Arizona Short Term Disability

Senate Democrats on Friday to push the efforts of Republicans to strip two major provisions of their bill of health that would make deep cuts in payments to private Medicare Advantage plans and create a new insurance program for long-term care. In different ways, the two provisions reflect Democratic priorities. For years, Democrats have argued that private plans in Medicare, operated by insurance companies under contract with the government, obtain grants unjustified. Many Democrats say the program's long-term care would fill a gap in the social safety net, although critics say the program would be financially untenable.

The vote capped a week of bitterly partisan first debate on the legislation. The majority leader in the Senate, Harry Reid, Nevada Democrat, said the Senate working through the weekend.

By a vote of 57 to 41, the Senate on Friday rejected a Republican request to eliminate the cuts affect private Medicare Advantage plans, which provide comprehensive care to nearly one quarter of the 45 million Medicare beneficiaries. The bill would eliminate $ 118 billion in planned spending for such plans over the next 10 years.

Senator Orrin G. Hatch, Republican of Utah, said that some older Americans would inevitably lose some benefits, like vision and dental care, which they currently benefit from the Medicare Advantage plans.

The No. 2 Senate Republican, Jon Kyl of Arizona, said Democrats broke a promise to Mr. Obama that "if you like your health care plan, you will be able to keep it."

But Democrats said the Republicans were simply trying to protect the insurance companies that offer Medicare Advantage plans.

Senator Sheldon Whitehouse, Democrat of Rhode Island, said he had not yet seen any instance in which the Republican argument "does not coincide with the interests of the insurance industry."

In the insurance program's long-term care, people may be eligible for cash benefits if they were severely disabled after voluntarily pay premiums for at least five years. The money could be used for things that help people maintain their independence, such as housing modifications, special telephone and computer equipment or services of a caregiver.

Senator Tom Harkin, Democrat of Iowa, said: "This is the next logical step after the Americans with Disabilities Act. It will provide many people in this country with security and peace of mind knowing they will not go to a nursing home or institution in case of disability. "

Under the bill, premiums would be established to cover the cost of the new program. But Senator John Thune, Republican of South Dakota, said that the government could initiate a "huge responsibility on the road again."

The Senate voted 51 to 47, the new program to strip the bill but the Senate had already agreed to set a threshold of 60 votes, so that the attempt failed, and the program remains in the bill .

Mr. Thune has led efforts to eliminate the program. He has won support from 11 Democrats, including Chairman of the Finance Committee, Max Baucus of Montana and chairman of the Budget Committee, Kent Conrad of North Dakota.

The program is supported by President Obama. The bill the House has a similar program.

Far from the floor debate, Democrats have continued to seek a compromise on the question of whether the division to create a new plan of government-run Medicare.

Two pivotal centrist, Senators Joseph I. Lieberman, independent of Connecticut, and Susan Collins, Maine Republican, said they could not support any of these proposals have been floated by Democrats.

"The public option is actually a government created by the insurance company and managed by the government," said Lieberman. "It will not help one poor get.