The White House has unveiled a new plan for restructuring the healthcare system in an attempt to break the deadlock over a key campaign issue for Barack Obama, the US president.
The compromise, set out on the website of the White House on Monday, seeks to provide healthcare coverage to the 31 million Americans currently uninsured without adding to the national deficit.
It is largely similar to a version of the healthcare bill passed by the US senate in December, but it includes a number of changes it is hoped will help it pass through the House of Representatives.
The proposal would require most Americans to carry health insurance coverage, with federal subsidies to help many afford the premiums.
Under the planned legislation, insurance companies would be barred from denying coverage to people with medical problems or charging them more.
It also grants the federal government greater power to block hikes in insurance premiums and envisages the creation of a new monitoring body of health industry experts.
This could tap into public anger at the recent decision Anthem Blue Cross of California, a leading insurer, to raise its premiums by as much as 39 per cent on March 1.
Estimated to cost about $1 trillion over 10 years, Obama's plan would be paid for by a mix of tax increases, new fees on health care industries and cost cutting in an existing government health care programme for the elderly.
Republican opposition has made it difficult for Obama to push through changes to the healthcare system and after the Democrats lost the crucial 60th seat on the senate negotiations on merging two bills previously passed by the two houses ended.
"This is President Barack Obama coming back and saying 'No I am not going to let this go'," Al Jazeera's Patty Culhane, reporting from Washington, said.
"Basically he has taken most of the issues from the senate, put in some of the proposals from the House, and even some very minor proposals from the Republicans and put his name on it.
"What the president is saying officially is that they want to come up with a bipartisan proposal, but the real goal here is to convince the American public that the president is right on healthcare reform."
The White House proposal comes ahead of a televised summit with congressional leaders of both parties on healthcare on Thursday.
"We view this as the opening bid for the health meeting," Dan Pfeiffer, the White House communications director, said.
"The president is coming into the meeting with an open mind," he said. "If the Republicans do, too, our hope is that we can find some areas of agreement."
But Republicans have already criticised the White House plan.
"This week's summit clearly has all the makings of a Democratic infomercial for continuing on a partisan course that relies on more backroom deals and parliamentary tricks," John Boehner, the Republican party leader in the House of Representatives, said.
"This week's summit clearly has all the makings of a Democratic infomercial for continuing on a partisan course"
Republican party leader
Mitch McConnell, the senate Republican leader, said it was "disappointing that Democrats in Washington either aren't listening, or are completely ignoring what Americans across the country have been saying".
The White House said Obama's proposal would make it easier to bypass the Republicans if necessary, pushing the legislation through in a process requiring a simple majority in the 100-member senate rather than the 60 votes needed to clear procedural hurdles.
Pfeiffer said no decision has been made on whether to follow that route, but the president believed "people deserve an up-or-down vote on health reform".
"This package is designed to provide us the flexibility to achieve that if the Republican Party decides to filibuster," he said, referring to a procedural tactic used to block legislation.
The US is the world's only industrialised democracy that does not provide healthcare coverage to all of its citizens.
It spends more than double Britain, France and Germany on healthcare, but lags behind other countries in life expectancy and infant mortality, according to the Organisation for Economic Co-operation and Development (OECD).