politics

WASHINGTON - Sen. Ben Nelson of Nebraska, one of three wavering Democrats, said Friday that he would vote today to start debate on a giant health care bill as Democrats and Republicans squared off over the legislation in advance of its first big test in the Senate.

Nelson's announcement had the effect of increasing pressure on the two other uncommitted Democrats, Sens. Mary Landrieu of Louisiana and Blanche Lincoln of Arkansas, who faces a difficult race for re-election next year.

In agreeing to proceed to the bill, Nelson emphasized that his vote should not be construed as support for the legislation in its current form.

"Throughout my Senate career," Nelson said, "I have consistently rejected efforts to obstruct. That's what the vote on the motion to proceed is all about. It is not for or against the Senate health care bill released Wednesday. It is only to begin debate and an opportunity to make improvements.

"If you don't like a bill," Nelson asked, "why block your own opportunity to amend it?"

The Senate plans to vote today on whether to take up the legislation, which would remake the nation's health care system and provide insurance to more than 30 million people, at a cost of $848 billion over 10 years. The House passed a different version of the legislation two weeks ago.

With no immediate prospect of support from Republicans, the Senate Majority Leader Harry Reid, D-Nev., needs backing from all 60 members of his caucus to clear the first hurdle to action on the bill.

Democratic leaders expressed confidence they could muster the 60 votes, even as Republicans stepped up the pressure on centrist Democrats.

Sen. John McCain, R-Ariz., sent an e-mail message on Friday, urging his supporters to call Nelson and "ask him to vote 'no' on government-run health care."

In debate Friday, senators previewed the arguments they will use. Democrats said their bill would guarantee affordable health care for all Americans, slow the growth of insurance premiums, reduce the federal deficit and strengthen Medicare.

Republicans said the bill would increase taxes, cut Medicare and lead to higher premiums for tens of millions of people who already have insurance.

As part of his effort to solidify support for the bill, Reid disclosed Friday that he had accepted a potentially significant change, which would provide additional insurance options to at least a million people who cannot easily afford insurance offered by their employers. Under the proposal, by Sen. Ron Wyden, D-Ore., the employer's contribution to health coverage would be converted into a voucher. Workers could use the voucher to shop for coverage on their own, in new government-regulated markets known as insurance exchanges.

Many companies are apprehensive about such changes, saying they would undermine the employer-based system of health insurance, which provides coverage to more than 150 million people.

In scheduling the vote on Saturday, Reid made sure to keep a commitment to Lincoln that all senators would have at least 72 hours to study the bill after it was released.

Reid posted the text of his bill on the Internet on Wednesday night, after a meeting of the Democratic caucus. Aides to Lincoln said Friday that she was still studying it.