Senate Democrats late Monday said they were moving toward eliminating a Medicare expansion from the health care overhaul — the last vestige of a public insurance option — as their party leaders tried to appease moderates in pursuit of the 60 votes needed to pass President Obama’s top agenda item by Christmas.
“There’s a general consensus building, supported by the leadership, that there’s a lot of good things in this bill and in order to get those accomplished that particular proposal would be gone,” Sen. Evan Bayh, Indiana Democrat, said when leaving a closed-door meeting of Democrats.
The Medicare expansion plan, which would have allowed people ages 55 to 64 to buy in to the program, was designed to pacify liberals in exchange for dropping a robust, government-run public insurance option last week. But moderates, including Sen. Joseph I. Lieberman, Connecticut independent, said he wouldn’t support it, citing fear over adding to the deficit and burdening taxpayers.
“Democrats aren’t going to let the American people down. We all stand shoulder to shoulder,” said Majority Leader Harry Reid of Nevada, who did not commit publicly to jettisoning the Medicare buy-in even though party members said it was inevitable.
Senate Democrats are scheduled to meet with Mr. Obama on Tuesday. In order to vote on Christmas Eve, Democratic leaders would have to get the necessary procedural measures in motion by the end of the week. White House officials were encouraging Mr. Reid to eliminate the Medicare plan. Democrats said they likely would be in session this weekend.
Mr. Lieberman said he was encouraged by the talks but said he wasn’t ready to commit to voting either way.
“Put me down tonight as encouraged about the direction at which the discussions are going,” he said. “I think we’re within reach of a very significant accomplishment.”
Mr. Reid has been trying to cobble together enough support for the measure that has fractured Democrats on a series of topics, from a public option to compete with private insurers to concerns over using federal money in the plan for abortions as public support for the effort continues to slide.
Removing the public insurance plan and the Medicare buy-in proposal, which liberals long championed as the best way to drive down health care costs, would eliminate the most controversial element of the health care debate.
But it may only delay a fight over providing government insurance as a linchpin of the overhaul in conference, where the House and Senate bills will have to be merged. Democrats in the House, who have a larger majority than in the Senate, strongly support the public plan and likely would object to passing a bill without it.
A Quinnipiac University poll released last week found sliding support for the government-run public option, though with 56 percent in favor, it’s still a clear majority.
Liberal Democrats in the Senate said they would support the bill for what it contained and not what it didn’t, pointing to insurance industry reforms and tax subsidies to help the poor and middle class purchase coverage.
“How could I not vote for the bill?” said Sen. John D. Rockefeller IV, West Virginia Democrat and one of the Senate’s strongest supporters of the public insurance plan.
Sen. Paul Kirk, the Massachusetts Democrat in the seat of the late Sen. Edward M. Kennedy, dubbed it “too good to fail.”
Other liberal Democrats, however, say a health care bill without a public option wouldn’t be enough.
“Until I see more I can only say again what I have said from the very first day of this debate so many months ago - that I am committed to voting for a bill that achieves the goals of a public option, competition, cost savings and accountability. I will not be able to vote for lesser legislation that ignores these fundamentals,” Sen. Roland W. Burris, Illinois Democrat, said on the Senate floor shortly after the meeting adjourned. “My colleagues may forge a compromise bill that can achieve the 60 votes that will be needed for its passage. But until this bill addresses costs, competition and accountability in a meaningful way, it will not win my vote.”
Sen. Max Baucus of Montana, chairman of the Finance Committee, warned that Democrats are still looking forward to the Congressional Budget Office’s analysis of the Medicare expansion plan and that things change quickly in the Senate.
“I do not want to say categorically that we’re headed in that direction,” he said of removing the Medicare plan. “Anything can change around here.”
One of the main objectives of health care reform is to drive down costs. But reports on whether the Senate bill does that have been mixed - and removing the Medicare and public option proposals could change that.
A White House Council of Economic Advisers report released Monday found that within five to 10 years of enactment, the Senate’s bill would reduce the growth rate of health care costs by 1 percent. But a report by the Centers for Medicare and Medicaid said last week that the bills would increase the nation’s total health care expenditures by 0.7 percent over the next decade and undermine the program.
It became clear in recent days that the health care debate was heading for a standoff. For months, liberals and moderates stood at opposite ends of the debate. Liberals argued that the public insurance plan was the only thing strong enough to hold insurance companies accountable. Moderates warned that they were leery of giving the government too large a role in the doctor-patient relationship.
All the while, Republicans stood uniformly opposed to the public plan. With Democrats controlling 60 seats, they need the support of all members of their caucus or would have to make dramatic changes to the bill to win Republican votes.
A compromise between moderate and liberal Democrats to expand Medicare appeared have the framework for a deal, but fell apart over the weekend when Mr. Lieberman said he couldn’t support it.
Polls show Americans oppose the overhaul being crafted by Democrats. Several surveys show a majority of the public against the plan. The Quinnipiac poll said 52 percent are against it while 38 percent support it.
• Sean Lengell contributed to this report.