WASHINGTON — Senate Majority Leader Harry Reid (D., Nev.) introduced a health care reform bill in that chamber earlier this month, setting the stage for a debate there and the eventual merging of the Senate measure with the bill passed in the House on November 7.

At presstime, however, Senate leaders were unsure whether they could muster the 60 votes needed to bring the bill to the floor for debate but indicated that more Democrats were showing a willingness to at least debate the proposal.

Senate Republicans have remained united in their opposition to the bill.

The 2,074-page measure introduced by Reid calls for spending $848 billion over 10 years. It would extend insurance to 31 million Americans who do not have coverage as well as offer subsidies to help people buy insurance and sharply expand Medicaid, the federal/state health insurance program for the poor.

The $848 billion cost is below the $1.05 trillion price tag of the health overhaul passed by the House this month.

Senate leaders stress that the cost of the bill will be more than offset by reductions in the growth of Medicare and by new taxes on such elective medical procedures as cosmetic surgeries (dubbed by some as the “botax”).

The nonpartisan Congressional Budget Office (CBO) estimates the Senate bill would ensure that 94% of the people living in the United States, excluding illegal immigrants, have insurance coverage. Only about 83% of Americans now have insurance, the CBO says.

In a boost for the Senate bill’s prospects, the CBO projects that it would reduce the federal budget deficit by $130 billion over the next decade.

Of particular interest to community pharmacies is that both the Senate and House bills contain provisions focusing on outcome-based care and would pay health care providers for such services as medication therapy management.

In addition, both bills include a public option, but in the Senate version, states would have the option of not participating. As in the House, the Senate plan would have the public plan negotiate payment rates directly with health care providers, rather than tying payments to Medicare’s low rates.

Under the Senate bill, nearly every American would be required to obtain health insurance. Those who opt not to get insurance could face a penalty of up to $750.

Reconciliation of the Senate and House bills is expected to require considerable work if Congress hopes to pass some form of health care overhaul — the centerpiece of President Barack Obama’s domestic agenda.