WASHINGTON - Partisan anger flared Wednesday as senators began the public drafting of legislation to remake the health care system. By day's end, lawmakers had settled in for a long, hard slog that may not fit with President Obama's goal of signing a bill within four months.
"This is about as historic as it gets for all of us," Senator Christopher J. Dodd, Democrat of Connecticut, said as he opened a day-long session of the Committee on Health, Education, Labor and Pensions.
Another Senate committee, dogged by questions about the cost and complexity of the legislation, postponed its session, scheduled for next Tuesday, until after July 4. Democrats said they needed the delay by the Finance Committee to work on reducing the cost of the bill, intended to provide insurance to millions of people with no coverage.
Mr. Dodd presided over the health committee in the absence of its chairman, Senator Edward M. Kennedy, Democrat of Massachusetts, who is battling brain cancer.
Senator Dodd said he hoped the committee would finish its work and approve a bill by June 26. But he told his colleagues, "My intent is not to jam anything, force anything on people."
Within 15 minutes after the session started Wednesday, Republicans began to protest. Senator John McCain, Republican of Arizona, said it was ridiculous to take up such a large bill without a complete cost estimate.
He and other Republicans demanded more details of the legislation and more time to digest it.
Senator Orrin G. Hatch, Republican of Utah, said Democrats had made some grave errors.
"You advance legislation by focusing on areas of compromise, not strife," Mr. Hatch said. "Now unfortunately we are beginning a partisan exercise on perhaps the most important legislation of our lives. I am personally somewhat, well, actually, very disappointed, because I wanted a thoughtful bipartisan compromise that could have become a lasting legacy for my dear friend, Ted Kennedy."
President Obama is pressing Congress to speed work on the measures, which embody his top legislative priorities, reining in health costs and covering the uninsured. Mr. Obama wants to sign a bill by October, but senators of both parties said it was more important to get the policy right.
The bill before the health committee, drafted by Mr. Kennedy and Mr. Dodd, would require people to carry insurance, with federal subsidies for those who could not afford it, and would require most employers to help pay for coverage of their employees.
The bill would impose stringent new federal regulations on insurers and make far-reaching changes in the health care industry, which accounts for one-sixth of the economy.
Senator Michael B. Enzi of Wyoming, the senior Republican on the health committee, said the panel was moving "too fast to do an adequate job."
Mr. Dodd said, "I appreciate the frustrations being expressed," but plowed ahead. "We have a moral imperative to act," he said.
Mr. Enzi said the bill had been drafted "with no input from Republicans," and he asserted, "The bill costs too much, covers too few and will cause 10 million Americans to lose the insurance they currently enjoy."
A preliminary estimate by the Congressional Budget Office said the bill would cost $1 trillion over 10 years but leave many uninsured. The office said an early version of the Finance Committee bill would cost $1.6 trillion.
Senate Democrats conceded that the unexpectedly high estimates had forced them to regroup, and acknowledged that they were still divided over how to pay for the legislation.
But Robert Gibbs, the White House press secretary, said he did not see any setback. "The president, I think, has laid out a timeline to get this done this year, and thinks that we're on course to do it," he said.
Senator Judd Gregg, Republican of New Hampshire, said he was on the committee when it considered President Bill Clinton's plan for universal coverage in 1993-4. "It's sort of déjà vu all over again for me," he said.
Mr. Gregg said the Kennedy bill looked as if it had been written by Rube Goldberg, Karl Marx and Ira C. Magaziner, Mr. Clinton's health care coordinator. Mr. Gregg criticized a provision that would establish a Medical Advisory Council to recommend minimum benefits for insurance policies.
"This is the elite of the elite deciding how everybody else will get health care," Mr. Gregg said.
Senator Barbara A. Mikulski, Democrat of Maryland, fired back. "Our current system is a combination of Adam Smith, Darth Vader and the ‘Invasion of the Body Snatchers,' " she said. "So I like our plan the better."
Ms. Mikulski said the Republicans' complaints reminded her of objections to the creation of Medicare in 1965.
"The arguments against Medicare are the same arguments we are hearing now - government control, centralized bureaucracy," she said. But, she noted, Medicare is hugely popular.
Senator Bernard Sanders, independent of Vermont, said, "The fight for comprehensive, universal health care is the civil rights struggle of the moment."
And he issued this warning: "To all the lobbyists, all the big-money interests who give us campaign contributions and lobby so successfully with those 30-second ads on TV, I say your time has come and gone."
Mr. Obama and many other Democrats have called for a new public health insurance plan, to compete with private insurers.
Senator Sherrod Brown, Democrat of Ohio, said such competition would "hold down premiums, discipline the market and keep the private insurances industry on its toes."
But Mr. Hatch said, "Medicare and Medicaid are already on a path to fiscal insolvency; creating a brand-new government program makes no sense."