House Democratic leaders, desperate to cut the cost of a health care overhaul, are considering steps as drastic as increasing the size of the legislation’s proposed expansion of Medicaid, lawmakers said Wednesday.

It’s cheaper to cover people through Medicaid than to provide them subsidies to buy health insurance, according to the Congressional Budget Office (CBO).

“The irony is, what CBO is telling us is if you expand the number of people getting Medicaid, you reduce the cost of the bill,” said Rep. Anthony Weiner , D-N.Y.

So Democratic leaders suggested to their caucus, in a meeting Wednesday, that they could increase the Medicaid expansion to cover people earning up to 150 percent of the poverty level, Weiner and other members said. Right now the House version of the legislation would cover people earning up to 133 percent of the poverty level, or about $29,000 for a family of four.

The proposal to expand Medicaid is controversial. The program pays doctors and other health providers such low rates that many of them refuse to accept patients covered by the program. Increasing the number of people enrolled in Medicaid without improving its payments would exacerbate that problem.

“I have some concerns about that,” said Allyson V. Schwartz, D-Pa. “Medicaid rates are so low in Pennsylvania.”

State governors and legislators also are likely to bristle at the approach; Medicaid is a joint state-federal program, and with the economic recession, states are already being forced to cut their budgets deeply in other areas to maintain their Medicaid obligations.

House Democratic leaders hope to settle soon on a combination of policies that will draw the support of most of their caucus, so that they can push the health overhaul through the House in the weeks ahead.