WASHINGTON — House Democratic leaders Thursday abandoned a long struggle to strike a compromise on abortion in their ranks, gambling that they can secure the support for President Barack Obama’s sweeping health care legislation with showdown votes looming as early as next week.
In doing so, they are all but counting out a small but potentially decisive group whose views on abortion coverage have become the principal hang-up for Democrats fighting to achieve the biggest change in American health care in generations. Congressional leaders are hoping they can find enough support from other wavering Democrats to pass legislation that only cleared the House by five votes in an earlier incarnation.
The concession came as House Democrats attended a lengthy meeting with White House health adviser Nancy Ann DeParle, who tried to answer questions, resolve differences and calm nerves, especially for lawmakers expecting tough challenges in November. Participants said they generally embraced White House-brokered compromises on prescription drug benefits for the elderly and new taxes on generous insurance plans.
At stake is the president’s call to expand health care to some 30 million people who lack insurance and to prohibit insurance company practices such as denying coverage to people who have been sick. Almost every American would be affected by the legislation, which would change the ways many people receive and pay for health care, from the most routine checkup to the most expensive, lifesaving treatment. And most Americans would be required by law to get health insurance.
Republicans continued their fierce criticisms of the president’s efforts, vowing to make Democrats pay dearly in the fall elections if they don’t back off from what they brand a government takeover of health care. But senior Democrats predicted they can convince their colleagues that doing nothing is the worst option of all, politically and substantively.
“The stars are aligning for victory on comprehensive health reform,” said Sen. Tom Harkin, D-Iowa. “The end is in sight.”
The end might be in sight, but the outcome remains uncertain. House Speaker Nancy Pelosi, D-Calif., must round up at least 216 votes when the real nose-counting and arm-twisting begin in a few days, after final cost estimates arrive from the Congressional Budget Office. All House and Senate Republicans have vowed to oppose the legislation.
The White House seemed to back away from its earlier insistence that Congress act by March 18. “If it takes a couple extra days after a year” of struggles, presidential spokesman Robert Gibbs said Thursday, then “it takes a couple extra days.”
Democratic leaders must resolve several more issues before presenting a final package to their colleagues and the public. Lawmakers have not decided whether to attach an overhaul of the college student loan program to the health legislation. Nor have they settled on details for a higher Medicare tax on wealthy Americans, treatment of a dozen states that give their residents relatively generous Medicaid benefits and subsidies to help low-income people buy health insurance.
Congressional Democrats appeared to agree with the White House on Thursday on a handful of issues. One would close a coverage gap in the Medicare prescription drug benefit, the so-called doughnut hole that has caused financial and emotional stress for numerous elderly Americans.
Another would impose a new excise tax, starting in 2018, on employer-provided health plans worth more than $10,200 for individuals and $27,500 for families. The Senate had wanted a stiffer tax on such “Cadillac plans,” but the more labor-friendly House resisted.
Republican and Democratic lawmakers quarreled Thursday over whether Obama must sign the Senate bill into law before Congress can make changes, which Democrats see as crucial to making the overall package more politically palatable. Republicans plan to pounce on Democrats the instant the Senate bill becomes law, and House and Senate parliamentarians eventually may have to determine the allowable sequence of legislative actions.
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