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Democrats reach cost, coverage deal for health bill

WASHINGTON - President Barack Obama and top congressional Democrats reached for agreement Friday on cost and coverage disputes at the heart of sweeping health care legislation, their marathon White House bargaining sessions given fresh urgency by an unpredictable Massachusetts Senate race.

One key obstacle appeared on its way to a resolution when Sen. Ben Nelson (D-Neb.) requested the elimination of an intensely controversial, one-of-a-kind federal subsidy to cover the entire cost of a Medicaid expansion in his home state.

That provision in the Senate-passed measure has drawn bipartisan criticism from the moment it was disclosed. In its place, officials said Obama and lawmakers decided to increase federal aid for Medicaid in all 50 states, although it was not clear whether there would be enough funds.

The increase in the Medicaid program is a key element in the bill's overall goal of expanding health coverage to millions who lack it. The bill also envisions creation of new insurance exchanges, essentially federally regulated marketplaces where consumers can shop for coverage. Individuals and families at lower incomes would receive federal subsidies to defray the cost. The legislation also is designed to curb industry practices such as denial of coverage for pre-existing medical conditions.

At the White House, spokesman Robert Gibbs was unequivocal that Obama's yearlong campaign for health care legislation would prove successful.

Not everyone was quite so certain, with poll results from Massachusetts showing Republican Scott Brown within reach of a possible upset over Democrat Martha Coakley in the race to succeed the late Sen. Edward M. Kennedy. "If Scott Brown wins, it'll kill the health bill," said Rep. Barney Frank (D-Mass.).