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, in a politically charged visit to Capitol Hill, tried to rally support for the measure by telling the House's 253 Democrats to ignore the gloom-and-doom midterm election scenarios that Republican leaders and pundits have suggested if they pass the health care measure.
"You're here to represent your constituencies, and if you think your constituencies honestly shouldn't be helped, you shouldn't vote for this," Obama said. "But if you agree the system's not working for ordinary families...then help us fix this system."
"Don't do it for me. Don't do it for the Democratic Party," Obama said. "Do it for the American people."
Before Obama's arrival on the Hill, House leaders worked feverishly 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 pace was furious and sometimes heated both inside and outside the Capitol where thousands of Tea party demonstrators gathered to protest the bill. Some demonstrators hurled racial and sexual insults at Democratic lawmakers.
Some demonstrators called Rep. John Lewis, D-Ga., "nigger" as he left a nearby House office building and other used the word "faggot" as they confronted Rep. Barney Frank, D-Mass. Lewis, a noted civil rights leader, is black and Frank is openly gay.
Inside the building, House Democratic leaders dropped a controversial plan that would have "deemed" Senate-approved health care legislation passed as part of a resolution setting rules of debate but would not have required House members to vote directly on the legislation.
House Majority Leader Steny Hoyer, D-Md., Democrats abandoned "deem and pass" because the party leadership is confident that the votes to pass the health care bill.
"We determined that we could do this and it's a better process," Hoyer told reporters. "We believe we have the votes."
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., a supporter of the legislation. "This is something that should be done in the light of day."
Hoyer said the House on Sunday would vote first on a bill that would change parts of the health care bill the Senate passed on Christmas Eve. Then, if that bill passes, the House will vote on the Senate health care bill.
The second vote would send the Senate bill to Obama to sign while the first bill would goes to the Senate for a vote under so-called "reconciliation" rules that prohibit a filibuster and would require only 51 votes for passage. The Democrats control 59 Senate seats.
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.
Meanwhile, House Democratic leaders hope to attract more nervous Democrats by showing them a letter from Senate Majority Leader Harry Reid, D-Nev., and signed by more than 50 Democratic senators that says they'll support the reconciliation bill.
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.
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."
Five Democrats who voted "no" say 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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