Robert Schroeder is a reporter for MarketWatch in Washington.



WASHINGTON (MarketWatch) -- Senate lawmakers began hammering out details of an historic overhaul of the U.S. health-care system on Wednesday, beginning a work session with a clash over costs that threatened to slow progress on one of President Barack Obama's top legislative priorities.

With Obama calling for enacting reform this year, members of the Senate Health, Education, Labor and Pensions Committee got to work on a bill that would create a new government health-insurance plan to compete with private insurers. Among other things, it would require most Americans to buy health insurance.

But the meeting began on a tense note as Republicans cited a preliminary congressional analysis showing that the bill would cost about $1 trillion over a decade while only adding 15 million more Americans to the ranks of the insured. About 46 million are now without insurance.

Sen. Christopher Dodd, leading the committee's work session in the absence of ailing chairman Sen. Edward Kennedy, D-Mass., said that most of the underlying bill's costs have been worked out but that some costs weren't yet known.

But without fully knowing the cost of the bill, asked Sen. John McCain, R-Ariz., "how in the world do we expect to reasonably address this?"

Dodd, D-Conn., said that the committee will have a bill that is paid for.

Democrats are plowing ahead with the bill, which would also create government-run exchanges where Americans could buy insurance policies and require employers to provide health benefits to their employees.

"This is about as historic as it gets for all of us," Dodd said at the opening of the hearing. "A hundred percent of our fellow citizens will be affected by what we do."


Intense schedule

Lawmakers and the White House are working furiously to get a bill done by this fall, in line with Obama's aim of signing legislation into law by October.

The Senate panel plans to meet every weekday until June 26 to work on the bill. House Democrats may unveil their own bill this week and the House Energy and Commerce Committee has planned a slew of health-care hearings for next week.

Meanwhile, Democrats' efforts to move the bill quickly hit a snag on Wednesday, as the Senate Finance Committee reportedly delayed its own work session on writing a bill to pay for health-care reform.

Sen. Max Baucus, D-Mont., the committee's chairman, had been planning to hold a bill-writing session next week. But he said Wednesday that he's delaying it indefinitely until members do more work on costs.

"We're not there yet," Baucus said after a closed-door committee meeting, Congressional Quarterly reported.

The costs of funding an overhaul are bedeviling the process, and lawmakers are searching hard for ways to save money in order to extend coverage to the roughly 46 million uninsured Americans.

The Senate Finance Committee, for example, is looking to cut more than $500 billion from government health spending over 10 years, The Wall Street Journal reported Wednesday.

A preliminary analysis by the Congressional Budget Office of the Finance Committee's bill put its cost at $1.6 trillion. Baucus is trying to keep costs to less than $1 trillion over 10 years.

Meanwhile, House Republicans rolled out a health-care reform plan of their own that they say aims to protect Americans from being forced into a government-run system.

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