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The speaker of the U.S. House of Representatives, Democrat Nancy Pelosi, has presented health care legislation that she says would extend coverage to millions of Americans.

At an event on the lawn of the U.S. Capitol building, Pelosi said the bill reflects the best values of the country and addresses the greatest challenges facing the nation.

She said the legislation would cover 96 percent of all Americans and put affordable coverage in reach for millions of uninsured and underinsured people.

The bill is a merger of bills passed by three key House committees.  It would create a new health insurance exchange where small businesses and individuals can shop among insurers for the most affordable plan.

The exchange would include a controversial government-run plan that would compete with private insurers.  

Liberal Democrats wanted a plan that would base reimbursement rates for healthcare providers on those paid by Medicare, the federal health care program for elderly Americans.  But moderate Democrats from rural districts opposed that measure, saying it would hurt small hospitals.

Pelosi has settled on a plan that would allow the government to negotiate rates with doctors and hospitals.

Republicans are strongly opposed to a government-run health insurance plan, saying it would lead to a government takeover of the U.S. health care system.

The House plan also calls for a significant expansion of Medicaid, the joint federal-state health care program for the poor.  

The measure would pay for the overhaul by imposing a tax on high-income Americans and annual fees on medical device makers, along with $500 billion in cuts to Medicare.  

House Democratic leaders hope to present the bill before the full chamber next week.

In the U.S. Senate, Majority Leader Harry Reid is struggling to keep moderate Democrats from joining with opposition Republicans to block a final vote on that chamber's version of the bill.  Reid said earlier this week that the Senate bill will contain the public insurance plan.

Connecticut Senator Joseph Lieberman, an independent who sides with Democrats on most issues, announced earlier this week he would oppose a final bill if it included the government-run plan.  

The Senate bill would allow states to decline to participate in the government-run plan if they wish.