Democrats in Congress pressed forward this week with plans to expand health care coverage. Sen. Max Baucus (D-MT) put out a detailed plan, Nov. 12, that called for a variety of means aimed at different population groups to ensure near-universal health care.

With a strong supporter of universal health care in the White House and a bipartisan majority in Congress that has expressed support for it, many believe that a major reform in health care has never had a better chance.

The Baucus plan would expand existing public programs such as S-CHIP, Medicaid, and Medicare to provide coverage for lower-income families, children, and seniors. Middle-income families, defined as being at 400 percent of the poverty level, would see new tax credits to help pay for the cost of insurance premiums. In addition, the plan would create a new national insurance market to help families who seek insurance with a range of private and public options.

Under the Baucus plan, people over 55 would be allowed to buy into Medicare if they do not now have access to other public programs or private insurance plans. Further, the Baucus proposal would ease restrictions against access to Medicaid and S-CHIP now placed on legal immigrants. It would further boost tax credits for businesses that provide health care benefits for their employees.

According to the the New York Times, Baucus' plan could provide affordable coverage to as many as 90 percent of the nearly 50 million people who currently lack coverage. In addition, it would mandate that everyone purchase private insurance or seek access through one of the public programs.

Congressional leaders on health care policy, such as Sen. Ted Kennedy (D-MA) and Rep. John Dingell (D-MI), who have co-sponsored a universal coverage plan they label as 'Medicare for all,' say they plan to work with Baucus to produce a single bill that could pass early next year.

The Obama transition team has expressed a preference for allowing Congress to take the lead on health care reform. In the near term, however, Obama plans to overturn a Bush order that places restrictions on the use of S-CHIP funds which has kept hundreds of thousands of uninsured children off of its rolls. The Obama transition team has also stated that it plans to support an S-CHIP reauthorization bill early next year.

Health Care for America Now (HCAN), a coalition of national community organizations, important civil rights groups, and international labor unions applauded the release of the Baucus proposals. In a press statement, HCAN praised 'Senator Baucus for coming up with a comprehensive health care plan that is a blueprint for enacting quality, affordable health care for everyone in 2009 and is generally consistent with our principles.'

Echoing this positive response, AFL-CIO President John Sweeney described Baucus' proposal as 'a giant step towards the comprehensive health reform that Americans so badly want and need.'

Sweeney did, however, express reservations about the portion of the plan calling for tax reforms related to health care. New policies should strengthen the employment-based system of coverage, he said. 'Employer-sponsored coverage is largely preferred by workers not because of this tax treatment, as economists may suggest, but because it is the most stable source of affordable coverage for most Americans and is the best, natural pooling mechanism available in our fractured health care system.'

The mixed approaches advanced in Congress differ in philosophy and structure from other existing proposals that call for a national health insurance program. For example, the United States National Health Insurance Act (H.R. 676), authored by Rep. John Conyers (D-MI), offers a 'single-payer' plan based on a universal expansion of Medicare.

In a recent press statement, Dr. Quentin Young, who heads Physicians for a National Health Program, which has endorsed the United States National Health Insurance Act, explained his group's differences with the kind of proposals Baucus, other Democrats and even the Obama campaign have put out.

'The prescription offered during the campaign by the president-elect and most Democratic policy makers – a hybrid of private health insurance plans and government subsidies – will not resolve the problems of our dangerously dysfunctional system,' Young said.

Young pointed to important limitations such plans have experienced on the state level where they have been implemented, including Massachusetts, Oregon and Minnesota. Young cited the single-payer plan's efficiency and reduced cost as among its best features.

'The only effective cure for our health care woes is to establish a single, publicly financed system, one that removes the inefficient, wasteful, for-profit private health insurance industry from the picture,' he said. 'Single payer has a proven track record of success – Medicare being just one example – and is the only medically and fiscally responsible course of action to take.'

Physicians for a National Health Plan claims a nationwide membership of 15,000 doctors.

While it has also garnered enormous grassroots support from hundreds of local labor unions and affiliated organizations and a growing list of supporters in the House of Representatives, a major obstacle for passage of the United States National Health Insurance Act is that no Senate version of the bill has yet been introduced.