WASHINGTON — Democrats on Monday began their climactic push to move health care legislation through the House by the end of the week, as President Barack Obama, House Speaker Nancy Pelosi and other senior leaders stepped up their efforts to win over the last wavering lawmakers needed for passage of the bill.
Obama took the case for action on Monday to suburban Cleveland, where he held his third campaign-style health care rally in eight days even as he continued his private effort to press House Democrats to support the legislation.
At a closed-door meeting on Capitol Hill, Pelosi urged her Democratic colleagues to get behind the sweeping health care overhaul.
And, with the end of a year-long struggle in sight, consumer groups, labor unions, industry associations and business groups intensified pressure on Democratic lawmakers who remain on the fence. Many are facing a barrage of television advertising in their districts, including a $10 million campaign by the U.S. Chamber of Commerce, a leading critic of the bill.
Meanwhile, the liberal grassroots group , which once targeted centrist Democrats who backed compromise legislation, is now asking members for contributions to support primary challenges to Democrats who vote against the health care bill.
“In nearly 30 years of doing this, I can’t remember a time when there has been as much focused and frenetic activity,” said Ron Pollack, executive director of Families USA, an influential consumer group that is targeting between 30 and 40 House Democrats.
The behind-the-scenes pressure from Democratic leaders is focused primarily on conservative Democrats, as most liberals have already resigned themselves to supporting the legislation, even though it lacks a so-called public option and other features they favor.
Many conservative Democrats, particularly so-called Blue Dogs, are concerned about cost and the bill’s sweeping scope.
Democratic leaders acknowledge that they don’t yet have the votes to move the president’s top domestic priority forward.
Many rank-and-file Democrats are deeply concerned about details of the legislation and the complex parliamentary maneuvering being contemplated by party leaders as a result of the party’s loss of its filibuster-proof majority in the Senate.
Republican lawmakers remain steadfastly opposed to the legislation, which they have pledged to try to block first in the House and later in the Senate. As a result, Democrats are seeking to have the House approve the Senate-passed bill — avoiding the need to return the measure to the Senate.
To address House Democrats’ concerns, they plan to push through a package of changes in the Senate blueprint using a process known as budget reconciliation, which requires only a simple majority, rather than the 60 votes normally necessary to squash a filibuster.
Pelosi effectively started the clock ticking Monday afternoon as the House Budget Committee took the first of several procedural steps that will be necessary to send legislation to the president’s desk before Easter.
As the committee met, Pelosi repeated her prediction that Democrats would pass a health care bill.
“When we bring the bill to the floor, we will have the votes,” she said.
On Wednesday, the House Rules Committee is expected to take a more consequential step by wrapping together the Senate health care bill and the package of changes.
Democratic leaders are still working on the package, the details of which are likely to determine whether Pelosi and her lieutenants will be able to secure the 216 votes they need by the end of the week.
The package is expected to boost subsidies to help low- and moderate-income Americans buy health insurance, as well as provide additional coverage to seniors on Medicare by eliminating the gap in drug coverage known as the “doughnut hole.” Democrats also plan to use the package to scale back a proposed new tax on high-end “Cadillac” health plans and eliminate a special deal that would provide extra federal Medicare funding for Nebraska.
As critical as the details of the package will be the issue of how much the changes cost. The original Senate health care bill is estimated to cost $875 billion over the next decade, which would be offset with a mix of new taxes and cuts in Medicare spending.
Any changes such as additional subsidies that push the cost much over $950 billion over the next decade could drive away fiscally conservative Democrats who will be vital to advancing the legislation.
Monday, two such Democrats — Reps. Allen Boyd of Florida and Chet Edwards of Texas — voted against advancing health care legislation out of the House Budget Committee. Both men opposed health care legislation last year.
A group of socially conservative Democrats, led by Michigan Rep. Bart Stupak, also continue to threaten to vote against any legislation that does not put more restrictions on women’s ability to buy insurance policies that cover abortion services.
Republicans, meanwhile, are intensifying their attacks on House Democrats for plotting a legislative maneuver that could allow them to bring forward the package of changes without forcing their members to take a vote for the unpopular Senate health care bill.
“They are working overtime to avoid accountability,” said California Rep. David Dreier, the ranking Republican on the House Rules Committee.
Speaking to some 1,450 people in the Cleveland suburb of Strongsville, Obama kept up his warnings that a failure to enact his health care overhaul would condemn millions more Americans to face illness without health coverage.
Obama began the speech with the story of Natoma Canfield, an Ohio woman who was forced to give up her health insurance in January after her insurer raised her premium by 25 percent. Canfield was diagnosed with leukemia last week, the president said.
House may try new tactic
House Speaker Nancy Pelosi suggested Monday that she might attempt to pass health reform with the “self-executing rule”: The House would vote on a more popular package of changes to the Senate bill; under the House rule for that vote, passage would signify that lawmakers “deem” the health care bill to be passed. The tactic would politically protect lawmakers who are reluctant to publicly support the bill.
