Be strategic. Be willing to compromise. Make your voices heard. Just get a health care reform bill past the U.S. Senate.

That was the message of Democratic U.S. Reps. Carol Shea-Porter and Paul Hodes when they spoke yesterday to a crowd of about 50 legislators, health care advocates and health care professionals at an event sponsored by New Hampshire Voices for Health and AARP at the Holiday Inn in Concord.

"It's important in dealing with the Senate not to be too doctrinaire," Hodes said. "It's a different body than the house."

Hodes said as important as it is for senators to hear about support for a public option, a government-run health insurance plan, the bigger issue is simply getting a bill passed that meets the major goals of reform. Then, the details can be ironed out in a conference committee before a final vote.

"It's crucial to get a bill out of the Senate to go to conference," he said.

Both Hodes and Shea-Porter were enthusiastic supporters of the bill that passed the House. They also prefer the House version of the bill to the Senate version. Among the biggest bones of contention is the way the bill would pay for expanded health care coverage. The House version would tax individuals making more than $500,000, while the Senate version would tax the most expensive - or "Cadillac"- health insurance plans.

Shea-Porter said she worries that many New Hampshire residents have insurance plans that fall into that range, because of the state's high insurance premiums relative to the rest of the country. Someone who bought an expensive plan because of a disabled child, she said, might be considered to have a "Cadillac" plan.

Hodes added that taxing the most expensive plans could hurt union workers who may have given up wage increases at the bargaining table in order to get better health insurance plans.

In New Hampshire, the Senate tax could affect health plans that cost more than $9,600 per person, or $25,200 per family. John Rother, executive vice president of policy and strategy for AARP, said the top 10 percent of health care plans would be affected.

But despite the differences between the House and Senate plans, the representatives remained open regarding what form of the bill they would ultimately be willing to vote for. Shea-Porter said her red line was "I'd never deliver $47 million customers to insurance companies without helping people pay for it." She was ambiguous on whether she would refuse to vote for a bill without a public option, saying only that she remained "very strongly committed to the public option."

Asked whether he had any red lines affecting his support, Hodes responded, "I don't draw lines in the sand." He said he would judge a final bill on whether it lowered costs, delivered higher quality care, strengthened Medicare, did not raise taxes on working-class and middle-class families and "put the American people back in control of their health care."

One major concern among state officials has been the financial impact of the bill on state budgets, because of provisions such as the expansion of Medicaid. Gov. John Lynch, through spokesman Colin Manning, yesterday reiterated his concerns for the state. Manning said Lynch supports the goals of reform, particularly the increased access to health care.

"The governor remains concerned about possible cost shifting to the state," Manning said. "How health care reform will be paid for is obviously still a question."

Shea-Porter responded to Lynch's concerns that without reform, "costs will shoot up anyway." With reform, she said, people who arrive at the hospital will have insurance, saving the state money.

The bill continues to face fierce opposition from Republicans, nationally and locally. State Republican Party spokesman Ryan Williams said, "(Hodes's and Shea-Porter's) budget-busting health care agenda is a prescription for new job-killing taxes, devastating Medicare cuts and record deficits."

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