WASHINGTON — As the battle over health care lurches toward a conclusion, President Obama is confronting an increasingly sharp divide on the Democratic left, with liberals in the Senate and the House split on a critical question: How much of what they want is enough?
Senator Joseph I. Lieberman spoke with reporters on Capitol Hill on Tuesday.
In the Senate, where time is running out for Democrats to meet the president’s deadline of passing a bill by Christmas, liberals signaled on Tuesday that they would hold their noses and vote for a version of the measure that would strip out some of their most cherished provisions, including an expansion of Medicare and the possibility of a government-run insurance plan.
But the House seemed unwilling to fall in line. The majority leader, Representative Steny H. Hoyer of Maryland, said flatly on Tuesday that the House would not “simply take the Senate bill” and adopt it unchanged.
And Howard Dean, the former Vermont governor and presidential candidate who is a respected voice among liberals, stirred the pot on the Democratic left by saying, “the best thing to do right now is kill the Senate bill” and start over.
At the White House, Mr. Obama declared himself “cautiously optimistic” after a meeting with the entire Senate Democratic caucus, where he urged senators to put aside their differences and “seize the moment,” to pass a measure that would extend health coverage to 30 million uninsured Americans.
“Now, let’s be clear,” Mr. Obama said after the hourlong private meeting. “The final bill won’t include everything that everybody wants. No bill can do that. But what I told my former colleagues today is that we simply cannot allow differences over individual elements of this plan to prevent us from meeting our responsibility to solve a longstanding and urgent problem for the American people.”
The meeting underscored the sense of urgency for Mr. Obama, who has made passing a health care overhaul his highest legislative priority. He is leaving on Thursday night for Copenhagen to attend a conference on climate change, and he acknowledged that “there are still disagreements that have to be ironed out” and “work to be done in the next few days.”
In the Senate, Democratic leaders said they were confident they could resolve those disagreements because liberals seemed willing to make concessions to get a bill passed. The latest version of the Senate legislation omits a new government-run insurance plan to compete with the private sector, and the expansion of Medicare to allow people as young as 55 to buy into it.
“We are very disappointed,” said Senator Sherrod Brown, Democrat of Ohio, who is a leading liberal in the Senate. Still, Mr. Brown said, “I’m going to vote for the bill — there’s too much at stake.”
Speaking to reporters after the White House session, the No. 2 Democrat in the Senate, Senator Richard J. Durbin of Illinois, cast the liberals’ dilemma this way: “Many of us who are on that side of the caucus really felt we had to weigh on balance what remains. And what remains is dramatic, and we just don’t want to lose the opportunity, the once-in-a-lifetime opportunity.”
The Senate majority leader, Harry Reid of Nevada, is still putting the bill together, but he and other leading Democrats sounded confident after the session with Mr. Obama that they would get the 60 votes they need to overcome staunch Republican opposition. Mr. Reid sketched out a timeline in which he would move Friday to bring the debate to a close and would hold final votes on the bill on Dec. 23 or 24.
Senator Max Baucus, Democrat of Montana and chairman of the Finance Committee, said: “We don’t have 60 votes locked in yet. But we will get 60.”
In the House, though, liberals were none too pleased. Representative Lynn Woolsey, Democrat of California and co-chairwoman of the Congressional Progressive Caucus, said it would be “very difficult” for her to vote for legislation that does not include a government plan, dubbed a public option, or a Medicare buy-in.
“Without that and without any public option, I don’t see what we are offering the American people,” Ms. Woolsey said. “We are not offering any significant competition to the insurance industry. Premiums could skyrocket.”
As Democrats debated among themselves, Republicans made clear that they would fight the bill every step of the way in the Senate. “Our Democratic friends are about to walk off a political cliff here,” Senator Lindsey Graham, Republican of South Carolina, said Tuesday. “Do we really want to change one-sixth of the economy without a single Republican vote?”
One Republican being courted by the White House, Senator Susan Collins of Maine, said Tuesday that she could not vote for the measure in its current form. “This bill is getting better,” she said, “but it’s still too deeply flawed for me to support it.”
Other issues flared Tuesday as well. The Senate rejected a bipartisan proposal to allow imports of prescription drugs from Canada and other countries where prices are often lower; the provision fell 9 votes short of the 60 needed. The Senate also turned down a Republican effort to revise the bill to eliminate any tax increases for individuals with incomes less than $200,000 a year and for couples with incomes less than $250,000. At the same time, Democrats are trying to negotiate a compromise on abortion coverage that would help win the vote of Senator Ben Nelson, Democrat of Nebraska.
At the White House session, Mr. Obama tried to appeal to lawmakers’ sense of history. Mr. Baucus, who took notes on a paper napkin, quoted the president as saying: “This is the moment of our legislative lifetimes. This is why people run for public office, to be here at the creation of something really big.”
Just how big, though, remains an open question, especially among liberals in the president’s party. The session was called after Senator Joseph I. Lieberman, independent of Connecticut, announced over the weekend that he could not vote for the measure unless the Medicare expansion was stripped from the bill.
Several people who attended the session recounted this exchange:
“What’s happening is not any fun for me,” Mr. Lieberman said.
Mr. Brown, who has championed the public option, turned to Mr. Lieberman and said, “You know, Joe, it’s not fun for us either.”
At that point, Mr. Obama stepped in.
“Why don’t we all begin to have some fun?” he said. “Let’s pass the bill.”