Healthcare reform effort grinds slowly in the House

Healthcare reform vote Saturday may be delayed as Democratic leaders work to make sure they have the necessary 218 votes - including more conservative members of their own party.

On the eve of a historic healthcare vote, House Democrats are scaling back expectations that the legislation must be wrapped up in the next 24 hours.

“Sunday afternoon we will have available to us, and I’ve also indicated to members that Monday and Tuesday are a possibility,” said House majority leader Steny Hoyer in a conference call with reporters Friday. “My expectation is that we will not need it and we’ll be done tomorrow night.”

Republicans have procedural options to delay the vote and are not tipping their hand on plans to use them. The mood in the House Rules Committee -- Republicans made a final pitch to have amendments considered in debate on the bill -- was not conciliatory.

“Can you show us a single Republican idea that has been included in this bill?” said Rep. Joe Barton (R) of Texas, the top Republican on the House Energy and Commerce Committee.

But the major 11th-hour issue for the Democratic majority isn’t feuds with Republicans, it’s repairing rifts in their own ranks on issues ranging from abortion and illegal immigration to fiscal restraint.

In a bid to rally support, President Obama is planning a Saturday morning visit to Capitol Hill for a “discussion” with the House Democratic caucus.

As many as 40 Democrats are balking at backing the bill without stronger language to ensure that federal funds not be used to pay for abortion services.

“We don’t think that’s what the bill does. But we want to make sure that members are comfortable with that reality that they are not funding through this bill abortions,” said Rep. Hoyer. House Democrats are planning to add compromise legislation to the rule on the bill to be debated on the floor.

“We are working on those issues now to make sure that we have a construct that will facilitate the passage of the bill,” he added.

Democratic leaders are also negotiating on language that meets President Obama’s pledge to not include illegal workers. Members of the Hispanic Caucus want assurances that undocumented workers still have the option to purchase health insurance on their own, just as they can purchase automobile insurance.

From the start, House leaders have had to take into account the view of fiscal conservatives, known as the Blue Dog Coalition, who say they will not vote for any bill that adds to the deficit. A last-minute deal with the American Medical Association, included in the rule on the healthcare bill, proposes a $210 billion “fix” in payments to physicians serving Medicare patients that is not offset by cost-cutting elsewhere.

Rep. John Tanner (D) of Tennessee, a member of the Blue Dog Coalition, announced today that he opposes the bill.

“After careful review of the current legislation pending in the House and the Congressional Budget Office’s analysis, I believe the bill will not help control the long-term costs of healthcare and puts in place an infrastructure that is not fiscally sustainable over time. I am unable to support this legislation in its present form,” he said in a statement.

With two newly elected Democrats sworn in this week, Democrats have 258 seats and need 218 votes to pass health reform. Ongoing negotiations tonight -- and the president’s visit tomorrow -- are focused like a laser on finding them.

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