WASHINGTON - Sweeping health care legislation cleared its first hurdles in the Senate Finance Committee on Wednesday as Democrats turned back a series of proposed changes by Republicans who attacked it as a threat to Medicare.
Yet even as they prevailed on politically charged votes, majority Democrats also tacitly conceded one point - that despite a pledge by President Barack Obama, some seniors who receive coverage from private insurers could lose some of the optional benefits they enjoy.
The early skirmishes in the panel also coincided with attempts by the Obama administration to reassure seniors about the legislation. Older Americans are more likely to vote than younger men and women, and public polling shows many harbor significant skepticism about attempts to redo the health care system.
"Nobody is going to mess with your benefits. Nobody. All we do is make it better for people on Medicare," Vice President Joe Biden told about 150 people at the Leisure World retirement community in suburban Maryland.
The Finance Committee is the last of five congressional panels to debate health care legislation that is atop Obama's domestic agenda. While the bill omits several provisions backed by liberals, Sen. Max Baucus, D-Mont., the committee chairman, hopes to hold support from all Democrats on the panel, and perhaps pick up Snowe's vote as well.
At its core, the bill is designed to expand coverage to millions who lack it, employing a new system of federal subsidies for lower-income individuals and families and establishing an insurance exchange in which coverage would have federally guaranteed benefits. Insurance companies would be banned from refusing to sell insurance based on an individual's health history, and limits would be imposed on higher premiums based on age.
At the same time, Baucus - in keeping with Obama's wishes - drafted legislation that would reduce the skyrocketing rate of medical spending overall. The bill's price tag is less than $900 billion over a decade.
Republicans criticized several cost-cutting provisions, in particular an estimated $500 billion that would be cut from projected Medicare payments over a decade.
Sen. Jon Kyl, R-Ariz., said it was "disingenuous to say Congress can cut this much ... without having an adverse affect on seniors' access to care."
Sen. Pat Roberts, R-Kan., said the bill is "paid for by cutting, maybe a better word is slashing, Medicare by $500 billion."
But some Democrats noted that other portions of the bill would increase benefits for all beneficiaries on Medicare, sweetening prescription drug benefits, for example, and Baucus said the net result of the legislation would be added years of solvency for the program's troubled trust fund.
Baucus effectively sidetracked the amendments by Kyl and Roberts by noting they failed to replace the lost savings, but a proposal by Sen. Orrin Hatch, R-Utah, was a different challenge.
The Utah Republican sought to clarify that the legislation would not result in the loss of any Medicare benefits under a provision to cut subsidies to private plans by $123 billion over a decade. His attempt failed, 14-9, and Snowe sided with the Democrats.
In its place, Baucus won approval for an alternative that said no cut in legally guaranteed Medicare benefits could result, a tacit admission that additional benefits that go to seniors in some private plans could be reduced.
Baucus is under pressure from the Democratic leadership to complete work on the bill by week's end so the full Senate can begin its long-anticipated debate quickly. More than 500 amendments from committee members were stacked up awaiting votes, and Republicans appeared to be in no hurry, taking as much time as Baucus would allow to make their arguments.
"It's not impossible to speculate without being called radical that there is a substantial slow-walk taking place in this committee," Sen. Jay Rockefeller, D-W.Va., said in remarks aimed at Republicans.
Republicans also failed to overturn a two-day old Obama administration order to insurance companies to stop warning seniors that the legislation could lead to cuts in benefits.
Kyl called the ban unconstitutional, adding the issue was "the essence of political free speech."
Democrats said it was nothing of the sort, pointing out that there are laws on the books to prohibit scaring seniors, and adding that private Medicare companies were effectively government contractors. The proposal was rejected 13-10.
The Finance Committee met as House leaders worked privately to prepare legislation for a vote next month. Officials said Speaker Nancy Pelosi hoped to have a proposal worked out by the end of next week for the rank-and-file to review.
The leadership has numerous contentious issues to resolve. Liberals strongly support a provision allowing the government to sell insurance in competition with private industry. Many moderate Democrats oppose it, and their votes could be pivotal in the House, where Republicans are expected to oppose the legislation without exception.
Associated Press writers Erica Werner and Julie Hirschfeld Davis in Washington, and Jessica Gresko in Silver Spring, Md., contributed to this report.