Enacting comprehensive health reform is not one of the top priorities of Senate Finance Committee chairman Max Baucus. It is—plain and simple—the top priority.

And so far, Baucus says, so good.

During a breakfast conversation with health care reporters at the Kaiser Family Foundation on Tuesday morning, the Montana Democrat assessed the prospects for reform.

"There has never been a better moment," he said. "The stars are all aligned."

Baucus's health reform white paper and President Obama's budget both left many of the details of health reform to the legislative process, but together they created a framework for an ambitious initiative to expand coverage, bring down costs, and improve quality.

As we know, Baucus and Senate HELP committee chairman Ted Kennedy (D-MA) have been working closely together. Baucus also meets regularly with the top Finance Republican, Charles Grassley of Iowa, as well as the relevant House committee chairmen and at least one key House Republican (Dave Camp of Ways and Means). Baucus did not rule out a Democrat-only, 51-vote strategy if that's what it takes at the end of the day, but he said he is still convinced that health reform can be bipartisan in the Senate. Despite the intense partisanship over the Obama's stimulus package, Baucus sees a "real deep desire among many Republicans" to find a health care solution that will also be a part of the country's economic solution.

"We've got a huge mess on our hands, " he said. "We know that."

"Everything has to be on the table. Everything... Keep open minds. Don't say no to anything... for at least five or 10 minutes." (In response to a question, however, he said a Canadian-style single payer plan is not on the table, that "this country is not ready, does not want, single payer.)

Lawmakers are pretty familiar with the coverage challenges in a nation with some 46-million uninsured people, but for some legislators, the whole discussion about delivery system reform and payment realignment is new. Engaging lawmakers and explaining that complex undertaking is a challenge. But Baucus also sees delivery system reform, with its promise of higher quality care for less money, as a vast opportunity. "It's going to be the driver," he said. The goal will be a plan that may take a few years to fully phase in and implement but will cover all Americans in a cost-effective quality system.

Baucus has disagreed with a bipartisan group of lawmakers who want to eliminate the whole tax break for employer-sponsored insurance, the so-called tax exclusion, but he is very open to limiting or modifying it. "The tax provision is on the table. It's too regressive. It skews the system." And it can be a source of revenue to pay for other aspects of health care, including expanded coverage and subsidies.

Although Baucus believes Democrats have already "advanced the ball," he is not minimizing the challenge as he sets an ambitious agenda to try to act on health legislation by summer.

One hurdle: explaining the complexity, helping both lawmakers and the public comprehend the many moving parts, designing, scoring and fitting together the health reform mosaic. And yes, there's still that problem of finding billions of dollars above and beyond the $634 billion 10-year "down payment" in the president's budget.

But Baucus is very optimistic. Even cheerful. His working assumption is that there is a way to get to yes, and he hopes it will be with Republicans like Grassley as partners. And finding that way, in Baucus's view, is actually fun.

"I know I have never attempted anything as challenging. This is the most difficult legislative challenge in my life," he said. "I relish it. It's so much fun."