Senator Kennedy is signaling that he will push for universal health care as the new chairman of the powerful Senate Health, Education, Labor, and Pensions Committee.

But judging by an initial hearing on the topic yesterday, getting a bill through Congress won't be easy, even with a new Democratic majority.

Despite a consensus that costs have risen dramatically for both consumers and employers, a panel of 10 leaders representing labor, business, and health care advocates offered differing solutions to what many have deemed a crisis. An estimated 46.6 million Americans do not have health insurance.

Some urged the federal government to follow the lead of Mr. Kennedy's home state, Massachusetts, and California in advancing universal health care plans, while others pushed for more aid to small businesses and changes to medical liability laws.

Mr. Kennedy is seeking to take advantage of rising momentum for expanded health care coverage, particularly among Republicans. In Massachusetts, Governor Romney, a Republican who recently left office, signed off on the nation's first law mandating that all residents have health insurance. And in California, another Republican, Governor Schwarzenegger, announced a similarly sweeping proposal this week.

"The American people are crying for some focus, and some attention, and some relief," Mr. Kennedy said. Under a plan he is proposing, Medicare would be expanded to all Americans by 2010. Currently, only people age 65 and over are eligible.

He is likely to face resistance from Republicans, particularly Senator Coburn of Oklahoma, who railed against creating what he said would be a "Soviet-style" health care system that would stifle innovation and free market forces.

The committee's former chairman, Senator Enzi, a Republican of Wyoming, staked out a moderate stance, saying his priority was to pass legislation that would lessen costs for small businesses. But he also said lawmakers need to find a "third way" to solve the problem that would benefit the most people.

Senator Clinton, a member of the committee who spearheaded the last, failed attempt to enact universal health care as first lady in 1994, had been scheduled to attend the hearing but did not appear.