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Pelosi Vows Passage of Health-Care Overhaul

"I don't know whose decision it was to put cap-and-trade first, but it was a huge mistake," said Rep. Mike Ross (D-Ark.), a conservative leader on the Energy and Commerce Committee. "It's a divisive issue. I felt like we had the opportunity to do one thing before the August recess . . . and everybody agrees we need to reform health care."

Pelosi defended her decision. "A number of the people who are having a problem now didn't vote for the climate bill," she said. Those include Ross, a leader of the conservative Blue Dog Coalition.

But freshman Rep. Tom Perriello (D), who represents rural parts of central and southern Virginia, voted for the cap-and-trade bill and is urging leadership to give him time to vet the health-care package with his constituents. "You want to come up with your best ideas and take them out on the road and make them better," he said, adding that the climate vote had already "unleashed a full range of emotions" back home.

Pelosi still held out the prospect of a floor vote this week. "The closer we get, the more you will hear about this difference and that difference," Pelosi said. "But I am very confident that we will be on schedule and we will be able to present a wonderful gift to the American people."

House leaders face two rebellious factions: the Blue Dogs, who want more cost savings in the health-care bill, and newly elected Democrats from moderate districts, who are protesting the surtax on wealthy households that would fund about half of the House bill.

Rep. Jared Polis, a first-term Democrat who represents the affluent Boulder, Colo., area, signed a letter with 20 fellow freshmen and one sophomore member objecting to the tax, which would apply to families with incomes of $350,000 and higher. Polis and his allies worry about the tax hitting small businesses, like the thriving Boulder Book Store and the Mountain Sun brewery in his home town.

Polis said he is encouraged that Pelosi is considering revising the surtax provision so that it hits only millionaire households, a threshold Obama endorsed at his news conference Wednesday. But Polis said he still worries about the small-business impact -- a question he knows Republican critics will raise, as well.

In several meetings with the speaker, the freshmen expressed their concern to Pelosi that the bill reinforces the image of Democrats as "the tax-and-spend party of the your grandfather," as Polis put it.

But the dissent has caused friction among Democratic leaders. The more interest House Democrats express in the more narrowly targeted Senate tax provisions, the more irritated Rangel appears. The chairman said he heard only the usual complaints about the surtax before he announced it, and he said he knew nothing about the health-care benefits tax, to be paid by insurers, that the Senate Finance Committee is considering.

"I don't know anything about the Senate. Never have. And they've told me if I can't say anything good, shut up," Rangel said.

But for Rangel and Pelosi, the fate of the House bill may rest with the Senate. At a minimum, House Democrats want to see where talks between Finance Committee Chairman Max Baucus (D-Mont.) and ranking Republican Charles E. Grassley (Iowa) will lead. If their efforts result in a bill this week, nervous House Democrats are expected to rally around its more moderate coverage provisions and more aggressive approach to cost savings.

"There are some members of our caucus who feel it's very important," House Majority Whip James E. Clyburn (D-S.C.) said.

Staff writers Perry Bacon Jr. and Ben Pershing contributed to this report.

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