WASHINGTON — Relentless attacks on President Barack Obama's health care overhaul effort, coupled with continued questions about how to pay for it, are prompting analysts to suggest that Democrats will have to scale back the cost and scope of the legislation to get anything through Congress this year.

Analysts say it would be disastrous politically for Obama and his party to emerge emptyhanded from this year's heated battle over health care legislation. In 1994, the Clinton administration's high-profile failure to pass a national health care program set the stage for a Republican revival in congressional elections that fall.

"I absolutely think they'll have to have a fallback position," said Ross K. Baker, a political science professor and expert on Congress at Rutgers University. "They'll have to accept something considerably less comprehensive, less federal government-centered, and simply use it as a place holder . . . for something to come along later."

Sen. Charles Grassley, R-Iowa, a key participant in Senate Finance Committee negotiations, told The Washington Post on Wednesday that the outpouring of anger at town hall meetings with members of Congress this month has convinced him that the public has rejected the Democrats' far-ranging proposals for health care overhaul. He said that lawmakers should consider sharply curtailing the scope of the effort.

"Not just on health care, but on a lot of other things Congress has done this year, people are signaling that we ought to slow up and . . . don't spend so much money," he said. The Finance Committee group is still discussing a "comprehensive" plan for extending coverage to millions of uninsured families, he said, but revisiting that approach would be "a natural outcome of what people may be getting from the town hall meetings."

Democrats probably will have to "scale back" the package this fall if the bipartisan negotiations involving six Finance Committee members fall apart, one senior Senate Democratic aide acknowledged this week. The aide spoke only on the condition of anonymity because of the political sensitivity of the situation.

Henry J. Aaron, an economist with the Brookings Institution, a center-left research center, said the administration should identify elements that could be financed at a "politically digestible price."

"One has to ask what can we do now to change incentives and improve the prospects of an evolution into a new health care system," Aaron said.

Many backers of an overhaul, however, say that Democratic leaders remain committed to comprehensive legislation and that lowering their sights would be a mistake. In particular, liberal Democrats in Congress who advocate a government-run health insurance plan to compete with private insurers reject any suggestion that they scale back their goal.

"The fact is, we've got 60 people, and maybe more, who say there will be no health care, we will not vote for a plan, without a public option," Rep. Keith Ellison, D-Minn., a member of the Congressional Progressive Caucus, said on a conference call Thursday. "These people against the public option, they're standing against reform ... and we're not simply going to stand for it. ... We've got 60 people, and we're not going to back down."