For weeks, the Senate has been mired in a debate over what's more important: extending expiring tax incentives for businessses and individuals, as well as jobless benefits, at any cost -- or doing so while paying for nearly every penny.

Democratic leaders are poised to introduce their third version of a so-called "extenders" bill on Wednesday, according to a senior Democratic leadership aide. The aide told Fox that critical Medicaid money for the states, $24 billion in previous bills, is likely to not only be pared back but also fully offset with spending cuts, some of that in unspent stimulus funds, once considered anathema to the Majority party.

But a number of senior Democratic leadership aides predicted to Fox on Wednesday that the new effort is not likely to be any more successful in breaking a GOP-led filibuster. The trim-back of Medicaid money reportedly infuriated many Democrats, so Majority Leader Harry Reid, D-NV, and Senate Finance Committee Chairman Max Baucus, D-MT, find themselves in a tough spot.

According to one lobbyist who saw a draft bill circulating K Street on Tuesday, the Medicaid money would be phased out. An aide to Baucus cautioned that the draft was "already old," however.

For weeks, the senators have courted moderate Republican Sen. Olympia Snowe of Maine and to a lesser extent her home state GOP colleague, Susan Collins. Snowe told reporters on Tuesday that she is not as concerned that the jobless benefits be offset, but she said that the rest of the bill should be. As well, the senator wants more of a break for small businesses, a move that would remove revenue raised by the bill, thus offseting its deficit impact.

It is unclear if the bill will have any better time in the House.

That chamber removed the $24 billion in Medicaid money to satisfy demands from fiscally conservative Blue Dog Democrats who wanted less of a hit to the deficit.

Another looming battle in the House will be whether or not to accept a short term Medicare providers payment patch, the so-called "doc fix," passed by the Senate last week that is fully paid for. The Speaker and Majority Leader have sent mixed signals on that issue. Meanwhile, the Centers for Medicare and Medicaid, the federal agency that administers the two programs, let lapse a stop payment order that kept Medicare doctors from seeing a 21% cut in their federal reimbursements. Anything Congress does on that front, however, is expected to be retroactive.

One motivator for action could be a letter sent by AARP CEO Barry Rand to members of Congress Tuesday calling on them "to immediately pass legislation that ensures seniors have access to their physicians, and provides much needed fiscal relief to the states and to unemployed individuals." Rand added that the Medicare physician payment cut "threatens access to physician services for millions of Medicare beneficiaries - especially those living in rural and other underserved areas."

And those beneficiaries are often the most active participants in midterm elections.