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Health-Care Overhaul 2010

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House may try to pass Senate health-care bill without voting on it

The House of Representatives passed landmark legislation to overhaul the nation's health-care system, approving a Senate bill and a separate package of amendments.

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As he addressed a crowd of more than 1,400, Obama repeatedly called on lawmakers to summon the "courage to pass the far-reaching package." He painted the existing insurance system as a nightmare for millions of American who cannot afford quality coverage.

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The president lashed out at Republican critics who have argued that the health-care initiative would undermine Medicare, and he argued that the measure would end "the worst practices" of insurance companies.

"I don't know about the politics, but I know what's the right thing to do," he said, nearly shouting as the crowd cheered. "And so I'm calling on Congress to pass these reforms -- and I'm going to sign them into law. I want some courage. I want us to do the right thing."

Asked whether he was reconsidering his position, Kucinich demurred. But Sen. Sherrod Brown (D-Ohio) said Kucinich is coming under intense pressure from Ohioans who want Congress to act, and from his colleagues in Washington.

"All of us -- the governor, the congressional delegation, the president -- are making clear to Dennis that we won't have another chance for a decade if this doesn't happen," Brown said.

Persuading liberals such as Kucinich to support the Senate bill is critical to the Democratic strategy, which has been rewritten since January, when Democrats lost their supermajority in the Senate. The Senate Democratic caucus, reduced to 59 seats, lost its ability to override Republican filibusters and soon abandoned plans to pass a revised version of the health-care bill that would reflect a compromise with House leaders.

As House leaders looked for a path that could get the Senate legislation through the chamber and onto Obama's desk, conservatives warned that Pelosi's use of deem-and-pass in this way would run afoul of the Constitution. They pointed to a 1998 Supreme Court ruling that said each house of Congress must approve the exact same text of a bill before it can become law. A self-executing rule sidesteps that requirement, former federal appellate judge Michael McConnell argued in a Wall Street Journal op-ed.

Democrats were also struggling Monday to put the finishing touches on the package of fixes. Under reconciliation rules, it is protected from filibusters and could pass the Senate with only 50 votes, but can include only provisions that would affect the budget.

Democratic leaders learned over the weekend that they may not be able to include a number of favored items, including some Republican proposals to stem fraud in federal health-care programs and a plan to weaken a new board that would be empowered to cut Medicare payments.

Rep. Chris Van Hollen (Md.), the Democratic leader tasked with protecting politically vulnerable incumbents, said Republicans would twist the nature of the health-care vote, no matter how the leadership proceeds. He defended the deem-and-pass strategy as a way "to make it clear we're amending the Senate bill."

Without that approach, Van Hollen warned, "people are going to try to create the impression that the Senate bill is the final product, and it's not."

Undecided Democrats appeared unconcerned by the flap. Rep. Bart Gordon (D-Tenn.), a retiring lawmaker who opposed the original House bill and is undecided on the new package, mocked Republican criticism of the process. Ultimately, he said, voters will hold lawmakers responsible for any changes in law.

"I don't think anybody's going to say that we didn't vote for the bill," he said.

Staff writer Peter Slevin in Ohio contributed to this report.


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