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House Education and Labor Committee Chairman George Miller says Congress will pass health overhaul legislation this year even though Democratic leaders are increasingly focusing on the economy and jobs.

The tax agency would be responsible for checking whether individuals get required insurance, distributing billions of dollars in subsidies and collecting new taxes and penalties.

Some lawmakers are considering a scaled-back health bill in place of the comprehensive legislation now stalled in Congress. But there's debate about whether popular insurance reforms, such as requiring insurers to accept applicants with health problems, can be successful without an unpopular individual insurance mandate.

Democrats, who no longer have a filibuster-proof majority in the Senate, are weighing the use of a budget rule called reconciliation to pass at least part of the long-debated health overhaul package with a simple majority.

The Democrats' health overhaul legislation is in trouble for many reasons, including key policy decisions that led many Americans to wonder whether they would wind up worse off.

The final decision on who should supervise health exchanges is critical to health plan choices available to consumers, the cost of the premiums and the clout regulators may have.

Hospitals, doctors and insurers are opposed to allowing people under 65 to join Medicare – an idea being considered by Senate negotiators struggling to put together the 60 votes needed to pass a health bill.

Successful demonstration projects are often derailed by objections from hospitals, doctors and other providers — or caught up in political fights as control of Congress shifted.

Dr. Richard "Buz" Cooper doesn't mince words as he challenges highly-respected research that asserts hospitals and doctors waste up to $700 billion a year on unnecessary testing and treatment. He says the Dartmouth Atlas of Health Care doesn't adequately account for the health care needs of poor people.

June O'Neill says the national debt would grow and the elderly on Medicare would suffer, but her successors at the Congressional Budget Office disagree.