WASHINGTON — The House Energy and Commerce Committee resumed work Thursday on major health care legislation, voting to establish a government-run health insurance plan, as top Republicans stepped up their criticism of the ambitious legislation.
By a vote of 35 to 24, Democrats defeated a Republican effort to eliminate a section of the bill that would create the public health insurance option.
“Our constituents should have the choice of a public plan,” said Representative Christopher S. Murphy, Democrat of Connecticut. “There is nothing to be scared of here. No one will be forced into the public plan.”
President Obama supports a public plan, saying it would foster competition and keep private insurers honest.
Representative Michael C. Burgess, Republican of Texas, said the public plan would lead slowly but inevitably to “a government takeover of our health care system.”
With the government plan, said Representative Mike Rogers, Republican of Michigan, “you will have to call a bureaucrat and hope to God his calculator is more compassionate and smarter than your doctor.”
On Thursday night, the Energy and Commerce Committee also voted to allow health plans to cover or not cover abortion, as they see fit, but stipulated that insurers must use money from private sources to pay for any abortions.
By a vote of 30 to 28, the committee approved an amendment setting forth abortion policy. The proposal, offered by Representative Lois Capps, Democrat of California, was supported by most Democrats and opposed by Republicans.
The amendment said abortion could not be included in the “essential benefits package” to be defined by the government. Further, it said insurers would not be required or forbidden to cover abortion. But, it says, in every part of the country, the government must ensure that there is at least one plan that covers abortion and at least one that does not.
Under the bill, health plans would receive federal subsidies to help pay premiums for low-income people. But under the amendment, subsidies could not be used to pay for abortions.
Democrats described the amendment as a compromise. But Representative Phil Gingrey, Republican of Georgia, who opposed the amendment, said, “We don’t compromise on the use of taxpayer funds for the destruction of human life.”
Democrats were also forced to contend with rising discontent in the left wing of their party over the deal that House leaders struck with the Blue Dog Coalition, a group of fiscally conservative Democrats.
The liberal lawmakers voiced concern that the agreement would reduce federal subsidies intended to help people with low or moderate incomes buy insurance. In addition, they contended that the deal would weaken the proposed new government health insurance plan, which would compete with private insurers.
Moreover, the liberals also expressed a political concern, saying House leaders had compromised too early. “Under the agreement, private insurers are coming off unscathed,” said Representative Peter Welch, Democrat of Vermont.
He added, “They do quite well — too well, frankly.”
Representative Eliot L. Engel, Democrat of New York, said, “The public plan was eviscerated” under the deal announced Wednesday to get the bill moving again in the Energy and Commerce Committee.
Mr. Engel was less than enthusiastic about the resulting legislation. “It’s not a terrible bill,” he said, “but it’s not what I had hoped for.”
On the Senate side of the Capitol, where efforts to produce a bipartisan health care measure continued in the Finance Committee, top Republicans seemed eager to avoid early compromises that would let Democrats head to their home states for the August recess boasting of any progress.
And Senators Charles E. Grassley of Iowa and Michael B. Enzi of Wyoming, two of the top Republican negotiators, have expressed frustration with suggestions that an agreement is near.
Mr. Grassley, the senior Republican on the Finance Committee, and Mr. Enzi, the senior Republican on the Senate health committee, are members of a team of six senators working to draft compromise legislation.
After a meeting on Thursday evening, five of the six appeared before a crowd of reporters and said that they were committed to working toward a deal, but that they would not complete the legislation before the Senate leaves on its August recess.
“We are committed to find a bipartisan solution as expeditiously as possible,” said the Finance Committee chairman, Senator Max Baucus, Democrat of Montana.
Mr. Grassley and Mr. Enzi clearly face a tough balancing act, as their party’s leadership maneuvers to torpedo any emerging compromise and force Democrats to start over.
The third Republican in the group of six health care negotiators, Senator Olympia J. Snowe of Maine, is a centrist with a long history of working with Democrats, and Republican leaders are under no illusion that they can control her vote.
Mr. Grassley angrily dismissed suggestions that he and Mr. Enzi were being pressured by party leaders.
“What you are observing is a continuation of where we have been for a doggone long time,” he said. “The trouble is you all are looking for news and there ain’t no news.”
Some Republicans have begun to warn that Mr. Grassley should tread carefully on the health care bill if he wants to become the senior Republican on the Judiciary Committee, a post that he is in line to take in the next Congress, when his term on the Finance Committee will be up.
And there have even been suggestions that Mr. Grassley, who is up for re-election next year, could face a primary challenge because of unhappiness among conservatives in his state over his support of the $787 billion bailout of the financial system last fall.
Earlier in the day, Mr. Enzi said the legislation was simply not finished. “The bill is not ready for prime time, so I don’t know any way that it could be completed today or next week and then we are at the August break,” he said.