Sen. Edward Kennedy says he wants to use state health coverage expansion programs as a model for federal health insurance reform efforts.

Kennedy, D-Mass., now has succeeded Sen. Michael Enzi, R-Wyo., as chairman of the Senate Health, Education, Labor and Pensions Committee.

The federal government should follow the lead of Kennedy’s state, Massachusetts, and require everyone to have health insurance, Kennedy said today at a committee hearing.

“The stakes couldn’t be higher.” Kennedy said. “Too many trends in health care are going in the wrong direction. Insurance coverage is down. Costs are up. And America is heading to the bottom of the league of major nations in important measures of the quality of care.”

Enzi, who is replacing Kennedy as the most senior minority party member on the committee, said he hopes to find bipartisan agreement with Kennedy and others on efforts to reduce health care costs, improve health care quality and expand access to care.

Enzi has been a major supporter of association health plans. He said he sees room for a compromise that would combine an AHP program with health insurance purchasing tax incentives for small businesses, low-wage businesses and employees of those businesses.

“I am prepared to seriously explore such an approach, provided it is fiscally responsible, operationally sound, and fully paid for,” Enzi said.

Karen Davis, president of the Commonwealth Fund, New York, testified at the hearing that the United States now spends at least twice as much per person on health care as other major industrialized countries but is the only major industrialized country that fails to provide universal health coverage.

“One-third of families now report medical bill or medical debt problems,” Davis said.

Another witness, Pat Vredevoogd Combs, president of the National Association of Realtors, Chicago, pointed out that the percentage of NAR members without health coverage has doubled since 1996.

“As we sit here, 28% of the nation’s 1.3 million Realtors do not have health insurance,” Combs said.