“It’s not good enough that it’s just paid for; it actually has to start driving long-term costs down,” said Sen. Mark Warner (D-Va.), one of nine freshman Democrats who last month urged Senate leaders to pay more attention to controlling federal health spending in this era of “exploding debt and deficits.”

“The status quo is going to bankrupt the federal government and bankrupt most American families,” Warner said…

“You won’t get a Republican to sign on if it does not,” said Sen. Olympia J. Snowe (Maine), one of three Republicans involved in the Finance Committee negotiations. “At this precarious time in our nation’s history, frankly, we have to be rigorous in our fiscal approach. There’s just no latitude.”

Snowe and other Republicans are counseling Obama to scale back his expectations, not only to cut costs but also to deflate hysteria over reform. In a meeting at the White House last week, Snowe said she urged Obama to seek “practical” changes that “don’t create too much upheaval and uncertainty.”