As Congress works to overhaul the nation's $2.5 trillion health care system, health insurers are trying to stave off a government health plan that would ultimately insure all Americans, and at the same time create their largest competitor.

This effort turned into something of a skirmish on Tuesday as the head of a leading private insurance group told senators that as long as all Americans are required to get insurance coverage, women should no longer be charged more than men in the individual market. Health care costs for women tend to be higher during childbearing years, say analysts.

"We don't believe gender should be a subject of rating," Karen Ignagni, president of America's Health Insurance Plans, said as the Senate Finance Committee convened a roundtable on covering the uninsured, reports the Associated Press. "We are ready to be accountable to those rules," she said.

In response to the push for a public plan, health insurers have offered to submit to a series of restrictions they contend would add up to a fairer marketplace, and cut into the ranks of the 50 million uninsured.

For some Democrats, however, support for a public plan is a compromise because their real preference is for a "single-payer" plan —an entirely government-run program like some European countries have.

Tuesday's meeting began with capitol police ejecting eight protesters who interrupted senators by shouting in favor of a single-payer plan. Finance Committee Chairman Max Baucus, D-Mont., has said that's not on the table.

Last year, insurers offered to end the practice of denying coverage to certain individuals with illnesses, and earlier this year they went still farther by offering to stop charging sick people more.

"The bottom line is you need somebody who is not a private insurance company to be in the mix, and there are many of us who feel very strongly about that," Sen. Charles Schumer, D-N.Y., told Ignagni and a panel of witnesses from the insurance industry, labor unions, business groups and others. "It would be giving all of you in the insurance industry an unfair advantage not to have a public plan."

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