With three days left in the legislative session, Gov. Ed Rendell again is appealing to Senate Republicans to extend health coverage to the uninsured and reinstate a program that helps doctors pay for their malpractice insurance.

"After endless meetings between our staffs, it is time to act," the Democratic governor said in a letter sent yesterday to Sen. Dominic Pileggi, R-Delaware, the Senate majority leader.

The governor said the latest proposal offered by Democrats has "no measurable opposition" from leading health care groups and does not require a tax increase.

"I hope you will act on this compromise package before the end of this legislative session so that we can both meet the health care needs of our citizens and the needs of our doctors," Mr. Rendell said.

But a letter also sent yesterday from Senate Republican leaders to Mr. Rendell did not seem to raise hopes that the two sides will reach a quick agreement. The letter raised concerns about the fiscal sustainability of the Democrats' proposal, particularly against a projected year-end state budget deficit and a "worsening world economic crisis."

A number of proposals have been advanced over many months to extend health coverage to uninsured Pennsylvanians. Mr. Rendell unveiled one proposal in January 2007 in his sweeping health plan, "Prescription for Pennsylvania." It was later modified by House Democrats into the Pennsylvania ABC Plan. That plan, which the governor also supports, would extend affordable health insurance to small businesses and the uninsured, with subsidized coverage for people with low incomes.

It also would give grants to small employers who already provide coverage to such workers and phase out the assistance payments to physicians, known as MCare abatements, over 10 years.

Among other issues, Republicans have objected that about $120 million in funds needed annually for PA ABC were not identified. They offered their own plan, which, among other provisions, would enhance care at health centers.

Mr. Rendell's latest plan eliminates the need for $120 million annually by dropping some features of the ABC plan, including those that would allow small businesses to buy into the coverage or receive grants for already offering insurance to their workers. It also would provide additional funding for health centers and phase out the MCare abatements over five, rather than 10, years.

A standoff between the two sides led to an end to the MCare abatements on April 1. Reauthorization of a state agency, the Pennsylvania Health Care Cost Containment Council, also fell victim to the partisan squabble, though Mr. Rendell revived the agency through Nov. 30 by executive order.

Chuck Ardo, a spokesman for the governor, said yesterday that it is premature to discuss whether the governor would sign a similar order if needed to extend the cost containment council after Nov. 30.