Health-care vote may hinge on abortion issues

216 votes needed to pass; cliffhanger expected on Sunday

Understanding the health care overhaul

If enacted, the reconciliation bill combined with the Senate-passed bill would:

-Spend $794 billion on expanding insurance coverage

-Expand Medicaid coverage to 16 million additional people

-Provide coverage through an insurance exchange to 24 million people

-Reduce the number of uninsured by 32 million people


By Lori Montgomery and Paul Kane

House leaders decided Saturday to stage a vote on the Senate's health-care bill, dropping a much-criticized strategy of allowing lawmakers to "deem" the landmark legislation into law. But the outcome of that vote remained in doubt as a pivotal bloc of Democrats continued to withhold its support over fears that the bill would open the door to the federal funding of abortion.

House leaders were working to secure their votes late Saturday with the promise of an executive order affirming President Obama's commitment to a longstanding ban on public abortion funding except in cases of rape or incest, or to save the life of the mother. Rep. Marcy Kaptur (D-Ohio), a key antiabortion vote, said she thought the document would be insufficient to bring the entire group of about 10 antiabortion Democrats onboard.

Senior Democrats predicted a cliffhanger when the House is expected to vote Sunday night, saying they are likely to clear the 216-vote threshold for final passage by the narrowest of margins. Democratic leaders huddled in the office of House Speaker Nancy Pelosi (D-Calif.) late into the evening, reviewing the final list of commitments.
 
Throughout the day, thousands of angry protesters milled outside the Capitol; some hurled insults at black and gay lawmakers and shouted at Democrats to "kill the bill!" Meanwhile, Obama made a final pitch for reform, exhorting wavering lawmakers to rise to the aid of millions of uninsured Americans by taking "the single most important step that we have taken on health care since Medicare" was created in 1965.

Pelosi's decision to have the House hold two votes, one on the Senate bill and one on a separate package of revisions, reversed an apparent plan laid earlier in the week, when Pelosi said she preferred not to force rank-and-file Democrats to cast a separate vote on the unpopular Senate bill. Republicans had accused her of trying to dodge responsibility for health reform, and even some Democrats complained about the move.

On Saturday, House Minority Leader John A. Boehner (R-Ohio) hailed Pelosi's decision as "a victory for the American people." He vowed to force Democrats to stand up, one by one, to announce their vote for the Senate bill, which contains a number of politically fraught provisions, including a special deal for Sen. Ben Nelson (D-Neb.) that would require taxpayers nationally to pay for an expansion of Medicaid in his state.
 
"Now House Democrats will face two crucial votes tomorrow," Boehner said in a statement. "They will have to vote on the Senate-passed bill, stuffed with tax hikes, Medicare cuts, and infamous backroom deals -- and they will vote on something worse: their 'fix' with more taxes, more Medicare cuts, and new special deals."
 
For the first time since Wednesday, Democrats lost a vote. Rep. Zack Space, a second-term lawmaker from a swing district in eastern Ohio, said he would vote "no" Sunday, a switch from his vote for health care in November.

"This is not over," Boehner told reporters. "They do not have the votes yet. We've got to keep working to make sure that they never, ever, ever, ever get the votes to pass this bill."
 
House passage would immediately send the slightly narrower Senate version of the health bill to the White House for Obama's signature, allowing the president to claim victory on his most important domestic initiative. The package of revisions would go to the Senate for action next week under special rules that protect it from a GOP filibuster. On Saturday, Senate Majority Leader Harry M. Reid (D-Nev.) publicly assured House Democrats that he has the votes to approve their changes, making "a good law even better."
 
In a fiery closing argument for health reform, Obama urged lawmakers to focus not on the impact to his presidency or even the impact to their own political fortunes when they cast what he acknowledged will be a "tough vote." Instead, Obama reminded them of the nation's 100-year quest for universal health coverage, and told them to vote against the bill only if "you honestly believe in your heart of hearts" that it is not a "vast improvement over the status quo."

"This is a middle-of-the-road bill that is designed to help the American people in an area of their lives where they urgently need help," Obama told Democrats in the underground Capitol Visitor Center. "We have been debating health care for decades. . . . It is in your hands. It is time to pass health care, and I am confident you are going to do it tomorrow."