A group of Senate Democrats, led by Sen. Ted Kennedy (D-Mass.), has kicked off debate on the future of health care reform in America with legislation that fails to address one of the more controversial aspects of possible change: a public health insurance option.

Edward M. Kennedy

The 615-page Affordable Health Choices Act was introduced June 9 by Kennedy and the Democratic members and staff of the Senate Committee on Health, Education, Labor and Pensions. The basic premise of the bill, according to its sponsors, is reducing health care costs, making coverage more affordable for those without it, and permitting Americans to more easily choose between their existing coverage or other options.

It also mandates that all Americans purchase insurance if they can afford it, with waivers available under certain circumstances. The bill prohibits insurance companies from refusing coverage of pre-existing conditions and establishes an online exchange program for the uninsured and small business employees to shop for more affordable care. The proposed bill also addresses long-term care provisions to help the elderly and individuals with disabilities live at home and function independently.

The plan does not specifically address a public, government-run insurance program, nor does it tackle the issue of employer mandates.  Those topics, Democratic leaders said, will be part of an ongoing discussion with their Republican colleagues.

“Our goal is to strengthen what works and fix what doesn’t,” Kennedy, the chairman of the HELP Committee, said in a statement. “Much work remains, and the coming days and weeks won’t be easy. But we have a unique opportunity to give the American people, at long last, the health care they need and deserve.”

The bill features five major elements, coinciding with characteristics President Barack Obama has said he expects to see of any legislation that would bear his signature: choice, cost reduction, prevention, health system modernization, and long-term care and services.

Regarding choice, with no mention of a public plan, the bill says individuals can either keep the coverage they have or access “new, more affordable options” that will likely be later defined.

Sen. Chris Dodd (D-Conn.), vice chairman of the HELP Committee who has steered the effort while Kennedy battles brain cancer, said one such choice could include “a public option for health care,” but that discussions on comprehensive reform have just begun.

“This does not symbolize the end of the game or even the end of the first quarter,” Dodd said in a statement. “We still have a lot of work ahead of us and are looking forward to working with our colleagues on a bipartisan basis to resolve the remaining issues and move forward with a mark-up of this legislation next week.”

In remarks made following the release of the proposed legislation, Sen. Republican Leader Mitch McConnell (R-Ky.) spoke in opposition of any public plan for health insurance.

“Americans don’t want a government-run health plan,” he said in a statement. “And they certainly don’t want a government board to dictate their health care coverage. They want real reform that solves the problems they face without sacrificing the benefits they enjoy.”

The HELP Committee is set to discuss the bill June 10 and 11, including a public hearing, to discuss outstanding options such as the public option and employer mandate, according to lawmakers. Mark-ups on the bill are scheduled to begin June 16.