Without the universal or near-universal coverage that Democrats support, just telling insurance companies that they must accept everyone becomes another way of distributing health care by ability to pay.

In particular, the mainstream group's provisions would allow near-universal coverage of children.

A3 National A14-19 The health care system in Hawaii is the only one in the nation that provides near-universal coverage.

A mandate is critical, however, to helping the state achieve near-universal coverage, Mr. Ginsburg said.

Massachusetts, which has achieved near-universal coverage this way, had its exchange working in six months.

And it would lead to near-universal coverage.

Oregon was given a waiver to shape its own program because it promised to provide near-universal coverage for the poor, something only a handful of states have tried to do.

Both channels will continue to air Nickelodeon programs, despite the launch of Nickelodeon Canada, since those channels have near-universal coverage across Canada on basic analogue cable, whereas Nickelodeon is limited to digital distribution.

The Congressional Budget Office estimates that insurance reform without mandates can achieve near-universal coverage.

Mr. Bradley advocated another route to near-universal coverage, saying that if insurance changes and subsidies did not produce 96 percent coverage in five years, people should be required to insure themselves.