Kennedy's home state is the first to require everyone to have health insurance, just as drivers must have automobile coverage.
Kennedy has his own version of what universal health coverage would look like. He wants to extend Medicare to all. In his first hearing Wednesday as chairman of the Senate Health, Education, Labor and Pensions Committee, the Massachusetts Democrat called on 10 witnesses from all over the country to talk about how to make health care more affordable.
"Insurance coverage is down. Costs are up. And America is heading to the bottom of the league of major nations in important measures of the quality of care," Kennedy said.
Kennedy emphasized how Democratic legislators in his home state worked last year with Republican Gov. Mitt Romney in crafting universal coverage there. He wants the same spirit of compromise to take hold in Congress.
However, the hearing also showed that finding agreement won't be easy. While all the witnesses agreed that health care is becoming less affordable every year, they often had very different solutions.
For example, the Business Roundtable renewed its calls to change medical liability laws and for the federal government to give consumers more information about the cost and quality of the care they get, two priorities often cited by the Bush administration.
"High health care costs are affecting job creation, and high health care costs are hurting our ability to compete in global markets," said Larry Burton, the roundtable's executive director.
But Andrew Stern, international president of the Service Employees International Union, called for much more dramatic change. He told lawmakers that it's time to recognize that employer-based coverage "is dead." The statement infers a much more active role for the federal government in funding health care.
Karen Davis of the Commonwealth Fund, which conducts health research, told lawmakers to look at Denmark as a model for the United States. She said that nation's government pays doctors a capped rate for each of their patients, plus additional amounts when they perform a service. Each doctor handles about 1,500 patients, and they can handle walk-ins and same-day appointments. And Denmark residents love their health care system, she said.
Most of the witnesses agreed on two points:
First, Congress should expand funding for a health insurance program that now provides health insurance to about 5 million children. The children live in families that make too much to qualify for Medicaid, but not enough to afford the monthly health insurance premiums offered through the private sector.
Second, Congress should not get in the way of states trying to grow the number of residents who have health insurance.
The state of Massachusetts employs a combination of subsidies and penalties to make insurance more affordable and to force people to buy it. The law requires employers with 11 or more full-time employees to offer health coverage or be subject to a $295 fee for each employee, as well as face being billed for services their uninsured employees get.
California Gov. Arnold Schwarzenegger this week proposed a plan that would extend health care to 6.5 million uninsured Californians. Under the proposal, all Californians must have insurance, although the poorest would be subsidized.
Some of the committee's Republicans would like the committee to renew its attention to help for small businesses. They support a plan that would let businesses buy insurance through regional or national trade associations. The insurance would be free of many state mandates. That could make it a cheaper alternative, but would also provide scaled-back coverage in some instances.
"My primary interest is to provide health insurance reform for small businesses and working families, and I believe that 1 million more people will be insured if we enacted the (small business health plans)," said Sen. Mike Enzi, R-Wyo.
Also, Wednesday, the Children's Defense Fund called on Congress to provide health insurance for all children in the United States. About nine million live in families without insurance. The organization said all children in Medicaid or the State Children's Health Insurance Program should be automatically enrolled in one program that provides all medically necessary care.
Children in families with incomes over 300 percent of poverty could also pay premiums that would allow them to participate.
"A child's chance to survive and thrive should not depend on the lottery of geography," the organization said.