Q+A: Next steps in U.S. Congress on healthcare

(Reuters) - Congress returns on Tuesday from a month long recess to resume work on a landmark overhaul of the $2.5 trillion U.S. healthcare system that President Barack Obama has made his top domestic policy initiative.

To jump-start work on the bill, Obama plans to address Congress on Wednesday to lay out specifics of what he wants in a healthcare bill.

Three House of Representatives committees and one Senate committee have completed their work on a healthcare bill that Republicans rejected. But the focus is on the Senate Finance Committee where Democrats are trying to craft a compromise that will draw at least some Republican support. The bills seek to make major changes to insurance industry rules, expand coverage to nearly 46 million uninsured, and hold down costs, all without an increase in the federal deficit.

With the death of Senator Edward Kennedy on August 25, Democrats lost a leading champion of healthcare reform who was regarded as one of the Senate's foremost dealmakers, able to bring conservatives and liberals together on difficult issues.

WHAT'S NEXT FOR HEALTHCARE OVERHAUL IN CONGRESS?

* Senate Finance Committee Chairman Max Baucus, a Democrat, is facing a September 15 deadline for a bipartisan deal that would include sweeping insurance market reforms and ways to cover the cost of helping the uninsured and small businesses afford medical coverage. The nearly $1 trillion, 10-year price tag will be covered by proposed savings in Medicare and through some tax increases that panel negotiators are still working out. The finance committee negotiators say they will meet again on Tuesday to "take stock."

* House leaders have said they want to bring their health overhaul bill to a vote in September. To do this, they must meld changes in the legislation approved by three committees -- Ways and Means, Energy and Commerce, and Education and Labor. No Republicans voted to approve any of the versions.

* The Senate Health committee, which Kennedy led, approved its version of the bill with no Republican votes. The bill sets up a government-run insurance system to compete with private insurers, requires many employers to provide insurance for their workers or face penalties, and requires individuals to buy their own insurance, with government subsidy if necessary.

CAN THE BILL PASS?

Having missed the initial early August deadline, Democratic leaders hope to pass versions of the legislation in September. The Senate would act once the Finance Committee produces its bill.

While Democrats control a majority of seats in both chambers, this does not guarantee they will vote in concert with their leadership.

Unless Massachusetts lawmakers change state law to allow Governor Deval Patrick to pick a successor, Kennedy's Senate seat could remain vacant until a special election is held in January 2010 at the earliest.

That leaves Democrats in control of 59 Senate seats, one short of the 60 needed to overcome Republican procedural hurdles in the 100-seat chamber. Kennedy missed most votes over the past year due to illness, and another elderly Democrat, Robert Byrd, also missed many votes due to poor health.

Once each chamber has passed its version of the overhaul, a small group of lawmakers would meet to iron out differences between the versions that have passed the House and Senate. Then each chamber will vote on the compromise legislation.

If it passes, it would be sent to the White House for the president's signature into law. The president and congressional leaders have said they are aiming for enactment by the end of this year.

(Writing by Jackie Frank and Andy Sullivan in Washington, editing by Donna Smith and Stacey Joyce)