Health Care Hurdles: Legislation's Fate Hangs in the Balance

President Obama will likely press lawmakers to find common ground on health care in his first official State of the Union address tonight, but the fate of the bill remains in limbo as Democrats ponder options after losing the Massachusetts Senate seat to a Republican.

Despite telling Congress last week not to "jam" through a health care bill right now, the president is urging members of Congress to reach a consensus on core principles on which most members can agree.

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"As we move forward, we've got to make sure that we're focused on what is actually helping the American people deal with what is a very serious problem," Obama said Monday in an ABC News interview.

But many Democratic lawmakers who are up for re-election are jittery about their own political futures and the leadership is not confident that the party will garner enough votes to pass a bill.

Democratic leaders are even weighing the option of not passing health care legislation altogether, which would be a major blow to the president's agenda.

Here's a look at where lawmakers stand on some of the major components of health care overhaul:

Insurance Industry Reforms

Democrats, and possibly even some Republicans, may be able to reach a consensus on what reforms need to be implemented in the insurance industry. Most lawmakers agree on eliminating pre-existing conditions and barring insurance companies from rejecting patients based upon those.

Obama has urged Congress members to look for such commonalities and possibly even draft a new bill, taking the most popular ideas and scrapping the rest.

The Senate and House health care bills are also similar in that they expand Medicaid coverage, create insurance exchanges in which those who do not have insurance can compare and buy coverage and cut what some lawmakers deem as inefficiencies in Medicare.

But they also vastly differ in their language on abortion, the option of a government-run insurance plan and how to fund the cost of health care overhaul.

House Democrats have also objected to the concessions that some Democratic senators, such as Ben Nelson of Nebraska, received in return for their votes.

Cadillac Tax

One of the thorniest points of the Senate bill among House Democrats is the proposed tax on high-premium insurance plans, which some blame for rising insurance costs. The Senate bill imposes an excise tax on such plans, a move that irked some liberal Democrats who say it inadvertently hurts labor unions and some teachers who opt for a lower salary in exchange for a high-end insurance plan.

Senate and House Democrats reached a deal earlier this month that would exempt union-negotiated plans from any tax until 2018. But with Democrats rethinking their health care strategy, the fate of the so-called Cadillac tax is unclear.

Scrapping the Public Option

Another significant difference between the House and Senate bills was the option of a government-run insurance plan. The Senate eliminated such a plan but some House Democrats insist they won't support a health care bill without a public option.

The few Republicans who initially supported health care overhaul, such as Maine Sen. Olympia Snowe, were strongly against public option. Republicans say such a move would stifle the private sector and make it difficult for insurance companies to compete.

To pass health care legislation, Democrats may have to scrap the public option altogether if they can get enough votes in the House to support such a move.

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