WASHINGTON — With Democrats increasingly confident they have enough support, the House of Representatives planned for an historic vote Sunday that would enact the most dramatic changes in the nation's health care system in decades.
As a sign of that confidence — and to quiet concerns among Democrats as well as Republicans — House leaders Saturday abandoned a plan to approve the Senate's health care legislation without a direct vote.
President Barack Obama held a last-minute rally with the House’s 253 Democrats. He urged them to vote for the legislation because "good policy makes good politics." But he also said he recognized that voting for the bill in the face of often rowdy protests was a difficult step.
Behind closed doors, House leaders worked to round up the last undecided votes they need to reach the 216 needed for passage.
House Speaker Nancy Pelosi, D-Calif., was confident about Sunday’s prospects, saying flatly, “We will pass the bill.”
The mood at the Capitol was unusually calm, but not without last-minute drama.
With Tea Party demonstrators rallying outside to protest the legislation, the House Rules Committee dropped a controversial plan that would have "deemed" Senate-approved health care legislation passed as part of a resolution setting rules of debate. The maneuver had been seen as a way to allow Democrats to avoid voting on the bill, but Democrats were uneasy about the prospect. Rep. William Lacy Clay, D-Mo., said it looked like a "back door deal."
"We've had sanity prevail here," said Rep. Dennis Cordoza, D-Calif. "This is something that should be done in the light of day."
Under the arrangment agreed to Saturday, the House will vote first on a bill that contains proposed changes to health care legislation the Senate passed Dec. 24. Those changes would then be sent to the Senate for approval.
Then the House would vote on the Senate legislation itself. If passed, the bill would then be sent to Obama for his signature.
While the plan strongly suggested Democrats felt they had the momentum to pass the bills, Pelosi and others continued to meet with a handful of anti-abortion Democrats who'd refused to support the bill. Several alternatives were proposed, including an executive order reiterating federal policy toward abortion would not change, or a separate vote to toughen abortion restrictions.
A separate vote on abortion language will not happen Sunday, Rep. Diana DeGette, D-Colo., a leader of the abortion rights forces, said.
The legislation would require most employers and consumers to obtain coverage by 2014 or face penalties. Families earning up to $88,000 a year would be eligible for help paying premiums. Consumers would be able to use new exchanges, or marketplaces, to easily shop for coverage.
Senate Republicans have voewed to fight the likely House changes, but the Democratic strategy forbids a filibuster and only 51 Senate votes are needed to enact it into law. Democrats control 59 seats in the Senate.
The nonpartisan Congressional Budget Office estimates the plan would reduce the federal deficit by $138 billion over 10 years. It includes a series of tax increases, including higher Medicare payroll taxes on the wealthy and a new tax on dividend, interest and other unearned income.
The House considered its own version of health care in November, and 219 Democrats and one Republican, Rep. Joseph Cao of Louisiana, backed the bill. Cao has said he’s opposed this time, and at least two Democrats who voted "yes," Reps. Stephen Lynch, D-Mass., and Michael Arcuri, D-N.Y., are expected to switch to "no."
At least five Democrats who voted "no" have said they will vote "yes," but the margin for passage remains perilously thin _ dependent on anti-abortion Democrats who voted "yes" in November to remain committed to passage.
Democrats were hopeful anti-abortion Democrats could be swayed to stay with their November vote.
“We’re hopeful a deal can be worked out,” said Rep. James Langevin, D-R.I., an anti-abortion Democrat who plans to vote for the measure.
House Democratic leaders Saturday urged skittish colleagues to consider the bill not only as a health care measure, but legislation that would help create jobs, boost the economy, reduce deficits and help the Obama presidency thrive.
“The vote this week will demonstrate clearly which side Democrats are on in the United States Congress,” said House Democratic Caucus Chairman John Larson of Connecticut.
“This bill is the biggest deficit reduction bill that any member of Congress is going to have the opportunity to vote on,” added House Majority Leader Steny Hoyer, D-Md.
That was unpersuasive to some Democrats from conservative districts. “I just can’t sell this. People feel this is going to change their current plans, even though it’s not, and I just can’t get beyond that,” said Rep. Bobby Bright, D-Ala.
Others, however, moved into the "yes" column.
Rep. Allen Boyd, D-Fla., said the bill “will successfully reduce the deficit more than any other policy enacted since 1993,” when Democrats pushed a half-trillion dollar deficit reduction plan through Congress.
Others made it clear they planned to vote for the bill and sell the vote as repairing a broken system.
“A 'no' vote perpetuates the status quo where insurance company bureaucrats make life and death decisions in the name of a profitable bottom line,” said Rep. John Boccieri, D-Ohio, who said he would to switch his vote to "yes." “A no vote condemns nearly 40,000 people in our district to a life's choice between the lesser of two evils: skyrocketing premiums or possible bankruptcy should they become ill.” (Lesley Clark contributed to this story)
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