill doesn’t include as many limits as the House bill and already is drawing fire from anti-abortion activists.

Democrats hope the deficit figures in the plan "would knock down one of the last remaining obstacles to winning the votes of key centrists, at least to go ahead with debate on the bill as early as this weekend."

Politico reports that the Reid plan to attract moderates might work. But now the Democratic leader has to hope that liberals will remain in the fold.

At the liberal firedoglake blog, Jane Hamsher writes, "It is encouraging that Senator Reid respected the will of the American people and included a public option in the merged Senate bill. However, the addition of a state opt-out provision threatens to leave millions of Americans at the mercy of private insurance monopolies, with the federal government acting as enforcers for a product with no competition to keep prices down."

Hamsher complains that "while people struggling with crippling health care costs and pre-existing conditions may have to wait until 2014 for relief, states can begin opting out immediately. That means for the next four years, health care will become a partisan football at the state level, easily gamed by the same insurance company lobbyist dollars that flooded on to Capitol Hill this year. And just as 42 members of the House did the bidding of PhRMA and inserted language into the Congressional Record in support of their endless monopolies on biologic 'drugs of the future,' the Senate bill followed suit and included the Anna Eshoo-written language which prevents generic versions of vital lifesaving drugs from ever coming to market. "

"If Harry Reid truly cares about fighting for the good of the country over the good of Wellpoint, he will immediately dispense with the opt-out and move to reconciliation and allow a majority in the Senate to deliver to Americans what they want and desperately need," Hamsher concludes.

(with afp report)