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Four Democrats change sides, will vote for health-care bill

By Paul Kane, Lori Montgomery and Ben Pershing
Washington Post Staff Writer
Saturday, March 20, 2010; A01

Democratic leaders persuaded four more House members Friday to support a landmark health-care bill after initially opposing it, but they still need votes from a pivotal bloc of lawmakers who remain concerned that the proposal would open the door for the federal funding of abortions.

More than 200 House members have announced that they will vote on Sunday against the Senate's health-care bill. That leaves Democrats little margin for error as they attempt to gather the 216 votes needed for passage among the few dozen lawmakers who remain publicly undeclared.

Speaking to thousands of cheering supporters Friday at George Mason University, President Obama predicted a "tough vote" as he prepared to meet with House Democrats at the Capitol on Saturday. House leaders publicly predicted victory, but they kept private their own vote count as they continued to woo the undeclared Democrats.

The largest clutch of targets in that lobbying effort is antiabortion Democrats; garnering their votes would ensure the bill's passage, senior Democrats said Friday.

Those holdout lawmakers, most of whom hail from the Midwest and are Catholic, generally support the $940 billion package and its aim of providing coverage for 32 million more Americans. But they have voiced objections to how the Senate bill would handle insurance coverage of abortions.

"I want to vote for the bill. I just need to take care of a few issues before I can," Rep. James L. Oberstar (Minn.) said Friday.

In recent days, abortion opponents have gathered in meeting rooms and in huddles on the House floor, trading ideas and proposals, meeting with clergy and other religious officials, who are also deeply divided over the impact of the Senate bill's language. Those discussions continued deep into the night.

One potential compromise could include staging a vote, separate from the health bill, on stronger antiabortion provisions.

A few other Democrats voiced concern Friday about another issue, the bill's Medicare funding formulas for doctors and hospitals. Liberals such as Reps. Peter A. DeFazio (Ore.) and Michael E. Capuano (Mass.) said they would withhold their support unless the formulas were rewritten.

But House Speaker Nancy Pelosi exuded confidence, saying, "When we bring the bill to the floor, we will have a significant victory for the American people."

The House is expected to vote Sunday on a health-care bill that the Senate approved on Christmas Eve, along with a separate package of amendments.

All 178 Republicans are expected to oppose the bill, so they need to peel off 38 Democrats to defeat the measure, almost the exact number that opposed the first version of the legislation in November. "I just think it is clearly false momentum," said House Minority Whip Eric Cantor (R-Va.). "The votes still aren't there."

The White House said that, just this week, the president has spoken 64 times to wavering lawmakers, often in one-on-one meetings in the Oval Office. That work paid off Friday when Reps. John Boccieri (Ohio), Allen Boyd (Fla.), Suzanne Kosmas (Fla.) and Scott Murphy (N.Y.) announced their new support, bringing to seven the number of Democratic converts this week. Boccieri, Kosmas and Murphy are freshmen whom Republicans have targeted in November's elections.

The House has already confronted the hurdle of abortion once in this year-long health-care debate.

In November, antiabortion Democrats led by Rep. Bart Stupak (Mich.) successfully pushed an amendment that would bar people who receive federal subsidies for insurance from using that money to buy policies covering abortions. The House then passed its health-care bill.

The Senate's version included slightly less stringent restrictions. State-run insurance exchanges created under the legislation would be permitted to bar abortion coverage in the policies they offer, but recipients of federal tax credits for insurance would be permitted to buy policies with abortion coverage if it were available. Their tax credit would finance the bulk of their policy, but they would have to write a separate check, with their own money, to pay for the part of the policy that covers elective abortions.

"They'll send you two bills, and you'll write two checks," said Timothy Jost, a legal and health policy expert at the Washington and Lee School of Law who has studied the legislation. Jost, who appeared Friday at a news conference organized by antiabortion groups that support the Senate language, said he expects that few people will buy the extra coverage, particularly if they get insurance through an employer.

The Senate bill includes a number of often-overlooked provisions designed to reduce the number of abortions. They include a $250 million grant program for young pregnant women who need help with child care or college tuition, additional tax credits for adoptive parents, and $11 million for community health centers, which are barred by federal law from offering abortion services. Health and Human Services Secretary Kathleen Sebelius affirmed Friday the administration's commitment to that ban.

Despite claiming unity, the antiabortion bloc of Democrats has fissures within its ranks. Stupak is the staunchest critic of the Senate language, believing it would breach the 32-year-old Hyde Amendment prohibiting federal funding for abortion except in cases of rape, incest or to save the life of the mother.

Stupak said Friday he cannot support the legislation unless the House votes on a separate bill that would strip out the Senate's treatment of abortion and replace it with the language passed by the House. But House Rules Committee Chairwoman Louise Slaughter (D-N.Y.), who is also co-chair of the Congressional Pro-Choice Caucus, said, "There will be no separate vote" on abortion language.

Stupak also wants written assurance that the Senate would approve his abortion bill, and a promise from Obama that he would not sign the Senate bill until the abortion bill has been passed into law. But his provisions garnered only 45 votes in the Senate, making it almost impossible to win approval there.

Oberstar, an 18-term lawmaker, is studying the Senate's firewall segregating federal funds from abortion services to determine whether it is sufficient.

Rep. Marcy Kaptur (D-Ohio), a 14-term lawmaker from the Toledo area, is trying to forge a compromise that would bring most, if not all, of the group onboard to support the final bill. Although she would prefer another vote on Stupak's amendment, Kaptur pointed to the Sebelius letter and private talks with Senate Majority Leader Harry M. Reid (D-Nev.), co-author of the abortion language, as signs that a settlement could be reached.

"Some of the information we're getting is very reassuring," Kaptur said.

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