WASHINGTON — As a key Senate committee prepares today to pass its plan to overhaul the nation's healthcare system, senior Democrats are acknowledging that it may be impossible to provide coverage to all Americans -- a central goal of President Obama and his congressional allies.
That is fueling growing alarm among hospitals and insurance companies, which have made universal coverage a condition of their support.
On Monday, the insurance industry stepped up its warnings that leaving a large segment of the population without coverage would accelerate a rise in premiums for everyone else. The bill that has emerged from the Senate Finance Committee would leave about 17 million people uninsured.
But leading Democrats are standing behind the committee's series of compromises that are designed to control the cost of government subsidies for consumers forced to buy insurance.
They say the approach -- which would keep the cost of the legislation under its 10-year target of $900 billion -- is necessary to attract the moderate and conservative votes vital for passage.
"I'd like more [insurance coverage]," said Sen. Christopher J. Dodd of Connecticut, a Democrat who over the summer shepherded a version of the bill proposed by the late Sen. Edward M. Kennedy (D-Mass.) through the Senate health committee.
"But that's a pretty good start. . . . Sen. Kennedy was a great advocate of the idea that you do the best that you can."
The bill that comes out of the finance committee must be reconciled with the health panel's version before the legislation can be brought to the full chamber for a vote. A similar effort is underway in the House.
Rep. Henry A. Waxman (D-Beverly Hills), the House Energy and Commerce Committee chairman and a leading author of the chamber's healthcare bill, also said that compromises might be necessary over how many Americans and legal immigrants would be covered. There are 40 million in the country without insurance, excluding illegal immigrants.
"The effort to reform healthcare is a balancing act," Waxman said Monday. "And we are limited in how much money we can spend."
Sen. Charles E. Schumer (D-N.Y.), a leading member of the finance committee, said Senate Democrats shared the concern about federal spending.
"We're focused on the budget number," he said. "That's the most important number right now."
