Democrats round up health bill votes

By Lori Montgomery and Shailagh Murray
Washington Post Staff Writer
Saturday, November 7, 2009

House Democratic leaders pushed with mounting confidence Friday toward a historic vote on expanding the nation's health-care system, and President Obama joined an intense last-minute lobbying campaign to pick up the last few votes needed to secure the measure's passage.

The fate of the trillion-dollar health plan hung Friday on the outcome of a showdown with about two dozen anti-abortion Democrats, who wanted to explicitly prohibit federal funds from paying for abortion through new, federally sponsored health-insurance plans. The U.S. Conference of Catholic Bishops, which was backing the holdouts, circulated a letter late Friday arguing that the legislation could otherwise force individuals who oppose abortion to indirectly subsidize the procedure with their tax dollars.

The much larger group of Democrats who support abortion rights said that they were willing to accept only limited revisions to the health-care package, and House leaders were still scrambling late Friday to find a compromise that would pass muster with the party's abortion-rights wing while winning the blessing of the bishops.

"The Catholic bishops are a very important group, to especially a lot of the Catholic members and people from districts with large Catholic populations," said House Energy and Commerce Chairman Henry A. Waxman (D-Calif.). "The problem is that we have a very fragile situation. You give somebody a vote one way and we lose people on the other side."

House Speaker Nancy Pelosi (Calif.) has little margin for error: Democrats control 258 seats and need 218 votes for passage, meaning she can afford to lose only 40 members of her caucus. Obama delayed a visit to Capitol Hill until early Saturday, but the president, his top aides and at least two Cabinet secretaries worked the phones Friday, trying to win over wavering lawmakers. Asked if she had the votes for passage, Pelosi said only: "We'll see when we get to the floor."

House leaders said they were inclined to resolve the abortion dispute by adopting a compromise offered by Rep. Brad Ellsworth (D-Ind.), who opposes abortion. That would designate a private contractor to ensure that federal dollars were not used to pay for abortion services under the proposed government-run plan or any other insurance plan offered through a marketplace that would be created by the legislation.

It was not clear that the Ellsworth compromise would satisfy all parties. Waxman said the bishops were seeking language that would have the effect of discouraging every insurance plan from covering abortion services. But Democratic leaders were hoping that the compromise would deliver enough votes to pass the bill.

Rep. John P. Murtha (D), a Catholic who represents a heavily Catholic district in central Pennsylvania, said he would support the measure if the compromise were added. "The way they've worked it out, I'll be fine," he said.

A separate dispute over immigration policy was still festering, although it took a back seat to the battle over abortion. Hispanic lawmakers said they had received assurances from House leaders that the bill would not be changed to bar undocumented workers from purchasing insurance through newly created insurance marketplaces. Language promoted by the White House and adopted by the Senate Finance Committee would establish such a barrier.

Hispanic lawmakers said they remained concerned, however, that Republicans would attempt a parliamentary maneuver to add the provision to the bill -- and that the maneuver would attract enough votes from conservative Democrats to win approval. Republican aides declined Friday to say whether they were planning such a move.

House leaders were working late Friday to secure assurances from about 20 Hispanic Democrats that they would vote for the health-care package regardless. Hispanic lawmakers, for their part, were seeking Pelosi's commitment to try to prevent Democratic defections. Leaving a meeting in the speaker's office Friday morning, Rep. Raul M. Grijalva (D-Ariz.) said: "We have the support of leadership to defeat that."

Other undecided lawmakers had more fundamental concerns about the health-care package. Rep. Jason Altmire, a second-term Democrat who represents a blue-collar district in suburban Pittsburgh, was the focus of an aggressive lobbying effort Friday, taking calls from Obama, Pelosi and White House Chief of Staff Rahm Emanuel, as well as Health and Human Services Secretary Kathleen Sebelius and Education Secretary Arne Duncan.

A former hospital association executive, Altmire said the White House was appealing to his firsthand knowledge of the insurmountable flaws in the current system, and encouraging him to use that expertise to explain the benefits of reform to his deeply skeptical constituents.

"They're pulling out all the stops," said Altmire, who opposes the bill's proposed surtax on the wealthy, among other provisions. "I don't think there would be this drama if they had the votes."

For others, the lobbying campaign was working. Rep. Jared Polis of Colorado, who voted against the package in the Education and Labor Committee, threw his support behind the measure Friday, largely because House leaders had adjusted the surtax to apply only to family income over $1 million, rather than the $350,000 threshold set earlier. The new version, Polis said, has "become a much more favorable bill for small business."

As for the 'no' votes . . .

Amid the frenzied horse trading, the hard "no" votes wandered the ornate halls of the Capitol serenely unaccosted. Democratic Rep. Artur Davis, who is running for governor of Alabama and thinks the bill costs too much, lingered outside the House chamber, leisurely chatting on a cell phone. Rep. Charlie Melancon (D-La.), who is also running statewide and voted against the House package in the Energy and Commerce Committee, cheerfully complained to reporters that he was "feeling neglected."

The "no" votes, who numbered around 25, gained at least one member Friday: Maryland Rep. Frank M. Kratovil Jr., a freshman Democrat who represents the traditionally Republican Eastern Shore. After reading the revised package House leaders unveiled last week, Kratovil said the bill is better than it was in July, but it still costs too much and would impose too heavy a burden on small businesses, many of which would be required for the first time to offer health insurance to their workers or face a stiff fine.

Kratovil said he had not received any calls from the White House. But "at this point," he said, "there's not much point in lobbying me."

© 2009 The Washington Post Company