Democrats more hopeful on health-care vote

By Shailagh Murray and Lori Montgomery
Washington Post Staff Writer
Saturday, March 13, 2010; A01

Democratic leaders on Friday stoked expectations that the year-long debate in Congress over health care may be coming to an end, after President Obama delayed his upcoming trip to the South Pacific and House leaders indicated they could deliver a final bill for his signature by the end of next week.

The House is preparing to vote, perhaps Friday or next Saturday, on the legislation that passed the Senate on Christmas Eve, and House Speaker Nancy Pelosi (D-Calif.) said she was "delighted that the president will be here for the passage of the bill. It's going to be historic."

Obama was scheduled to depart Washington on Thursday for Indonesia, Guam and Australia. Instead, he condensed the visit and will now leave March 21, planning to spend the extra days helping to lock down House votes for the bill, White House press secretary Robert Gibbs said.

Obama's delayed departure marks the third time he has put off a trip to use his powers of persuasion to lobby on behalf of legislation. But there are no guarantees that he can soothe the concerns of wavering House Democrats, who are not yet ready to commit to the Senate bill.

The health-care debate has been marked for months by false hints of resolution. Although House Democrats believe they may finally be on the brink of victory, they lack iron-clad commitments from the needed 216 lawmakers. The biggest worry for the caucus is the Senate, where Republicans are blocking a host of major bills and where action looms once the House completes its work.

"At the end of the day, members of the House are being asked to trust an untrustworthy body," said Rep. Anthony Weiner (D-N.Y.), who still has qualms about the Senate bill. But, he added, "the very idea that we're talking about the endgame tactical stuff is a sign that, I think, there's increasing confidence we're going to get this done."

If the House passes the health-care bill, it will turn immediately to a package of fixes to that legislation. That measure must then go to the other side of the Capitol, where it is expected to face GOP parliamentary challenges. Some Democrats are worried that the Senate drama will unfold after Obama leaves for Asia and have said privately that they would prefer that he cancel his travels.

But Gibbs said Obama views the trip as a priority. "The president believed it was important to give the issue of health care and the effort to get votes on health care a few more days, but also believes, as do those leaders in Congress, that it's important to keep this trip on our schedule," Gibbs told reporters Friday.

Gibbs said Obama's family -- his wife, Michelle, and their daughters, Malia and Sasha -- will no longer make the trip. It had been scheduled during the girls' spring break from school, which prompted questions to Gibbs about whether it was basically a vacation. "It's not a vacation at all," he said Thursday.

The House Budget Committee is scheduled to kick off the climactic week on Monday afternoon, even though Democratic leaders said Friday that they had not yet completed the fixes package. That measure is being written under reconciliation rules, to protect it from a Senate filibuster, and must meet specific budget requirements.

Major provisions in the package include increased subsidies for uninsured people, more-generous Medicaid funding for states, and a reduction in the excise tax on high-value insurance policies, which the Senate proposed as its primary revenue source.

The fixes package also will include an overhaul of the student loan system, expanding funding for Pell Grants. But Rep. George Miller (D-Calif.), chairman of the House Education and Labor Committee, told reporters Friday that the Pell Grant initiative needs to be scaled back significantly because of new budget estimates showing it would cost more and save less than originally projected. "We're redoing the whole bill," he said.

As Pelosi and her leadership team scoured the Democratic caucus for votes this week, they confronted smaller problems. Obama's leverage could be critical to wooing Democrats whose problems with the Senate bill are serious but narrow, and those are unlikely to be addressed in the package of fixes.

Rep. Luis V. Gutierrez (D-Ill.) said he would vote against the health-care bill if it contains provisions barring undocumented workers from buying insurance in government exchanges, even with their own money. "As it stands, I'm not going to vote for it. And they know that," he said.

Gutierrez was among a group of black and Hispanic lawmakers who met Thursday with Obama at the White House. Gutierrez said the meeting left him "hopeful that the president can take steps that would garner my support for this health-care proposal."

Democratic members of the House Ways and Means Committee have raised concerns about an independent Medicare commission that the Senate bill would establish, arguing that it would usurp congressional authority over Medicare spending. Rep. Richard E. Neal (D-Mass.), a senior Ways and Means member, has threatened to vote against the Senate bill unless Congress's control over Medicare hospital reimbursements is fully retained.

Rep. Michael E. Capuano (D-Mass.) outlined his objections on Thursday in a lengthy letter to supporters. Capuano, who, like Neal, voted for a House health-care bill in November, said he fears that Senate cost-saving measures could cost Massachusetts billions of dollars in Medicare and Medicaid funding.

Rep. Robert E. Andrews (D-N.J.), recruited by House leaders to help sell the legislation, said Obama's decision to delay his trip would help keep wavering lawmakers focused on the big picture: passing the most significant overhaul of the nation's health-care system in decades.

"We need him to do what he's done really well the last couple weeks, which is to go out and explain to the public what the stakes are. Be available to our members to reiterate the case for them," Andrews said.

House leaders hope to receive a final cost estimate for the reconciliation package by Monday and said they would then post the text online. Pelosi has pledged to give lawmakers and the public at least 72 hours to study it before the House votes on it; that clock will start ticking when the measure is made public, aides said.

Among those studying the details most closely will be senators of both parties, who plan to immediately begin seeking the guidance of Alan Frumin, the Senate parliamentarian.

Frumin is the arbiter of whether the reconciliation package will pass muster under Senate rules that limit its contents to provisions that affect the budget. Frumin's opinion carries no weight in the House, but it will carry considerable influence if the measure reaches the Senate.

Meanwhile, the machinery of the reconciliation process will grind into action Monday afternoon, when the House Budget Committee is scheduled to cast the first vote on the fixes package. It would then go to the House Rules Committee, where the final legislation will be assembled. Aides said that process will probably take place Thursday, with a vote on the House floor possible that day but more likely on Friday or Saturday.

Senate Republicans have secured a preliminary ruling from Frumin that appears to limit Pelosi's options for bringing the Senate bill and the fixes package to the floor. Democratic leaders had considered combining the measures, so that members who don't like the Senate bill could avoid a vote on it. But a reconciliation bill cannot make changes to legislation that has yet to become law, Frumin said.

"I know the other side's been playing around with all things they might somehow be able to do," Senate Minority Leader Mitch McConnell (R-Ky.) told reporters. "That isn't going to be one of them."

Pelosi shrugged off the ruling, accepting that the Senate bill would have to move first, and independently. "It isn't going to make any difference except maybe the mood that people are in," she said Friday. "The fact is that once we pass it in the House, it's going to be the law of the land."

Staff writer Michael D. Shear contributed to this report.

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