Top Democrats say they are resolving disputes over President Barack Obama's health overhaul plan, but they face decisions on subsidizing coverage and are still hunting votes to push the vast package through Congress.
House Democrats were meeting again Friday to discuss the still-evolving plan and for leaders to try to soothe lawmakers worried about the price they might pay in November's congressional elections for supporting it. After a day of meetings with rank-and-file lawmakers and among House, Senate and White House bargainers, leaders expressed confidence Thursday evening that this stage of their labors was nearly complete.
"We made a lot of decisions. We're getting toward the end," White House Chief of Staff Rahm Emanuel told reporters as he left the office of Senate Majority Leader Harry Reid, D-Nev. Reid received disturbing news during the day that his wife and daughter were rear-ended in a serious traffic accident.
Reid's 69-year-old wife was hospitalized in serious condition with a broken neck and back, officials said.
Even with initial votes possible next week, few were claiming that Democrats had the votes in hand to prevail — especially in the House, where the roll call is expected to be a cliffhanger. House Speaker Nancy Pelosi, D-Calif., conceded that even once details of the package are complete, leaders will need time to sell it to lawmakers.
"We will have at least one week to have our conversation," Pelosi said. It could take longer, she added, "but it's not something we want to drag out."
The seemingly endless string of meetings and negotiations is aimed at finally wrapping up Obama's top-tier domestic goal of revamping the way many Americans get health care and how they pay for it. The legislation would restrict how insurance companies dole out coverage to customers, require most people to carry policies and extend coverage to 30 million uninsured Americans, financed by slowing the growth of Medicare and raising some taxes.
To finish a yearlong push and overcome unanimous Republican opposition, the House must finally approve a near $1 trillion health overhaul bill the Senate approved Christmas Eve.
Then, because that measure contains provisions that have become politically toxic — like extra Medicaid payments to Nebraska — Obama and Democrats want to pass a second bill revising parts of the first one. Obama has proposed a compromise to achieve that, and lawmakers have been deciding in recent days exactly what the final product would look like.
"We're pretty much in line with what the president asked," Rep. Henry Waxman, D-Calif., who chairs the Energy and Commerce Committee, said of the emerging deal.
Democrats plan to use budget reconciliation rules to skirt GOP filibusters that would let them kill that legislation with just 41 Senate votes. Republicans claim the Democratic strategy abuses Senate processes, but Democrats respond that reconciliation has been used mostly by the GOP in the past.
In their talks, Democrats said they have decided how to close a gap in prescription drug coverage for Medicare recipients and to ease a costly new tax on high-cost health insurance plans that the Senate has approved.
But in part because they haven't received final cost estimates from the nonpartisan Congressional Budget Office, some moving parts remain. These include how generous federal subsidies for low- and middle-income earners would be, how much extra Medicaid assistance to give states that are providing richer benefits and how much to boost a payroll tax on upper income people.
Also unresolved was whether to include an unrelated plan to change the federal government's multibillion-dollar college student loan program. And the White House is pressuring the Senate to remove some specific deals in the legislation, including money for asbestos-disease sufferers in Montana and to build a hospital in Connecticut.
One of Democrats' biggest hurdles is easing House concerns that the Senate won't approve the second "fix-it" measure. House Democrats worry that would leave them vulnerable to GOP campaign attack ads blaming them for unpopular items in the Senate bill, like the higher tax on expensive insurance policies.
Top House Democrats said they have given up trying to win over some conservative Democrats demanding that the bill strictly bar federal aid for abortion. That means they likely will have to win converts from among 39 House Democrats who voted against the House's initial health bill in November.
Associated Press writers Erica Werner, Charles Babington, Ricardo Alonso-Zaldivar, Laurie Kellman and Ann Sanner contributed to this report.
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