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WASHINGTON -- After months of turmoil, President Barack Obama and Senate Democrats are reaching for the unity they need to pass health care legislation by Christmas, but without the government-run insurance program that liberals have long sought.

Even an expansion of Medicare, initially proposed as a backup to the government insurance option, appeared unlikely to survive following a closed-door senators-only meeting of the Democratic caucus called to consider trade-offs necessary to assure 60 votes for the bill. Medicare is the government program providing health care benefits to the elderly.