WASHINGTON -- Insurance companies aren't playing nice any more.

Their dire message that healthcare legislation will drive up premiums for people who already have coverage comes as a warning shot at a crucial point in the debate -- and threatens President Barack Obama's top domestic priority.

The issue broils as the Senate Finance Committee is expected to vote on a plan Tuesday that would require nearly all Americans to get coverage. It would also bar insurers from denying people policies because of preexisting conditions and imposing excise taxes on insurers' most expensive plans.

The committee is the last of five congressional panels considering the measure. Once Finance is done, Senate leaders and the White House will merge the proposal with another one written by the Senate Health Committee over the summer, creating one bill likely to be considered by lawmakers later this month.

Three House of Representatives committees also have finished writing bills, and those, too, will merge into one. Final House action also is expected in late October.

Democrats and their allies scrambled on Monday to knock down a new industry-funded study forecasting that Senate legislation, over time, will add thousands of dollars to a typical policy's cost.

``Distorted and flawed,'' said White House spokeswoman Linda Douglass. ``Fundamentally dishonest,'' said AARP's senior policy strategist, John Rother. ``A hatchet job,'' said a spokesman for Senate Finance Committee chairman Max Baucus, D-Mont.

But the health insurance industry's top lobbyist in Washington stood her ground. In a call with reporters, Karen Ignagni, president of America's Health Insurance Plans, pointedly refused to rule out attack ads on TV featuring the study, though she said she believed the industry's concerns could be amicably addressed.

At the heart of the industry's complaint is a decision by lawmakers to weaken the requirement that millions more Americans get coverage. Because the legislation would ban insurance companies from denying coverage on account of poor health, many people will wait to sign up until they get sick, the industry says. And that will drive up costs for everybody else.

Insurers are now raising possibilities such as higher premiums for people who postpone getting coverage, or waiting periods for those who ignore a proposed government requirement to get insurance and later have a change of heart.

The drama threatened to overshadow Tuesday's scheduled vote by the Senate Finance Committee on a 10-year, $829 billion plan that Baucus has touted as the sensible solution to America's problems of high medical costs and too many uninsured.

The Baucus bill is still expected to win Finance Committee approval. The insurance industry is trying to influence what happens beyond the vote, when legislation goes to the floor of the House and Senate, and, if passed, to a conference committee that would reconcile differences in the bills.

It's at that final stage where many expect the real deal will be cut.

Obama and a parade of GOP statesmen have urged bipartisan cooperation in recent days, but even last week's report from the nonpartisan Congressional Budget Office that the $829 billion plan will cut $81 billion from the federal deficit over 10 years didn't move most congressional Republicans. The report ``masks who pays the bills. This package includes hundreds of billions of dollars in new taxes and fees,'' said Sen. Charles Grassley, R-Iowa, the committee's top Republican.

Republicans' alternatives to Democrats' plans usually include strengthening employer-provided insurance and offering tax benefits for those who buy coverage on their own. Democratic-controlled committees have routinely rejected Republican plans.

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