WASHINGTON — The Senate majority leader, Harry Reid, said Tuesday night that he and a group of 10 Democratic senators had reached “a broad agreement” to resolve a dispute over a proposed government-run health insurance plan, which has posed the biggest obstacle to passage of sweeping health care legislation.
Mr. Reid refused to provide details. Other senators said the tentative agreement would sideline but not kill the “public option” championed by President Obama and liberal Democrats in Congress.
Under the agreement, people ages 55 to 64 could “buy in” to Medicare. And a federal agency, the Office of Personnel Management, would negotiate with insurance companies to offer national health benefit plans, similar to those offered to federal employees, including members of Congress.
If these private plans did not meet certain goals for making affordable coverage available to all Americans, Senate Democratic aides said, then the government itself would offer a new insurance plan, somewhat like the “public option” in the bill Mr. Reid unveiled three weeks ago.
In announcing the agreement, Mr. Reid was apparently trying to create a sense of momentum for the health care legislation, which has been on the Senate floor for nine days, with no immediate end in sight.
The White House praised the announcement. “Senators are making great progress, and we’re pleased that they’re working together to find common ground,” said Dan Pfeiffer, the White House communications director.
The majority leader has not briefed the 60-member Senate Democratic caucus on the agreement, and liberals may have reservations. “I do not support proposals that would replace the public option in the bill with a purely private approach,” said Senator Russ Feingold, Democrat of Wisconsin. “We need to have some competition for the insurance industry to keep rates down and save taxpayer dollars.”
Even senior members of the party said late Tuesday that they did not know if an agreement had been reached. “I have no idea,” said Senator Richard J. Durbin of Illinois, the assistant Democratic leader.
While refusing to provide any specifics, Mr. Reid, Democrat of Nevada, said: “Insurance companies will certainly have more competition. The American people will certainly have more choices.”
A bill approved last month by the House calls for a government-run health plan. So even if Senate Democrats reach consensus and pass their bill, they would not have the last word.
Mr. Reid’s comments came a few hours after the Senate rejected a proposal to ban coverage of abortion by health plans that would insure millions of Americans under the Democrats’ bill. The vote was 54 to 45.
Two Republicans, Senators Olympia J. Snowe and Susan Collins of Maine, joined with 50 Democrats and two independents to kill the proposal. Seven Democrats joined 38 Republicans in support of the ban.
Mr. Reid said he would ask the Congressional Budget Office to estimate the cost of the ideas devised by the group of 10 senators — five liberals and five centrists. Lawmakers often revise their proposals in the light of analysis by the budget office.
The American Hospital Association and the American Medical Association expressed concern about the proposed Medicare expansion. They told Congress that Medicare payments were often inadequate to cover their costs.
AARP, the lobby for older Americans, endorsed an earlier proposal to let some people 55 to 64 “buy in” to Medicare, with subsidies to help pay premiums. But it said it did not know enough about the new initiative to take a position.
Democrats are trying to find a middle ground on the so-called public option, abortion and other contentious issues so they can attract the 60 votes necessary to move the bill forward, either by holding together all 58 Democrats and the two independents aligned with them or by attracting support from one or two Republicans like Ms. Snowe and Ms. Collins to offset any defections in their ranks.
While advocates of abortion rights hailed the Senate’s rejection of the stringent restrictions on abortion, the vote is unlikely to be the final word on how the issue is dealt with in the health bill.
“This is the first thing we’ve won in years,” said Senator Dianne Feinstein, Democrat of California. “A majority saw it was not right to say that a woman could not pay for abortion or abortion coverage herself if her insurance company received any federal dollars.”
The health care bill would provide federal subsidies to help low- and moderate-income people buy insurance. The anti-abortion proposal, offered as an amendment by Senators Ben Nelson, Democrat of Nebraska, and Orrin G. Hatch, Republican of Utah, would have barred any health plan bought even partly with federal subsidies from covering the procedure.
Just hours before passing its version of health care legislation on Nov. 7, the House adopted an amendment nearly identical to the one rejected Tuesday by the Senate. Representative Jan Schakowsky, Democrat of Illinois, said the restrictions were “the most crushing blow we have seen to reproductive rights since Roe v. Wade,” the 1973 Supreme Court decision that established a constitutional right to abortion.
The Senate action complicates the outlook for approval of the legislation. Mr. Nelson said, “I don’t want to be stubborn or close-minded,” but he hinted that with the defeat of his amendment, he could not support the overall bill.
The normally more liberal House now has language in its bill that is more conservative, on abortion, than that of the normally more conservative Senate.
The Senate and House bills are similar in some respects. Insurers would not be required or forbidden to cover abortion. But, the bills say, across the country, the government would have to ensure that there is at least one plan that covers abortion and at least one that does not.
The secretary of health and human services would decide whether a proposed new government insurance plan would cover abortion. If an insurer covers abortion, it could not use federal money to pay for the procedure. It could use only premiums paid by subscribers and would have to keep the money separate from subsidies received from the federal government.
Opponents of abortion describe this bookkeeping arrangement as a sham. “It’s a shell game,” said Senator Mike Johanns, Republican of Nebraska.
The anti-abortion amendment offered by Mr. Nelson, like the House version proposed by Representative Bart Stupak, Democrat of Michigan, said no federal money could be “used to pay for any abortion or to cover any part of the costs of any health plan that includes coverage of abortion,” except in case of rape or incest or if the life of a pregnant woman is in danger.
Under the amendment, people who received federal insurance subsidies could not buy coverage from any health plan that provides abortions. They could use their own money to buy “separate supplemental coverage for abortions.”
In allowing some health plans to cover elective abortions, Mr. Nelson said, “the Senate bill goes against public opinion.”
Mr. Hatch said rejection of the anti-abortion amendment meant “there will be more people opposed” to the bill.
In the House, many supporters of abortion rights, including Speaker Nancy Pelosi, voted for the bill, even though it included stringent limits on abortion. But some they might not do so again.
“Pro-choice members will be working to ensure that health care reform legislation does not restrict abortion rights beyond current law,” Representative Diana DeGette, Democrat of Colorado, said Tuesday. “Over 40 members of the House have vowed not to support a conference report that further restricts a woman’s right to choose.”
Besides Mr. Nelson, the Democrats who voted for the ban on abortion coverage were Senators Evan Bayh of Indiana, Bob Casey of Pennsylvania, Kent Conrad and Byron L. Dorgan of North Dakota, Ted Kaufman of Delaware and Mark Pryor of Arkansas.