Senate Finance Committee Chairman Max Baucus, a Democrat who is helping write healthcare legislation, in a speech to the Center for American Progress think tank said, "An individual obligation to get health coverage is essential."

Baucus added that this would help the market function better and reduce premium costs for everyone. He said that the cost of medical care for people with no insurance is being shifted to those with insurance, forcing costs higher.

The Health Reform Dialogue, an influential coalition of hospital, nurses, doctors, business, consumer and insurance groups said on Friday its members had agreed on a set of reform ideas including a mandate that all Americans obtain health insurance.

The coalition released a report yesterday endorsing a set of policy s that could cut in half the number of uninsured Americans calls for creating an "individual mandate" that would require every American to have some type of health coverage. Anyone who cannot afford insurance would be eligible for subsidies or expanded government programs such as Medicaid.

"We should seek to ensure coverage for all," the group which included the American Medical Association, the National Federation of Independent Business, two hospital groups, AARP, the liberal consumer advocacy group Families USA, the Business Roundtable and the U. S. Chamber of Commerce concluded.

Karen Davis, president of the Commonwealth Fund, a nonprofit private health-care foundation that was not involved in the effort said, "We're narrowing the range of disagreement." She noted that the Health Reform Dialogue and influential lawmakers are electing to build on the existing employer-based insurance arrangements rather than a European-style single-payer system.

Under the current system it is not mandatory for Americans to have health insurance and many do not with as many as 46 million people without public or private coverage in 2007 according to government sources. As a result President Barack Obama has said that an overhaul of the healthcare system is one of his priorities.

At a Senate hearing this week, insurance industry representatives said that they needed a mandate to keep premiums affordable if they were going to end the current practice of charging higher premiums for the sick and excluding pre-existing medical conditions from coverage.

It seems likely with Baucus and the coalition support that the healthcare legislation will go with the insurance mandate despite many fearing people not being able to afford it. Obama said on Thursday he was still "skeptical" about a mandate because people who lack health insurance do so because they cannot afford it, not because they do not want it.

Two unions, the American Federation of State, County and Municipal Employees and the Service Employees International Union, declined to sign yesterday's document, partly because of their support for a "public plan option."

House Speaker Nancy Pelosi (D-Calif.) has advocated including the public option in a bill, while Senate Finance Committee Chairman Max Baucus (D-Mont.) has said that it should be "on the table" for consideration.