WASHINGTON — President Barack Obama, claiming that momentum is building for a historic overhaul of the nation's health insurance system, on Friday postponed a trip to Asia so he can stay in the capital next week to twist arms in Congress.
Democrats in Congress said they didn't yet have the votes locked up to pass the legislation, but they were growing more confident that they could get a package through. "We're in a good place," said House Speaker Nancy Pelosi, D-Calif.
"The president feels some momentum on this issue," White House Press Secretary Robert Gibbs said.
After facing widespread public opposition for months, Gibbs said the tide started to turn in favor of the Democratic proposal when insurance companies began announcing big increases in health insurance premiums several weeks ago. That helped fuel a backlash and gave "new life" to the proposals stalled in Congress, he said.
Public opinion polls, however, haven't shown a turn in favor of the legislation, which is designed to help 31 million people get health insurance and to regulate rates for those who already have it.
The Gallup Poll, for example, found this week that 45 percent supported the legislation and 48 percent opposed it, essentially unchanged from a December survey and a slight drop in support since January.
"They are twisting themselves into pretzels trying to figure some way to get this health care bill passed when they know the public is overwhelmingly against it," said Sen. Mitch McConnell, R-Ky., his party's leader in the Senate.
With popular opinion closely divided, and the votes in Congress still uncertain, Obama said he'd travel to suburban Cleveland on Monday to make his third health overhaul pitch to the public in a week, after trips this week to Pennsylvania and Missouri.
He also announced that he'd postpone a long-planned March 18 departure for Indonesia and Australia until March 21 so he can remain in Washington to talk with wavering lawmakers if necessary.
That also meant that the White House dropped its March 18 deadline for the House of Representatives to approve the Senate-passed health bill. Obama has set repeated deadlines for congressional action dating to last summer, only to see them missed.
Pelosi said she was "exhilarated" about the legislation's prospects, but she stopped short of saying she had the 216 votes needed for passage. She said House floor votes on the measure were expected by the end of next week, but she remained uncommitted to any precise timetable.
"We stand ready to stay as long as necessary," she said.
The House is expected to vote first on the health legislation that the Senate passed Dec. 24. Then it will consider separate legislation under budget "reconciliation" rules to make changes in the Senate-passed version that would encourage more House Democrats to accept the amended bill.
Once the House passes the original Senate bill, however, it will become law as soon as Obama signs it, while the measure that makes changes to it will have to pass the Senate before those changes can be signed into law.
A key test is whether House Democrats will sign off on the original Senate bill — likely sending it to be signed into law as required by the Senate parliamentarian — while trusting that the Senate later will accept changes in the second bill. Many House Democrats don't trust the Senate.
"Two hundred and ninety times this Congress, the Senate has failed to act on bills passed by the House," said Rep. Anthony Weiner, D-NY. "Fool us once, shame on you; fool me 290 times, shame on us."
Democrats still face other challenges beyond rounding up votes in the House.
First, members are still waiting for an analysis of the second bill from the nonpartisan Congressional Budget Office, which is expected shortly.
Thirty-nine House Democrats opposed the version of the bill that the House passed in November and most have signaled that they still do, because they see it as costly and as more government intrusion.
"Look at the history of the Congressional Budget Office numbers. They're often way off," said Rep. Gene Taylor, D-Miss.
Also, 10 to 12 House Democrats are said to be concerned about Senate language on abortion that's less restrictive about the use of federal money than what the House passed Nov. 7. Indications are that the Senate's position will prevail, though no decisions have been made yet.
The reconciliation, or amending, legislation also is expected to include a plan to overhaul the nation's student loan system, allowing the government to lend directly to qualified students.
The major health provisions of the amended bill are expected to mirror proposals that Obama suggested last month. Pelosi's office said these points would be in the bill, though some details could change slightly:
- Affordability. Both the House and Senate bills provided insurance subsidies for families of four with annual incomes of up to $88,000. The House would have had such families pay no more than 12 percent of their incomes for health insurance; the Senate capped it at 9.8 percent. Obama proposed a 9.5 percent limit.
- Medicare prescription drugs. Medicare drug plans now stop paying for prescriptions each year once the government and the consumer have spent $2,830 on them. The benefit then resumes once annual out-of-pocket spending reaches $4,550.The bill would close that so-called "doughnut hole."
- Taxes. The House wanted to impose a tax surcharge on wealthy people; the Senate preferred an excise tax on high-end insurance policies. The amended bill accepts the excise tax, but it also accepts the delay Obama proposed — an effective date of 2018, rather than the Senate's 2013 — and raises the limit on premiums that are exempt from the tax to $10,200 for singles and $27,500 for families.
The bill also would expand the Medicare payroll tax to unearned income. Obama proposed adding a 2.9 percent tax on income from interest, dividends, annuities, royalties and rents for singles who make more than $200,000 a year and families that earn more than $250,000.
- Medicaid. Obama was generous to states with their Medicaid bills, promising full support for newly eligible people from 2014 to 2017, with a gradual decline after that.
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