By Laura Litvan

June 12 (Bloomberg) -- Health-care overhaul legislation being drafted by House Democrats will include $600 billion in tax increases and $400 billion in cuts to Medicare and Medicaid, Ways and Means Committee Chairman Charles Rangel said.

Democrats will work on the bill’s details next week as they struggle through “what kind of heartburn” it will cause to agree on how to pay for revamping the health-care system, Rangel, a New York Democrat, said today. The measure’s cost is reaching well beyond the $634 billion President Barack Obama proposed in his budget request to Congress as a 10-year down payment for the policy changes.

Asked whether the cost of a health-care overhaul would be more than $1 trillion over a decade, Rangel said, “the answer is yes.” Some Senate Republicans, including Senator Orrin Hatch of Utah, say the costs will likely exceed $1.5 trillion.

House Democrats plan to release their legislation next week. Obama is working with Congress to get legislation to his desk by October.

Democrats in the House and Senate are crafting legislation that would require all Americans to have health insurance, prohibit insurers from refusing to cover pre-existing conditions and place other restrictions on the industry.

Online Exchanges

The legislation would establish online exchanges for individuals to purchase insurance and would require employers to provide health benefits to workers or pay a penalty. Some Democrats also are backing creation of a government-run program to expand coverage to the uninsured. The issue is the subject of bipartisan negotiations with Republican who oppose the so-called public option.

Rangel said Democrats are still considering options for tax increases that might be in the bill, including a possible end to the income tax exclusion for employer-paid health benefits.

Senate Finance Committee Chairman Max Baucus, a Montana Democrat, is considering a proposal to apply income taxes to health-care plans if they are significantly more expensive than the basic health plan for federal employees -- $13,000 for a family of four.

Rangel said House Democrats want to avoid the deeper cuts to projected spending under Medicare and Medicaid that Obama has been putting forth. House Democrats want to achieve cost-savings by cuts in payments to private insurance plans under Medicare.

Covering the Costs

Obama has pledged that health-care changes won’t add to the deficit. To accomplish that, he’s proposed getting about $600 billion by reducing tax deductions available to the wealthy, and by trimming Medicare payments to insurance companies.

That won’t be enough to cover the overhaul costs. Obama said this week he plans in the coming days to disclose more proposals for raising “additional sources of revenue.” In a letter last week to Senate Democrats drafting legislation he said he will be proposing between $200 billion and $300 billion in further Medicare and Medicaid cuts.

Obama plans to give a speech Monday in Chicago to the American Medical Association as part of his campaign to build up support for what could be the biggest changes to healthcare policy since Medicare was established in 1965.

Rangel said that while House Democrats will likely release more details about health policy changes in their legislation next week, the package of offsetting tax increases and spending cuts likely will come later. Democrats, he said, want to put forth the more-positive aspects of an overhaul first. Rangel also wants to let lawmakers have time to study and weigh in on proposed offsets.

“We have a problem in not wanting to attract enough negative attention to the bill in terms of the pay-fors,” he said. “Let them get a good feel for the coverage.”

To contact the reporter on this story: Laura Litvan in Washington at llitvan@bloomberg.net