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A key Senate committee on Thursday unveiled significant new elements of health care reform legislation, including a plan for government-sponsored insurance and an employer mandate. The revised legislation is substantially cheaper than previous versions of the bill, according to the non-partisan Congressional Budget Office (CBO), with the changes bringing down the cost from previous estimates of $1 trillion to $611.4 billion over 10 years.

"We are on the cusp, on the brink of doing something here that is critical," said Sen. Chris Dodd (D-Conn.), who is leading health care reform efforts in the Senate Health, Education, Labor and Pensions Committee.

The HELP Committee will have to combine its legislation with legislation from the Senate Finance Committee, which is responsible for Medicaid provisions. The inclusion of Medicaid reforms could add to the total cost of reform significantly, but it would also help bring down the number of people in the United States left uninsured.

Analysis of the HELP bill (called the Affordable Choices Act) shows that it could bring down the number of uninsured to 34 million by 2019. If the Finance Committee expands Medicaid to anyone at 150 percent of the poverty line, as it is expected to do, it would cover an additional 20 million people. The combined result would bring coverage to 97 percent of Americans.

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Wal-Mart joined with a large union and a liberal think tank on Tuesday to endorse the idea of an employer mandate in health care reform, setting the major retailer apart from most other businesses.

"We are for shared responsibility," Wal-Mart Chief Executive Mike Duke said in a letter sent to President Obama on Tuesday. "Not every business can make the same contribution, but everyone must make some contribution."

The letter was also signed by Andrew Stern, president of the Service Employees International Union, and John Podesta, chief executive of the liberal group the Center for American Progress, who served as the head of Mr. Obama's presidential transition team.

An employer mandate - also referred to as "pay or play" - would require employers to either provide "meaningful" coverage for their workers or contribute to a public fund to cover the uninsured. There is debate over whether a mandate would help reduce the costs the government will take on to ensure universal access to health care or simply more deeply entrench the United States in an employer-based health care system.

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