Democrats' Momentum Building for Sunday Health Vote

After months of debate, delays and intraparty disarray, Democrats in Washington seemed to gain crucial momentum toward passing a health care reform bill by week's end. But legislative booby traps and fickle election-year politics mean that significant hurdles await the bill in the Senate, even if it passes the House in a likely Sunday vote.

The tide seemed to turn for House Speaker Nancy Pelosi and her fellow Democrats on Thursday morning, when the Congressional Budget Office released a very preliminary, but highly favorable, cost estimate for the newly combined House and Senate bills that the chambers will take up under reconciliation.

CBO Director Doug Elmendorf told Congressional leaders their compromise bill, which would extend coverage to 32 million Americans without insurance, will total $940 billion in new federal spending over 10 years. More importantly, he said, it will cut the deficit by $130 billion in the first 10 years and by $1.2 trillion in the 10 years after that. It will also overhaul the nation's student loan program, saving billions of dollars by eliminating private banks from most transactions.

Pelosi opened a Thursday press conference, her third in three days, with the CBO numbers on a large poster board beside her, a smile on her face, and a victorious message to the assembled crowd.

"They say a picture is worth a thousand words," she said. "But a number is worth a lot, too."

The CBO numbers, it turned out, were worth crucial votes for the bill as the day went on. Moments after Pelosi presented the findings to her caucus, Rep. Baron Hill (D-Ind.), a fiscally conservative holdout on the final bill, emerged from the meeting and said the deficit reduction projected by CBO would make a major difference in his thinking. "I'm pretty happy about the numbers," he said. "That moves me a step forward, and I want to get to a place where I can support it, but I'm not there yet."

Reps. Bart Gordon (D-Tenn.) and Betsy Markey (D-Colo.) said the numbers had done even more for them -- they will change their previous "no" votes to "yes."

With the CBO estimates softening resistance among the Blue Dog Democrats, some persuasion from the president seemed to be changing other Democrats' minds. When Rep. Dennis Kucinich (D-Ohio) announced Wednesday he would change his "no" to a "yes," the usually high-minded progressive spoke in starkly practical terms, saying President Obama had urged him to decide on the bill as it is, "not as I would want it to be."

Rep. Dale Kildee (D-Mich.), a pro-life supporter of Rep. Bart Stupak's language on abortion funding restrictions, announced Wednesday that he, too, would vote for the bill he had resisted for months. "We must not lose sight of what is at stake here -- the lives of 31 million American children, adults and seniors who don't have health insurance," he said in a written statement. "There is nothing more pro-life than protecting the lives of 31 million Americans."

A final group of holdouts from the Hispanic caucus relented on Thursday as well and endorsed the bill as pressure built against their resistance to the final package, which will prohibit illegal immigrants from purchasing health insurance through newly created exchanges with their own money.

Rep. Luis Gutierrez (D-Ill.), who made his frustration with the president over immigration reform well known over the last weeks, said, "I cannot see that voting against this health care bill is going to bring us any closer to comprehensive immigration reform. I do see that a success and a victory on health care will allow this president to be strengthened and to be able to carry out with more political capital our ultimate goal."

With votes lining up behind the Democrats, Rules Committee Chairwoman Louise Slaughter said she plans to convene her committee Saturday to vote on the rules for the House debate on the health care bill, and that she will most likely use the "deem and pass" procedure. That would allow Democrats to vote on changes they want to make to the deeply unpopular Senate health bill, and in the same vote "deem" that the underlying bill has passed as well.

"It is our protection to make sure the Senate bill is changed," she said. "It's not that complicated. It's been used here forever. This notion that this is some brand new byzantine thing we brought up out of the cave is nonsense." She said the House will most likely vote Sunday afternoon.

Meanwhile, Republicans vowed Thursday, as they have every day, to do everything possible to delay, dismantle, or destroy the health care bill.

Senate Minority Leader Mitch McConnell called the bill "a government take-over of health care" and said Democrats' relentless efforts to pass their legislation will backfire. "That kind of arrogance usually proceeds a big fall," he said.

House Minority Leader John Boehner of Ohio accused Democrats of trying to "ram, ram, ram this through the Congress" and promised, "We're going to do everything we can to make sure this bill never, ever passes."

He and his fellow Republicans lived up to their word Thursday, offering two separate measures to force the House to vote directly on the Senate bill. Both measures failed, but won the votes of all Republicans and several Democrats.

It remained unclear whether Pelosi and her deputies had indeed secured the 216 votes necessary to pass their bill through the House on Sunday. Stupak (D-Mich.) remained firmly against the abortion funding language in the bill and maintained that several of his pro-life colleagues would join him in switching their yes votes to nos. And even with a victory in the House, it is clear that the health care reform saga will only continue in the Senate.

Sen. Kent Conrad (D-N.D.), the chairman of the Budget Committee, described an arduous process of vetting each portion of the House bill though the Senate parliamentarian to ensure it complies with the rules. He also noted that Senate Republicans can offer an unlimited number of amendments to the Senate bill, which they have planned to do for months. If even one amendment is added or one provision is stripped out of the House-passed bill, the entire package will go back to the House to begin the process again.

But McConnell insisted he hasn't thought that far ahead. "Our plan is for it not to come to the Senate. Our plan is for it to be defeated in the House in the next few days."