WASHINGTON — Democrats in the House of Representatives struggled Friday to find enough votes to pass sweeping health care legislation, as lawmakers prepared for an all-day debate and perhaps a final vote on the bill Saturday.
President Barack Obama was scheduled to visit Capitol Hill early Saturday to give the House's 258 Democrats a pep talk and a push to back the top priority on his 2009 domestic agenda — although White House Press Secretary Robert Gibbs said Friday that Obama's schedule is subject to change.
Democratic leaders Friday found increasing numbers of their conservative and moderate caucus members — even some liberals — ready to vote no for a variety of reasons, including concern about the bill's abortion and immigration policies as well as qualms about its economic impact. In addition, the entire House will be up for election next year.
"There are many people who are still trying to get a comfort level that this is the right thing to do," said House Majority Leader Steny Hoyer, D-Md.
A lot of Democrats said they don't feel comfortable.
"I don't think there are 218 votes there right now," said Rep. Artur Davis, D-Ala., citing the number needed to pass the House. Davis, who's running for governor in Alabama next year, planned to vote no because of concerns about the bill's impact on business, and its funding.
If he goes to Capitol Hill Saturday, Obama is expected to reiterate the points in a statement the White House issued Friday giving the measure strong support.
The bill, it said, "meets the president's criteria for health insurance reform," and "will provide needed insurance reforms for Americans with insurance, expand coverage for those who do not have insurance, lower costs for families and businesses, and begin to reduce the nation's deficit."
The bill would create a government-run health insurance plan, or public option, to compete with private insurers. People could keep the coverage they now have, while a health exchange, or marketplace, would be created so consumers could easily shop for policies.
Insurers wouldn't be able to deny anyone coverage because of pre-existing conditions and couldn't charge anyone higher premiums solely because of gender.
The nonpartisan Congressional Budget Office estimates that, under this legislation, by 2019, 96 percent of eligible Americans would have health care coverage, up from the current 83 percent. The CBO estimates the plan's 10-year cost at $891 billion, financed by tax increases and spending cuts, and that it would reduce the federal budget deficit by $109 billion over 10 years.
House Democratic leaders hope to take an up-or-down vote on the proposal Saturday, but they warn that it could slip to as late as Tuesday.
Republicans will be allowed to offer an alternative on Saturday, but it's expected to be defeated easily in the Democratic-majority body.
No Republicans are expected to back the Democratic health care plan, and at least 25 Democrats are expected to oppose it.
That means Democratic leaders can't afford to lose many more.
At least 20 Democrats could walk away from the bill if their concerns about abortion aren't met. Currently, a 32-year-old law prohibits federal funds from being used for abortion except in cases of rape or incest, or in which a woman's life is in danger.
The House Democratic bill says that no federal money would be used for abortion services unless a pregnancy was the result of a rape, incest or endangered a woman's life. Only private funds, generated by the patients' private monthly premium payments, could be used to pay for abortion services under other conditions.
Neither side of the abortion debate is satisfied with that. Abortion rights advocates view the bill as having the potential to make it harder for women to get elective abortions from private insurance plans, while abortion opponents think it will be difficult to keep government money separate.
Democratic leaders have been in talks with members all week about the language, and are expected to produce new language clarifying the bill's position.
They're also trying to figure out ways to make the bill's policies on illegal immigration more acceptable.
Rep. Raul Grijalva, D-Ariz., said that many Hispanic lawmakers aren't happy with language backed by the White House that would prohibit illegal immigrants from buying health insurance within a proposed new marketplace, or exchange, even if they use their own money to purchase it from private companies.
"It's going to make it difficult for a lot of us — we communicated that to the leadership," Grijalva said. "It's difficult for me."
Other Democrats made it clear Friday that their unease is triggered by more than those two issues.
Davis was typical of members from conservative states. He thought the measure put too heavy a burden on business, and he disliked how the bill relies too heavily on higher income taxes on the wealthy.
One key revenue-raiser would be a surcharge on single filers with adjusted gross incomes of more than $500,000 and joint filers earning more than $1 million. A lot of Democrats have problems with that.
"The worst thing we could do during a recession is raise taxes, and this bill does just that," said Rep. Dan Boren, D-Okla.
"We need to pay for the bill through the health care system," Davis said, citing the Senate idea of taxing high-end insurance policies.
Even though the CBO said the bill would reduce the deficit over the next 10 years, some Democratic moderates were skeptical.
"I fear this bill will not reduce long-term costs, and our debt and deficits will suffer and balloon in the years ahead," said Rep. Bobby Bright, D-Ala., a freshman.
"I don't think they (Democratic leaders) have done enough to address the costs at the root of this problem," said Rep. Frank Kratovil, D-Md., another freshman. "I have genuine concerns in terms of the deficit."
The skeptics have one common thread: Most think the health care system needs fixing, but not this way. Many face potentially difficult re-election campaigns a year from now.
"While the health care reform bill before the U.S. House of Representatives has many positive elements, I believe that it does not do enough to slow the growth of health care costs and spending on care," said Rep. Suzanne Kosmas, D-Fla., also a first-termer.
"Health care reform legislation in the House has come incredibly far from where it was when we began this discussion," added Rep. Travis Childers, D-Miss., another freshman. "But we need to get this legislation right, not just get it fast."
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