WASHINGTON — House Democratic leaders pushed with mounting confidence Friday toward a historic vote on expanding the nation's health care system, and President Barack Obama joined an intense last-minute lobbying campaign to pick up the few votes needed to secure the measure's passage.
Ahead of today's historic floor debate, the fate of the trillion-dollar health plan hung on the outcome of a showdown with about two dozen antiabortion Democrats, who wanted to explicitly prohibit federal funds from paying for abortion through new, federally sponsored health-insurance plans. The U.S. Conference of Catholic Bishops circulated a letter late Friday arguing that the legislation could otherwise force individuals who oppose abortion to indirectly subsidize the procedure with their tax dollars.
The much larger group of Democrats who support abortion rights said that they were willing to accept only limited revisions to the health care package, and House leaders were scrambling to find a compromise that would pass muster with the party's abortion rights wing while winning the blessing of the bishops.
"The Catholic bishops are a very important group, to especially a lot of the Catholic members and people from districts with large Catholic populations," said House Energy and Commerce Chairman Henry Waxman, D-Calif. "The problem is that we have a very fragile situation. You give somebody a vote one way and we lose people on the other side."
House Speaker Nancy Pelosi. D-Calif., has little margin for error: Democrats control 258 seats and need 218 votes for passage, meaning she can afford to lose only 40 members of her caucus. Obama delayed a visit to Capitol Hill until early today, but the president, his top aides and at least two Cabinet secretaries worked the phones Friday. Asked if she had the votes for passage, Pelosi said only: "We'll see when we get to the floor."
House leaders said they were inclined to resolve the abortion dispute by adopting a compromise offered by Rep. Brad Ellsworth, D-Ind., who opposes abortion. That would designate a private contractor to ensure that federal dollars were not used to pay for abortion services under the proposed government-run plan or any other plan offered through a marketplace that would be created by the legislation.
It was not clear that the Ellsworth compromise would satisfy all parties. Waxman said the bishops were seeking language that would have the effect of discouraging every insurance plan from covering abortion services. But Democratic leaders were hoping that the compromise would give Democrats enough votes to pass the bill.
Democrats said their bill was designed to spread health insurance coverage to millions who lack it, ban insurance industry practices such as denying coverage on the basis of pre-existing medical conditions and restrain the growth of health care spending nationally. The Congressional Budget Office said that if enacted, the measure would extend coverage to 96 percent of all eligible Americans within 10 years.
Besides the battle over abortion, a dispute over immigration policy was festering. Hispanic lawmakers said they had received assurances from House leaders that the bill would not be changed to bar undocumented workers from purchasing insurance, even with their own money, through newly created insurance marketplaces. Language promoted by the White House and adopted by the Senate Finance Committee would establish such a barrier.
Hispanic lawmakers said they remained concerned that Republicans would attempt a legislative maneuver to add the provision to the bill — and it would get enough votes from conservative Democrats to win approval.
Information from the Associated Press was used in this report.