WASHINGTON | In a blow to the White House, the Senate&rsquo;s top Democrat signaled Tuesday that Congress may fail to meet a year-end deadline for passing health care legislation, leaving the measure&rsquo;s fate to the uncertainties of the 2010 election season.</p><p> Majority Leader Harry Reid of Nevada spoke as Democratic officials said it could be December before Senate debate would begin in earnest on the issue atop President Barack Obama&rsquo;s domestic agenda.</p><p> House leaders, on a somewhat faster track, pointed toward a vote this weekend on a bill that would extend coverage to tens of millions who lack it, ban insurance industry practices such as denying coverage because of pre-existing medical conditions, and generally slow the rate of growth of medical spending nationwide. The 10-year, $1.2 trillion legislation is estimated to expand coverage to about 96 percent of eligible Americans.</p><p> The measure includes an option for people to purchase a government insurance plan, an attempt to put pressure on private firms.</p><p>Meanwhile, House Republicans readied an alternative bill that bore little similarity to the Democratic blueprint. A copy obtained by The Associated Press called for loosening numerous restrictions on the insurance industry as a way of expanding coverage. </p><p> While House Democratic leaders weighed final changes to their version of the bill, Reid for the first time publicly raised the possibility that lawmakers would not be able to meet their &mdash; and Obama&rsquo;s &mdash; self-imposed deadline of completing work on health care by year&rsquo;s end.</p><p> &ldquo;We&rsquo;re not going to be bound by any timelines. We need to do the best job we can for the American people,&rdquo; he said after the weekly closed-door meeting of rank-and-file Democrats.</p><p> A few hours later, Reid&rsquo;s office revised his remarks.</p><p> &ldquo;Our goals remain unchanged,&rdquo; said spokesman Jim Manley. &ldquo;We want to get health insurance reform done this year, and we have unprecedented momentum to achieve that. There is no reason why we can&rsquo;t have a transparent and thorough debate in the Senate and still send a bill to the president by Christmas.&rdquo;</p><p> At the White House, spokesman Reid Cherlin sought to put the best face on the developments. </p><p>&ldquo;We&rsquo;re moving on the same timeline. The House plans to vote on the health reform bill within days, and as Senator Reid said today, he shares the White House&rsquo;s commitment to passing meaningful reform by Christmas and will be moving swiftly once the Senate hears back from CBO,&rdquo; he said.</p><p> The Congressional Budget Office is preparing cost estimates of a draft bill that Reid completed last week.</p><p> Any delay past Obama&rsquo;s oft-repeated, year-end timetable would put the issue off until the 2010 election year and inevitably raise doubts about Democrats&rsquo; ability to deliver on behalf of the Obama administration.</p><p> Democrats in both chambers of Congress have been plagued all year by internal divisions on the issue, a problem more difficult for Reid to manage because he must have unanimous support of his rank and file as he tries to overcome solid GOP opposition.</p><p> House Speaker Nancy Pelosi of California leads a caucus of 256 Democrats, and can afford more than two-dozen defections and still be assured of passing legislation in the House. She projected no concern about a possible delay in final action until next year.</p><p> The GOP alternative focuses on bringing down costs rather than extending coverage to nearly all Americans. The 230-page bill would leave out several of the key features of the Democrats&rsquo; 1,990-page legislation, such as new requirements for employers to insure their employees and for nearly all Americans to purchase insurance. It also would not block insurers from denying coverage to people with pre-existing health conditions.</p><p>It contained none of the proposed tax increases or Medicare cuts that Democrats would rely on.</p><p> Instead, the Republican plan would increase incentives for people to use health savings accounts, cap non-economic jury awards in medical malpractice cases at $250,000, provide various incentives to states with the aim of driving down premium costs, and allow health insurance to be sold across state lines.