The sweeping legislation, affecting virtually every American and more than a year in the making, would extend coverage to an estimated 32 million uninsured, forbid insurers to deny coverage on the basis of pre-existing medical conditions and cut federal deficits by an estimated $138 billion over a decade.

Congressional analysts estimate the cost of the two bills combined would be $940 billion over a decade.

For the first time, most Americans would be required to purchase insurance, and they would face penalties if they refused. Billions of dollars would be set aside for subsidies to help families at incomes of up to $88,000 a year afford the cost. And the legislation also provides for an expansion of Medicaid that would give government-paid health care to millions of the poor.

One day after Democrats released 153 pages of revisions to their bill, they were back at it, responding to fresh concerns from some of the rank and file about disparities in payment levels to Medicare providers in different areas of the country.

Democrats were angling for a government takeover of health care. They also said the cost of the bill would be covered by $900 billion in higher taxes and cuts in future Medicare payments.