Dems look to health vote without abortion foes

WASHINGTON -- House Democratic leaders abandoned a long struggle to appease the most ardent abortion opponents in their ranks, gambling Thursday that they can secure the support for President Barack Obama's sweeping health care legislation with showdown votes looming next week.

In doing so, they are all but counting out a small but potentially decisive group whose views on abortion coverage have become the principal hang-up for Democrats fighting to achieve the biggest change in American health care in generations. Congressional leaders are hoping they can find enough support from other wavering Democrats to pass legislation that only cleared the House by five votes in an earlier incarnation.

Democratic leaders are working to rally rank-and-file members around agreements on several complicated points, health insurance taxes and prescription drug coverage among them, and dozens of other sticky issues -- all as Republicans stand ready to oppose the overhaul en masse.

"We will finish the job," Senate Majority Leader Harry Reid, D-Nev., wrote in a letter to his Republican counterpart describing the path ahead.

Said Sen. Tom Harkin, D-Iowa: "The stars are aligning for victory on comprehensive health reform. The end is in sight."

Democratic Rep. Henry Waxman of California, chairman of the Energy and Commerce Committee, said the leadership will press ahead without reworking the abortion provision adopted by the Senate. Abortion opponents say the provision falls short in restricting taxpayer dollars for abortion coverage.

Rep. Bart Stupak, D-Mich., has been pushing for stricter provisions and says he and a dozen or so abortion opponents would vote against the health care bill if the Senate's version is retained. Leaders will try to peel off some of those lawmakers and make up for any remaining deficit with Democrats who opposed the health care legislation on the first round, when it passed 220-215.

"Many of the pro-life members are going to support passage of the health care bill," Waxman predicted. "They're either satisfied enough with the Senate provision, or they decide that that's as much as they're going to get and they don't want to defeat health care."

One point on which Obama may not get his way is the White House demand for a vote by March 18, a week away. Speaking to reporters after Democrats met for a status report on the emerging health care agreements, House Speaker Nancy Pelosi called the deadline merely "an interesting date."

Before a vote, Pelosi, D-Calif., said lawmakers must first receive a cost report from the Congressional Budget Office on changes to the bill being worked out among the White House and Democratic congressional leaders. After that, it could be a week or more before the legislation goes to the floor.

House Democrats were meeting behind closed doors Thursday to hear a point-by-point briefing on the latest health care compromise from White House health reform director Nancy Ann DeParle. Pelosi asked the members whether they wanted to vote sooner rather than later. They responded with a broad shout of "Yes!" according to lawmakers coming out of the session.

It will come down to a phenomenal effort by congressional leaders and the White House to win over skittish lawmakers after a year of incendiary debate, even as Obama keeps up campaign-style appearances designed to fire up public support.

At stake is the fate of the president's call to expand health care to some 30 million people who lack insurance and to prohibit insurance company practices such as denial of coverage on the basis of pre-existing medical conditions. Almost every American would be affected by the legislation, which would change the ways many people receive and pay for health care, from the most routine checkup to the most expensive, lifesaving treatment.

White House officials and congressional Democratic leaders met Wednesday evening in Pelosi's office. Aides said they agreed on scaling back a health insurance tax that unions oppose, and on gradually closing the Medicare prescription drug coverage gap. They were not far apart on other major issues, including Medicaid financing for states that already provide above-average benefits, and on improving subsidies that would be available under the plan to help individuals and families pay their premiums.

Several Democrats expressed frustration, however, with the absence of cost estimates from the Congressional Budget Office on the latest provisions. They want to ensure the total price tag stays around $950 billion over 10 years.

Those costs would be covered through a combination of Medicare cuts and tax increases. Among the new levies, the Medicare payroll tax would be applied to the investment earnings of upper-income people, including proceeds from capital gains. Until now, the tax has solely been levied on wages.

In a bit of bookkeeping, the Congressional Budget Office on Thursday released its final cost estimates for the bill the Senate passed on Christmas Eve. That 10-year, $875 billion plan would reduce the federal deficit and cover 31 million people who'd otherwise be uninsured. The Senate bill is the foundation of the proposal that Obama wants Congress to pass in the next few weeks. But the numbers will change yet again with the new version.

Obama invited members of the Congressional Black Caucus and the Congressional Hispanic Caucus to meet him Thursday at the White House to discuss the health legislation.

The health care legislation appeared on the cusp of passage late last year before Senate Republicans gained the strength to sustain a filibuster that could prevent final passage. The White House is pushing for a vote by the House before Obama leaves on a foreign trip at the end of next week.

The current plan is for the House to approve the Senate-passed bill from late last year, despite serious objections to numerous provisions. Both houses then would pass a second bill immediately, making changes in the first measure before both could take effect. The second bill would be debated under rules that bar a filibuster, meaning it could clear by majority vote in the Senate without Democrats needing the 60-vote supermajority now beyond their reach.

That strategy would leave in place the Senate language on abortion. It would allow health plans receiving federal subsidies in a new insurance marketplace to cover abortion, provided they pay for it only with money collected from policyholders. The House bill would have prohibited health plans receiving subsidies from covering abortions.

Stupak has been pushing for the stricter House provisions and claiming the dozen or so lawmakers are with him. But leaders appears to be moving to call his bluff.

Republicans have vowed to do everything they can to thwart the plan, and for the Democrats, some policy questions remain unsettled.

Obama already has moved to eliminate a couple of special deals in the Senate bill that turned off voters when they became public, including extra Medicaid money for Nebraska -- derided by critics as the "Cornhusker kickback." Late Wednesday the White House said the president was pushing to strip out a number of deals that remain, possibly including a provision sought by Sen. Max Baucus, D-Mont., providing Medicare coverage for residents of Libby, Mont., who suffer from asbestos-related illnesses because of a now-closed mining operation.

Politico first reported the list.

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Associated Press writers David Espo, Philip Elliott, Ricardo Alonso-Zaldivar, Alan Fram and Charles Babington contributed to this report.