Q+A: Where does healthcare reform stand in Congress?

By Donna Smith

WASHINGTON (Reuters) - President Barack Obama wants the U.S. Congress to send him a sweeping overhaul of the $2.5 trillion U.S. health care system by October to help put the struggling U.S. economy on a solid path of growth.

Below are some questions and answers about the state of play for the legislation in the Senate and the House of Representatives, where Democratic leaders, who control the agenda, believe they are on track to meet Obama's goal.

WHAT IS THE STATE OF PLAY IN THE SENATE?

* Senate Finance Committee Chairman Max Baucus is pushing for strong bipartisan support to help ensure final passage of legislation that can maintain public backing as changes are implemented throughout the healthcare system.

* The Senate Health, Education, Labor and Pensions Committee also drafted legislation that it unveiled on Tuesday. Senator Christopher Dodd has taken a lead role in managing the bill in that committee in the absence of the chairman, Edward Kennedy, who is battling brain cancer. Dodd and Kennedy have both expressed a desire for a bipartisan bill.

* There is broad agreement on the need to promote prevention and to reward hospitals and doctors for providing better quality of care instead of the quantity of services. Those changes would be driven through the Medicare program for the elderly.

* There is also broad agreement for maintaining employer-provided healthcare. For those without employer-provided insurance, the proposed legislation would set up an insurance exchange -- a clearinghouse -- in which individuals and small businesses could shop for medical plans and compare benefits and prices.

* A major sticking point is whether a new government-run insurance plan should compete with private insurers in the exchange. Republicans say they cannot support legislation that includes a new public plan, arguing it would drive private insurers out of business and lead to a government-run healthcare system. Many Democrats insist on a new public plan, arguing it can be set up to compete fairly with private insurers and that it is the only way to keep premiums low.