Medicare Expansion Clashes With Health Care for the Poor as Budget Bill Shrinks

Under pressure to cut the bill’s cost, Democrats disagree over whether to offer more benefits to older Americans or to cover more of the working poor.

Democrats are facing tough moral and political decisions over how to pursue their century-old dream of universal health care now that their ambitious $3.5 trillion social safety net bill will almost certainly have to be trimmed back.

As they try to reduce the bill’s cost, members of the party disagree over whether to prioritize expanding coverage to more poor adults in states whose leaders have refused to...