Health care vote planned for today

Democrats expected to go with up-or-down tally

WASHINGTON

After a frenzied last push to nail down final commitments and resolve lingering disputes in their ranks, House Democrats are poised today to pass the most sweeping change to the nation’s health care system since the creation of Medicare nearly half a century ago.

Democrats now will proceed with a straight up-or-down vote on the health care bill that passed the Senate last year, after party leaders, facing the possibility of failure, decided to scrap plans to use a controversial procedural maneuver to approve Senate legislation.

The House will hold a second vote on a package of amendments that will modify some provisions of the Senate legislation and expand its scope to satisfy demands from House Democrats.

The last-minute decision to vote on the Senate bill undercut a Republican argument that Democrats were abusing House rules and procedures in their eagerness to pass health care overhaul. It also appeared to swing several key lawmakers behind the legislation Saturday, including Rep. Dennis Cardoza, D-Calif., a member of the fiscally conservative House Blue Dog Coalition.

“We are on the verge of making great history for the American people,” House Speaker Nancy Pelosi, D-Calif., told her Democratic colleagues at a meeting at the Capitol with President Barack Obama that turned into spirited rally.

At the rally, Senate Majority Leader Harry Reid of Nevada also promised that he had the 51 votes needed to pass the amendments package, which will be presented in the form of a filibuster-proof budget reconciliation measure.

And Obama brought the Democratic lawmakers to their feet with a fiery speech reminding them of the historic opportunity they have today.

“Don’t do it for me. Don’t do it for the Democratic Party,” the president said. “Do it for the American people. They’re the ones looking for action right now.

“I know it is a tough vote,” Obama said. “And I am actually confident . . . it will end up being the smart thing to do politically because I believe that good policy is good politics.”

The 10-year, $940 billion health care package is expected to extend medical insurance coverage to 32 million people by 2019, while also using a series of tax hikes and cuts in Medicare spending to reduce the overall federal deficit by $138 billion over the next decade, according to a preliminary estimate by the nonpartisan Congressional Budget Office.

Barring a last-minute breakdown over abortion, House Democrats are now expected to have the 216 votes they need to pass the package.

The House is to begin voting this afternoon, unless Republicans try to use parliamentary rules to delay that.

GOP lawmakers pledged Saturday to continue fighting the legislation, which they say will drive up government spending and health care costs.

“This weekend, House Republicans will stand with the American people and do everything in our power to defend their freedom and bring about health care reform that gives them more freedom and not more government,” said Indiana Rep. Mike Pence, the No. 3 House Republican.

If passed, the Senate bill would go to Obama for his signature and the package of amendments would go to the Senate for its approval.

If the Senate passes the amendments package without any changes, they too would go to Obama for his signature, although Democratic officials concede that the Senate may alter the package, which would require yet another House vote on the changes — but not on the overall health care overhaul as defined in the Senate bill.

The legislative end-game came into focus Saturday after a flurry of last-minute negotiating and cajoling.

Pelosi and her lieutenants rushed between their offices and the House floor settling lingering disputes among rank-and-file Democrats.

The leaders worked particularly intensely with administration officials to satisfy demands from a small group of anti-abortion lawmakers who wanted to place tough restrictions on federal funding for abortion services.

Senior Democrats were exploring whether the president could issue an executive order to clarify that the health care legislation would not allow any taxpayer money to be used to pay for abortions and to further protect doctors and other medical providers who choose not to provide abortion services.

“It may be all that’s left,” said Rep. Marcy Kaptur, D-Ohio, a socially conservative lawmaker who was among the group of holdouts led by Rep. Bart Stupak, D-Mich., who said they could not support the legislation without more abortion restrictions.

Other social conservatives say they are satisfied that the bill’s language is sufficiently restrictive to ensure that women who receive federal insurance subsidies will not be able to use them to pay for abortion services.

The Senate bill currently requires women who buy subsidized insurance plans that cover abortion services to send their insurer a separate check to cover the abortion benefit.

Working with administration officials, a group of lawmakers from rural districts also hammered out an agreement to boost how much Medicare pays rural doctors and hospitals, a key issue for many lawmakers.

Under the terms of the agreement fleshed out in the early hours of the morning, the Department of Health and Human Services will develop a permanent fix over the next two years.

“You can’t do much better than that,” said Rep. Peter A DeFazio, D-Ore., who spoke with the president Saturday to help seal the agreement. DeFazio said he would back the bill.

Other holdouts who declared their support Saturday included Reps. Jim Costa of California, Chris Carney of Pennsylvania and Gerry Connelly of Virginia.

As Democrats collected votes inside the Capitol, tensions continued to mount outside, where angry crowds protested the impending vote and flooded into the buildings where lawmakers have their offices.

Rep. Andre Carson, D-Ind., a black, said he and Rep. John Lewis, D-Ga., a black veteran of the civil rights movement, were accosted outside the Capitol by one group of protestors who shouted racial epithets at them.

“It was like a page out of a time machine,” Carson said outside the chamber.

By NOAM N. LEVEY and KIM GEIGER – McClatchy Tribune
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