After months of divisive debate, a final deal on President Barack Obama's health care remake appeared within reach Thursday as negotiations picked up speed and House Democrats prepared to hear directly from the president.
House Ways and Means Committee Chairman Charles Rangel, D-N.Y., told reporters that negotiators hope to reach agreement on the core elements of the legislation by Friday, and send the package to the Congressional Budget Office for its estimates. The agreement in principle would cover key issues such as how many Americans would get coverage, and how to pay for it. Certain issues, including restrictions on taxpayer funding for abortion, would be resolved later.
"We're shooting for tomorrow," Rangel said early Thursday after meeting with Speaker Nancy Pelosi, D-Calif., and other leaders. "We hope to have the whole thing, as much as we can have (for the budget office) to be able to start working." The budget referees must review the legislation before Congress can cast a final vote and send the bill to Obama.
Obama and Democratic leaders spent all day Wednesday working intensely to resolve differences between the House and Senate versions of the legislation, which would expand coverage to more than 30 million people now uninsured, bar insurers from denying coverage to people with medical problems, and attempt to rein in ruinous increases in health care costs.
Negotiators were to meet again Thursday at the White House, and Obama planned to go to Capitol Hill to make a personal appeal to House Democrats, who are being asked to make major concessions. Democratic bargainers were also considering seeking more money from drug makers and other provider groups to help subsidize care for the uninsured.
Public support for the health care remake continues to drop, perhaps in part because of the messy debate in Congress, and lawmakers are feeling the pressure of other issues, from unemployment to ballooning budget deficits. In Massachusetts, the race to fill the seat of the late Sen. Edward M. Kennedy is turning into a referendum on health care overhaul, with Republicans hoping to capitalize on voters' misgivings.
Late Wednesday, Obama and senior Democrats emerged from marathon health care talks with a declaration that they had made tough gains — but no deal just yet. The same group of leaders was to meet again at the White House on Thursday.
House Democrats are uneasy over concessions they are being asked to make to preserve the 60 votes needed to pass the bill in the Senate. That includes dropping the government-run insurance option liberals have fought for and accepting some form of a tax on high-cost health insurance plans adamantly opposed by many House Democrats and by labor unions.
House Democratic leaders are pushing for more generous subsidies to help make health insurance affordable to a greater number of middle-class households, as well as other concessions.
To help pay for that, Democrats want health care providers to bear more of the cost, said lobbyists speaking on condition of anonymity because conversations within the industry were confidential. One said Democratic proposals include adding $10 billion to the $80 billion over 10 years that the drug industry had agreed to contribute, and raising the $20 billion in Senate-approved fees imposed on medical device makers by $10 billion.
Susan Feeney, spokeswoman for the American Health Care Association, said Wednesday that White House and Senate officials recently have asked the nursing home industry to agree to additional concessions.
Rep. Rob Andrews, D-N.J., predicted Obama would find support among House Democrats.
"I think there is a very mature understanding here that no one ever gets everything they want," Andrews said. "I think a lot of Democrats in the House who have misgivings about particulars will support the whole."
Wednesday's unusually long meeting at the White House — it began at midmorning and ended after sunset — underscored the urgency they and Obama feel about completing legislation on which they have staked so much.
The House and Senate passed the bills with just one Republican vote, and the GOP was not invited to the White House talks. Republicans say they still have a chance to derail the bill.
Union officials familiar with the negotiations said the White House would like a deal on the high-cost insurance plan tax by Friday. Options being considered to lessen the impact on union members included raising the threshold at which the tax would be levied — it's $23,000 for family plans in the Senate-passed bill — and exempting collective bargaining agreements negotiated before 2013 from the tax.
Associated Press writers David Espo, Alan Fram, Sam Hananel, Ben Feller and Mark S. Smith contributed to this report.
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