Health care reform is on the brink

WASHINGTON — Senior White House officials predicted Sunday that President Obama’s health care initiative will pass the House this week, and warned Republicans if they make it an issue in November elections they do so at their own political peril.

“We’re happy to have the 2010 elections be about the achievement of health care reform,” White House Press Secretary Robert Gibbs said. “That’s a debate I think we’re obviously comfortable having.”

“Make my day,” senior White House political advisor David Axelrod said. “Let’s have that fight. I’m ready to have that and every member of Congress ought to be willing to have that debate as well.”

But top Republicans said they were not walking away from the struggle over health care, whether it passes or fails and ultimately spills over into the midterm congressional elections.

“We have a chance at winning Republican control of the House” this year, House GOP leader John Boehner of Ohio said.

Sen. Lamar Alexander, R-Tenn., called the health care vote “a political kamikaze mission” for Democrats, saying it has morphed into a “larger issue of the role of government in American lives.”

Despite the White House bravado that health care legislation will pass the House, most political odds-makers predict it will be close and could go either way. And a key House Democratic leader cautioned Sunday they don’t have the votes yet.

“No, we don’t have them as of this morning,” said Rep. James Clyburn of South Carolina, the third-ranking Democratic leader in the House and the chief vote counter on the health care issue. But he expressed assurance the measure would succeed.

The bill needs 216 ayes to pass the House, and most observers think the Democrats remain about a half dozen votes short.

The president, keeping the pressure on now that House Speaker Nancy Pelosi, D-Calif., said a vote likely will come this week, plans to campaign for the measure in Strongsville, Ohio, today. Natoma Canfield, a cancer patient and self-employed maintenance worker from that Cleveland suburb, wrote the president saying she no longer could afford health care after her insurance premiums rose to $8,500 a year. The decision forced her to choose between insurance and her home, and she decided to keep her house.

The health care legislation has become the centerpiece of Obama’s first year in the White House, and once the votes are recorded it could be the chief legacy of his presidency.

Republicans, on the other hand, liken the legislation to socialized medicine and want to start over.

Under the highlights of Obama’s plan, tens of millions of uninsured Americans would get access to health insurance. Insurers could not refuse coverage for anyone with a preexisting health problem, and the government would subsidize premiums for those who couldn’t afford them — including families of four earning up to $88,000 a year.

The measure passed the Senate late last year, but its legislation differed from the version that passed the House in November. As Democrats sought to craft a compromise, they lost their 60-vote supermajority in the Senate — meaning they no longer had the votes to cut off a Republican filibuster.

The Democrats’ solution is for the House to pass the Senate bill, then for both chambers to pass a budget-reconciliation bill to resolve their differences. Under its rules, the Senate could pass that with a simple majority.

The issue also has bogged down over complaints some senators were given special incentives to support the legislation, such as more Medicaid funding in Nebraska. Axelrod said Sunday that special treatment like the “Cornhusker Kickback” would be eliminated unless the special provision involved more than one state.

“The principle we want to apply is that, are these applicable to all states?” Axelrod said.