In the Senate, the Finance Committee version of the bill is unlikely to include a government-run insurance option. Bipartisan negotiations are centered on a proposal for a nonprofit insurance cooperative as a competitor to private companies.

Three committees are collaborating in the House on legislation expected to come to a vote by the end of July. That measure is certain to include a government-run insurance option.

At their heart, all the bills would require insurance companies to sell coverage to any applicant, without charging higher premiums for pre-existing medical conditions. The poor and some middle-class families would qualify for government subsidies to help with the cost of coverage. The government’s costs would be covered by a combination of higher taxes and cuts in projected Medicare and Medicaid spending.