How much health care for $1 trillion?

WASHINGTON -- The White House and Democratic congressional leaders, scrambling to pass health care bills within the next few weeks, are trying to keep the cost of legislation that expands coverage and controls costs to about $1 trillion over 10 years — a benchmark for moderates in both parties.

So what can you buy for $1 trillion?

Although the eye-popping price tag would help boost insurance coverage to 95% or more of the public, it's not enough to do everything advocates initially want.

The proposals being shaped in Congress — including the $1.042 trillion bill unveiled by House Democratic leaders Tuesday — offer subsidies to fewer moderate-income families than originally intended, bar most workers from choosing to leave their employer-provided plans and likely drive up Medicaid costs for states.

At the end of a decade, 15 million to 20 million would remain uninsured, according to assessments by the non-partisan Congressional Budget Office— a sticking point for critics who argue the whole enterprise doesn't get enough bang for the buck.

Nearly 50 million now lack coverage.

"One of the major concerns that Americans have about health care reform is the price tag," Senate GOP leader Mitch McConnell said Monday on the Senate floor. "Every proposal we've seen would cost a fortune by any standard."

President Obama defends the overhaul as a critical investment to fix a dysfunctional system he says is hobbling many families and threatening the nation's fiscal future.

"This is no longer a problem we can wait to fix," he said Monday at the White House. "Inaction is not an option."

Here's the squeeze for policymakers: Allow the price tag to grow much past $1 trillion and you risk losing the support of fiscal hawks in Congress and voters alarmed by the costs of stimulus spending and corporate bailouts.

Because the president has promised the health care plan won't increase the deficit, a bigger bottom line means more taxes would have to be raised, or spending cut, to offset it.

On the other hand, cut back too far and you imperil the legislation's fundamental goal of giving everyone access to health insurance they can afford. That could undermine support from the strongest advocates for change.

The battles roiling the negotiations — and threatening Obama's call for votes in the House and Senate before their August recess — center on which taxes should be raised to finance the bill and whether the plan should include a public, government-run option to compete with private insurers.

There is much less debate about how the money should be spent, though the details differ.