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President Obama's quest to overhaul America's health-care system passed a critical test Saturday as the House of Representatives approved a bill containing many provisions Mr. Obama has advocated since last year's presidential campaign. Attention now shifts to the Senate, where passage of a similar bill is far from assured.
For months, debate has raged in Congress over whether health-care reform should include the creation of a government-run insurance program to compete with private insurers.
The House bill contains a robust version of what is commonly referred to as a "public option" that is championed by left-leaning Democrats but opposed by some of the party's more moderate legislators as well as virtually all Republicans.
Democratic National Committee Chairman Tim Kaine hailed passage of the House bill, which would extend health care insurance to tens of millions of Americans at an estimated cost of more than $1 trillion over 10 years.
"It provides security for the four-fifths of Americans who have health insurance, so that they cannot get abused by predatory insurance company practices," he said. "It provides a path to affordable coverage for uninsured Americans for the firsitself.
With 60 members, Democrats hold the bare minimum number of seats needed to end filibusters. But one member of the caucus, independent Democrat Joe Lieberman of Connecticut, says he will side with Republicans to prevent the Democratic bill from going to a vote.
"If the public-option plan is in there, as a matter of conscience I will not allow this bill to come to a final vote, because I believe the debt [incurred by the bill] can break America and send us into a recession that is worse than the one we are fighting our way out of today," Lieberman spoke on Fox News Sunday.
Should health reform pass in the Senate, the bill would have to be reconciled with the House version. President Obama says he hopes to sign a final bill into law by the end of the year, but Senate Majority Leader Harry Reid has said the legislative process may extend into 2010.