Florida's two Democratic holdouts announced Friday that they will switch their earlier "no'' votes and support the latest health care overhaul proposal.
Their moves signaled that the sweeping measure was edging closer to the 216 votes needed to pass even as disputes over Medicare payments and abortion restrictions arose.
Rep. Suzanne Kosmas of New Smyrna Beach told the Orlando Sentinel she changed her mind because the new bill addressed some of her previous concerns about its effect on small businesses and the federal deficit.
"I'm going to vote for health care reform," she said. "I know this is not a perfect bill. But in the scheme of things, it provides the best options and the best opportunities for my constituents."
Conservative North Florida Rep. Allen Boyd also said he will reverse his early opposition and support the bill.
"Throughout this entire debate, I have consistently said that responsible health care reform will embody four key principles: It will reduce costs, increase access, ensure patient choice, and not add to the federal deficit," he said in a statement. "This bill is not perfect, but I believe it meets these four principles of responsible reform by providing the largest middle class tax credits for health care in our nation's history and preserving a patient's ability to choose their own doctor."
Kosmas and Boyd voted against the original House bill in November. Barring unforeseen developments, the rest of the Florida delegation is expected to fall along party lines when the vote is taken on Sunday.
The flareup over Medicare, a dispute that has percolated throughout the yearlong health care debate, was just one in a series of fast-moving developments Friday. It came as rank-and-file lawmakers pored over the detailed legislative language released on Thursday, and a handful of representatives said their states were being short-changed by new provisions.
Rep. Peter A. DeFazio, D-Ore., who voted in favor of the bill in November, warned on Friday that he would not support the current measure unless it increased Medicare payments to states like his that provide high-quality care at comparatively lower cost.
House Speaker Nancy Pelosi acknowledged the concerns at a news conference, and said party leaders would work to address them. Lawmakers from Iowa, Minnesota, Oregon, Washington and Wisconsin have been meeting with Pelosi.
Also on Friday, the American Medical Association announced what it described as "qualified support" for the bill.
Dr. J. James Rohack, president of the association, said the bill would improve the lives of millions of Americans by "extending health coverage to the vast majority of the uninsured."
Doctors said they were deeply disappointed that the bill would not repeal the formula used to calculate Medicare payments to doctors. Under that formula, doctors face a 21 percent cut in Medicare payments next month, with smaller cuts in each of the next few years.
House Democratic leaders said they had made an informal commitment to the association to take up legislation that would eliminate the cuts. But they are reluctant to talk about the plan because of its cost, which could exceed $200 billion over 10 years.
Late Friday, Democratic leaders also were attempting to resolve a dispute over abortion. Rep. Bart Stupak, D-Mich., who succeeded in November in inserting strict antiabortion language into the House bill, hopes to do so again. That prospect angered lawmakers who support abortion rights.
"We're not going to vote for a bill that restricts a woman's right to choose beyond current law," said Rep. Diana DeGette, D-Colo. Abortion opponents are divided over whether restrictions on taxpayer funding currently in the bill go far enough.
Obama urges support
The health care bill, which would provide coverage to 32 million people, has a price tag of $940 billion over 10 years.
While House Democratic leaders cajoled their charges, President Barack Obama continued his efforts to drum up public support for his health policies, speaking at a campaign-style event in Fairfax, Va.
Obama called on the audience to knock on doors, sway their neighbors and make phone calls. He positioned the debate as a choice between the insurance industry and individuals.
"I stand before you, one year after the worst recession since the Great Depression, having to make a bunch of tough decisions, having had a tumultuous debate, having had a lot of folks who were skeptical that we could get anything done," Obama said. "And right now, we are at the point where we are going to do something historic this weekend."
Obama will press lawmakers for support when he addresses the full 253-member House Democratic caucus this afternoon.
Republicans continued to rail against the legislation, accusing Democrats of cutting deals in exchange for support.
"I'm sure the favor factory is in full tilt, but they're not there yet," said Republican Conference Chairman Mike Pence, R-Ind. "I still think that the bipartisan coalition of Republicans and some Democrats who think we still can do better still have a chance to win this thing and to immediately start over with the kind of incremental, step-by-step reforms that'll lower the cost of health care."
Meanwhile, South Carolina Attorney General Henry McMaster said he plans to join Florida Attorney General Bill McCollum in challenging the bill's constitutionally if it passes.
McMaster said that when the national government and Congress "start going wild," the states have to rein them in.
They expect other attorneys general will join their lawsuit.
Times staff writer Alex Leary contributed to this report, which includes information from the New York Times, McClatchy Newspapers and the Associated Press.