Historic Health Care Vote Goes Down To the Wire

With a controversy over abortion funding still unresolved and House Speaker Nancy Pelosi seemingly just short of the votes necessary to pass the bill, the House of Representatives is expected to cast its final votes on health care reform Sunday afternoon.

The votes will come after a weekend of tense, last-minute negotiations, and more than a year after Congress began debating how to reform the health care system in America.

The weekend began on Capitol Hill with an unusual Saturday Rules Committee hearing, where Democrats and Republicans clashed over the procedure known as "deem and pass." The process would have required a roll-call vote only on a set of changes to the Senate bill -- without a vote on the underlying bill itself. Pelosi confirmed this week that it was among the procedures she was considering to move the legislation through the House.

Rep. Joe Barton (R-Tex.) implored Democrats to put the Senate bill to a full roll-call vote. "This process corrupts and prostitutes the system," he said. "We are about to unleash a cultural war in this country if we use this process and don't allow the differences to be debated and hopefully moderated in compromise. Don't do this deem and pass."

Although several committee Democrats defended the process, at least two did not. One, Rep. Dennis Cardoza (D-Calif.), said he would pull his support for the bill if Democrats went ahead. "I want to make the announcement in the committee right now that I don't support that, and won't support a rule that does it that way," he said.

With criticism mounting from Republicans and Democrats alike, House leaders announced they would abandon the "deem and pass" plan and move ahead with three Sunday votes-- first a procedural one on the rules of the debate, then a vote on the changes House Democrats have sought to the Senate health care bill; and finally a vote on the Senate bill itself.

Whether those three pieces of legislation can win passage remained unclear Saturday night as a small but crucially important faction of anti-abortion Democrats, led by Rep. Bart Stupak (D-Mich.), continued to withhold their support for the final bill because of language drafted in the Senate that Stupak said amounts to taxpayer funding of abortion.

Word circulated Friday night that Pelosi would try to win over Stupak's group with a vote of the full House Sunday on Stupak's more restrictive language. Pro-abortion rights Democrats, led by Rep. Diana DeGette (D-Colo.) balked at the idea and by Saturday afternoon, it was clear an agreement with Stupak had fallen apart. "The bill is the bill," Pelosi told reporters.

Still eager to persuade Stupak and his coalition to support the overall measure, Democratic leaders floated the idea of having President Obama write an executive order confirming that no federal money in the new law could go to abortion services or coverage that includes abortion services.

As the abortion drama played out behind the scenes, President Obama traveled to Capitol Hill in the afternoon to make his final pitch to undecided lawmakers, calling health care reform the most important piece of domestic legislation since the enactment of Medicare in 1965. (See video below and transcript here).

He acknowledged that the legislation falls short in many people's eyes, including his own, but called it a vast improvement over the status quo. "There are some who wanted a single-payer, government-run system, that's not this bill." he said. "The Republicans wanted what I call the fox is guarding the hen house approach."

Ultimately, he told the Democrats, helping average Americans with the approval of health care is why many of them joined the Democratic Party in the first place, and he said the bill's success depended on the people assembled in that caucus room.

"We have been debating health care for decades. It is in your hands," he said. "It is time to pass health care reform for America and I am confident you are going to do it tomorrow."

Before Obama spoke, Speaker Pelosi took the podium to the roaring applause of the members of her caucus. After predicting all week that she will have the votes to pass health reform on Sunday, Pelosi told her members, "We are on the verge of making great history."

With the stakes as high as any vote could get, several whip counts reported that Pelosi and the Democrats head into Sunday's showdown still shy of the necessary 216 needed to win approval of the bill -- but with 20 Democrats still undecided about how they will vote.

Although seven Democrats who voted against the bill last year have changed their votes to yes, three yes votes from November have announced they will vote no this time. The Hill reported that of the 37 votes that Democrats could afford to write off and still gain passage of the bill on Sunday, 36 have announced that they will vote no or are leaning in that direction.

The House will begin the final debate on the health care bill at 1 p.m. Sunday.