Rep. Anthony Weiner, D-N.Y., called it "an unvarnished, complete victory for people like me who have been arguing for a single-payer system."
Majority Leader Harry Reid, D-Nev., described the agreement as a significant step in the struggle to round up the votes needed to pass the broader overhaul legislation. The House has already passed its version, and Democrats are driving for a Senate vote before Christmas.
That would leave only a final compromise between the houses before legislation could go to Obama for his signature.
Joe Lieberman, one of the last holdouts based on the subject of a public option, looks like he could go for the bill now.
It adds more regulation on industry:
Insurance companies would be required to spend 90 percent of their income from premiums on providing benefits.
Many officials declined to discuss details, heeding an admonition that if they did, the Congressional Budget office would feel compelled to release preliminary cost estimates that lawmakers prefer to receive secretly.
Sen. Olympia Snowe, R-Maine, told reporters premiums would total about $7,600 annually until federal subsidies became available in 2014. That translated into more than $600 a month, far higher than the $96.40 paid by beneficiaries age 65 and up.
The Mayo Clinic Health Policy Center sent notices to lawmakers criticizing the emerging plan. Expanding Medicare to individuals 55 to 64 years old, it said, "would ultimately hurt patients by accelerating the financial ruin of hospitals and doctors across the country."
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