Democrats Count Votes, Deal With Health Reform Hurdles

Halfway through what’s been deemed a make-or-break week for health care reform, the media’s vote-counting has begun in earnest, along with estimating the measure’s chance of success.

President Obama’s overhaul push picked up new traction Wednesday with the announcement from Rep. Dennis Kucinich, D-Ohio, that he would support the legislation, despite his earlier opposition to the lack of a government-run public option that could compete with private insurance.

“You do have to be very careful that the potential of President Obama’s presidency not be destroyed by this debate,” Kucinich told reporters, according to the AP. “Even though I have many differences with him on policy, there’s something much bigger at stake here for America.”

For those keeping track of the political scramble, The Washington Post has a graphic of how each House member voted on the original bill in December and which way they’re leaning now, while The New York Times focuses on the most likely swing votes.

The Times also identifies which of the undecideds are fiscally conservative Blue Dog Democrats, which were members of Rep. Bart Stupak’s anti-abortion voting bloc, and which are up for reelection in a contested district. The Hill’s “Whip Count” blog post is also tracking House members’ likely votes, with explanations for each.

House Speaker Nancy Pelosi needs to tally 216 votes to pass both the reconciliation bill with “fixes” to the original Senate bill, and the original Senate bill itself, before the Senate can take up the reconciliation bill. MSNBC.com has a seven-step guide to what they call the confusing “procedural dance” in progress.

As Pelosi works to round up votes, several issues remain stumbling blocks, including:

Cost — and Timing
The Congressional Budget Office still has not released a cost estimate for the Democrats’ package of changes to the Senate bill, and reports on Tuesday attributed the delay to the problem of getting the final bill to reduce the federal deficit by enough money.

In order for the package of amendments to qualify as a reconciliation bill, it must reduce the deficit by $2 billion more than the original Senate bill, over five years. But many of the changes House Democrats want to make cost money, such as offering more subsidies for low- and middle-income Americans to purchase insurance. So Democratic leaders have been going back and forth with the CBO to find the combination of changes that will work.

Meanwhile, some fiscally conservative Blue Dog Democrats say they will wait to see the final bill, and its cost, before they decide how to vote. Speaker Pelosi has promised to post the bill for 72 hours before the House vote, so even if the score comes out today, the earliest a vote might come is Saturday.

Procedure
Democratic leaders have yet to decide for certain exactly which legislative procedure they’ll use to pass the bill. Speaker Pelosi is leaning toward the idea of using a “deem and pass” option that would allow House Democrats to vote only on the package of changes to the Senate bill, and with that vote simply “deem” the underlying Senate bill passed as well, thus avoiding making House Democrats vote directly to pass a Senate bill that they dislike.

But Republican criticism of the tactic began immediately, with House Minority leader John Boehner calling it “the ultimate in Washington power grabs,” and Republicans have said they will try to force the House to vote on whether to use the “deem and pass” option. Some pundits who support the reform bill, such as the Washington Post’s Ezra Klein, aren’t so thrilled about the “deem and pass” option either, calling it needlessly difficult.

Abortion
Simmering in the background, as it has been for months, is the abortion issue. Rep. Bart Stupak, D-Mich., led a group of anti-abortion Democrats last year who vowed to vote for the House bill only if it included an amendment tightening restrictions on federal funding for abortion. But now that language is out — it’s not included in the Senate bill and it can’t be added back in via the reconciliation bill, since it’s not budget-related.

The U.S. Conference of Catholic Bishops has written a letter criticizing the Senate bill, while a group representing 60 orders of Catholic nuns recently broke ranks and urged passage of the bill. Stupak had said at one point that he had up to a dozen House Democrats who would join him in voting against the Senate bill because of its abortion language, but it’s still unclear how many of those anti-abortion votes are up for grabs. On Wednesday, one Stupak ally, Michigan Rep. Dale Kildee, said that he would vote for the measure.