Senate Democrats continue to hunt Thursday for the 60 votes they need to pass a slimmed-down legislative package containing a six-month physician pay patch and an extension of higher federal Medicaid funding.

The Senate's latest swing at passing a 7-week-old package of tax changes and safety net health provisions could again fall short, with at least one Democrat and two Republicans saying they oppose the billions of dollars it would add to the national deficit.

The Senate is expected to vote on the package Friday. Sen. Ben Nelson of Nebraska, a fiscally conservative Democrat, said he would vote against the package in large part because of the amount of spending that would not be offset by savings elsewhere.

A preliminary estimate by the Congressional Budget Offices shows that the revised bill would add $55 billion to the national deficit, down from $79 billion, but nevertheless a troublesome number that increasingly concerns debt-conscious lawmakers.

Sens. Susan Collins and Olympia Snowe, both moderate Republicans from Maine, also appeared to be “no” votes as of Thursday afternoon.

Collins said that the amended version “is moving in the right direction,” but added that she wants to see “more of the bill paid for.” 
 

Late Wednesday, Max Baucus, Senate finance committee chairman, formally introduced his amended version of the bill, which scaled down to about $118 billion over 10 years from $140 billion.

Some of those cost savers come from a shorter-term “doc fix,” which went from 19 months costing $22 billion down to six months and costing about $6.5 billion. Physicians would see a 2.2% increase in Medicare payment through November under the plan. Without it, physicians face a 21.2% pay cut that would kick in by week's end.

The previous version of the bill failed a test vote Wednesday, 45-62, with 10 Democrats and one Independent voting against the bill.

One of those against the bill appeared to have softened his stance today, though. “It's a lot closer,” said Sen. Mark Begich (D-Alaska). “I want to reconfirm where the numbers are, but it's a lot better than it was yesterday.”