Round 1

WASHINGTON-Senate leaders came out of their partisan corners fighting Monday afternoon-the first official day of its healthcare debate. In day one of what is expected to be weeks of squabbling over the 2,074-page, nearly $1 trillion bill, both parties could not even agree on the conclusions of a new Congressional Budget Office analysis.

The 28-page report, released Monday, said insurance premiums for non-group policies would rise by between 10 and 13 percent on average. Employees getting insurance through large companies would see premiums between zero and 3 percent lower on average under the proposed legislation.

"After . . . trillions more in government spending, massive new taxes, and a half-trillion dollars in cuts to Medicare for seniors, most people will end up paying more or seeing no significant savings," summarized Senate Republican leader Mitch McConnell of Kentucky. "This is not what the American people are asking for."

But Democrats countered that the study did not factor in federal subsidies, which would be available under the bill to help individuals purchase insurance.

Sen. Max Baucus, D-Mont, said the analysis "indicates that whether you work for a small business, a large company, or you work for yourself, the vast majority of Americans will see lower premiums than they would if we don't pass health reform."

The study does show that individuals who want to purchase insurance without federal subsidies will face higher premiums. And, under this formula, conservatives fear that the healthcare legislation would drive more Americans to greater government dependence.

"The administration and its allies in Congress have wanted to push government-run healthcare for years, and they viewed the economic crisis that we're in as their moment to do it," McConnell said in the opening speech for Republicans in this debate. "Americans are fed up with big-government solutions that drive up taxes and debt and which only seem to create more problems, more abuse, and more fraud."

Earlier Senate Majority Leader Harry Reid of Nevada began the argument for his healthcare overhaul bill by warning Republicans to refrain from scare tactics: "This debate must be about facts, not fear. And we must avoid the temptation to drown in distractions and distortions."

The Senate is expected to spend most of December debating healthcare. The bill would, for the first time, require Americans to purchase healthcare or face tax penalties. It also bars insurers from declining coverage based on medical history and establishes a government-run insurance option that currently would require at least one plan in every area to offer abortion coverage.

The bill would be funded through cuts in Medicare and a host of new taxes on wealthy families, drug makers, and medical device manufacturers.

Reid has a paper-thin margin for victory: He will need the support of all 60 Senate Democrats, and several moderate Democrats have been unwilling to support elements of the plan. But pro-reform advocates hope the expected long floor debate will give Reid ample time to both court and arm-twist these Democratic holdouts.

Later Monday, Sen. Barbara Mikulski, D-Md., offered the first of what will likely be many proposed changes to the bill. Her amendment would increase insurance benefits for women to include mandated annual health screenings.

But Republicans, sticking to their big government theme, warned that this amendment would give unnecessary additional power to an advisory committee that recently suggested-to much controversy-a delay in mammogram screening.

Sen. John McCain, R-Ariz., offered the first Republican amendment: to send the entire bill back to committee so it could be reworked without its proposed $500 billion in Medicare cuts. That will not happen. It remains to be seen how many, if any, Republican amendments eventually get added to the bill.