Despite an all-out push by Democratic congressional leaders, health care reform is unlikely to be enacted this year. The Democrats hope to get all of their major players on Capitol Hill lined up behind a plan similar to the "play or pay" scheme drafted by Senate Majority Leader George J. Mitchell (D-Me.). It would require businesses that don't provide employees with health benefits to pay a tax that would fund government-sponsored insurance. Consensus in the House appears within reach. But in the Senate, Finance Committee Chairman Lloyd Bentsen (D-Tex.), who looks after the interests of small business, could be a major impediment. And any bill that clears the Hill would likely face a veto.