Democrats Inch Closer to Pushing Health Reform Over Finish Line

With the hours ticking down before a pivotal vote on the fate of health reform, President Obama made a trip to Capitol Hill Saturday to rally the House Democratic caucus one final time in his push to persuade undecided Democrats to vote for the bill.

“We have been debating health care for decades,” Mr. Obama told members of his caucus in an address broadcast from the Capitol Visitors Center. “It is in your hands. It is time to pass health care, and I am confident you are going to do it tomorrow.”

More than a year in the making, it was yet one more unusual Saturday in the nation’s capital in the battle over health reform. Outside the Capitol, thousands of demonstrators protested against the bill. Inside and behind the scenes, the wrangling for votes continued as House Speaker Nancy Pelosi and her team continued working to get the 216 votes needed for passage in an expected Sunday vote.

Many of the day’s events were captured on video as seen here on the New York Times Prescriptions blog.

And there were other significant developments in the remaining hours as well.

Democratic leaders had spent much of the week defending the idea of approving the bill through a method known as “deem and pass” in which House lawmakers would avoid a direct vote on the Senate bill and instead “deem” it passed as part of vote on reconciliation bill with amendments.

But on Saturday, the House Rules Committee dropped that plan, instead setting up direct votes on both the Senate and the reconciliation bills. The House is now expected to vote first on the reconciliation bill, and then on the Senate bill itself.

With a potential cliffhanger in the works for Sunday, the vote-counting continued, in the Capitol and the media, as House leaders aimed toward the 216 votes. While no one — except maybe the politicians themselves — knows how many more votes are needed, several accounts suggested that Democratic leaders were still short of the threshold and reportedly needed to secure fewer than 10 votes for Sunday. The New York Times and Washington Post are charting the votes in play; Politico’s Live Pulse blog is updated each time an undecided Democrat announces a decision.

The $940 billion bill would expand coverage to 32 million Americans over the next decade through Medicaid and subsidies to buy insurance. It also would ban insurance companies from denying coverage for pre-existing conditions, cut some of the growth in Medicare costs and begin to change the way doctors and hospitals are paid for delivering care.

Once again, abortion remains a sticking point.

Several of the anti-abortion House Democrats voted for the House bill only because it contained tighter abortion restrictions than the Senate bill; they’re resisting voting for the Senate bill now. Several news organizations reported Saturday that President Obama is considering including an executive order that would make it clear that federal money would prohibit the use of federal money to pay for abortions, hoping to satisfy some members of the anti-abortion bloc.

Talks reportedly broke off with Rep. Bart Stupak, D-Mich., who had been seeking even stricter language about restricting the use of federal funds for health insurance plans that cover abortion. But one anti-abortion lawmaker, Rep. Chris Carney, D-Pa., said he would vote for the bill.

After lawmakers in several states complained about differences in Medicare reimbursement rates, Democrats announced a new agreement on that issue. Part of it included an announcement by Health and Human Services Secretary Kathleen Sebelius that the National Academy of Sciences would review the disparities and make recommendations about how to change it.

Meanwhile, House Republicans crowed over the change in the Democrats’ approach toward approving the bill, saying it was overdue. And they continued to make the case that Democrats would pay at the polls in November if they pass reform on Sunday.

“I don’t know, quite frankly, whether victory will come on the third Sunday in March or on the first Tuesday in November, but victory will come,” House Republican Conference leader Mike Pence, R-Ind., said Saturday afternoon.

Lea Winerman contributed to this report.