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“If the purpose is to strengthen Medicare, then let’s make sure that money goes to Medicare, not to deficit reduction,” Mrs. Pelosi told reporters.

Congressional Democrats are still smarting from the president’s deal with Republicans in December to extend the George W. Bush-era tax cuts for two more years. Liberal lawmakers opposed the agreement because it didn’t impose higher taxes on families earning more than $250,000 per year.

Mr. Carney said opponents of spending cuts on entitlements should focus on “distinctions” between the administration’s agenda and proposals advanced by Republican lawmakers.

“We can find savings in Medicaid and Medicare out of the cost of health care, not by transferring all of the burden onto seniors,” Mr. Carney said. “We certainly don’t think in order to pay for tax cuts or to balance the budget that we need to essentially end Medicare as we know it and voucherize it and shift costs of up to $6,000 per senior per year to pay for it.”