Obama pitches health care as Dems point toward a vote and progress in courting lawmakers

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Dems start countdown toward health care vote

WASHINGTON — House Democrats triggered the countdown Monday for the climactic vote on President Barack Obama’s fiercely contested remake of the health care system, even though the legislation remained incomplete and lacked the votes needed to pass.

Obama expressed optimism Congress would approve his call for affordable and nearly universal coverage as he pitched his plan on a trip to Ohio, and congressional leaders showed signs of progress in winning anti-abortion Democrats whose votes are pivotal.

At the same time, Sen. Jim DeMint, R-S.C., among the bill’s sharpest opponents, said he was “less confident” than before that it could be stopped.

“They’d have to be remarkable people not to fall under the kind of pressure they’ll be under,” he said of rank-and-file Democrats.

Some of the pressure was aimed at Rep. Dennis Kucinich, D-Ohio, who flew aboard Air Force One with President Barack Obama during the day, then walked into a senior citizen center with the chief executive in time to hear a voice from the audience yell out, “Vote yes.”

A smiling Obama turned to the liberal lawmaker and said, “Did you hear that, Dennis?” Then, turning back to the audience, he added, “Go ahead, say that again.”

“Vote yes!” came back the reply.

Kucinich, who said later he remains uncommitted, is one of 37 Democrats currently in the House who voted against Obama’s legislation when it cleared the House last fall.

In addition, the White House is laboring to hold the support of several other Democrats who voted for the earlier bill, but only after first supporting strict anti-abortion limits that would be altered the second time around.

At least two have signaled they are open to supporting the president when the vote comes. One of them, Rep. James Oberstar of Minnesota, is “in the leaning yes column,” said a spokesman, John Schadl.

“When we bring the bill to the floor, then we will have the votes,” said Speaker Nancy Pelosi.

Obama sounded similarly confident in an interview with ABC News. “I believe we’re going to get the votes, we’re going to make this happen,” said the president, who has traveled to three states and lobbied numerous lawmakers in recent days.

Outside interests on both sides sought to prevail on wavering lawmakers.

The National Right to Life Committee, which opposes abortions, wrote to lawmakers that support for the Senate bill would be a “career-defining pro-abortion vote.”

Union groups and other supporters announced a $1.3 million advertising campaign urging 17 House Democrats to vote for the measure, and officials at the Service Employees International Union threatened to withdraw support from Democrats who vote against the bill if it loses.

The lobbying came as the House Budget Committee, on a 21-16 vote, took an essential first step toward the House vote, which could come by the weekend.

It was more than a year ago that Obama asked Congress to approve legislation extending health coverage to tens of millions who lack it, curbing industry practices such as denying coverage on the basis of pre-existing medical conditions, and beginning to slow the growth of health care nationally. His plan would require most Americans to buy health insurance, fine most who fail to do so and provide government subsidies to help middle-income earners and the working poor afford it.

Sweeping legislation seemed to be on the brink of passage in January, after both houses approved bills and lawmakers began working out a final compromise in talks at the White House. But those efforts were sidetracked when Republicans won a special election in Massachusetts — and with it, the ability to block a vote on a final bill in the Senate.

Now, nearly two months later, lawmakers have embarked on a two-step approach that requires the House to approve the measure passed by the Senate, despite misgivings on key provisions. That would be followed by both houses quickly passing a second bill that makes numerous changes to the first. In the Senate, that second bill would come to a vote under rules that deny Republicans the ability to filibuster.

The details of the second, fix-it measure were closely guarded — and subject to last-minute changes. In general, officials have said they would provide more money for lower-income families unable to afford health care and states that already provide above average coverage for the poor under Medicaid, as well as improved prescription drug coverage under Medicare.

The legislation is expected to delete a provision in the Senate bill that singled out Nebraska for favorable treatment under a requirement to expand Medicaid coverage.

Instead, Democrats may provide as much as $15 billion to a dozen states and the District of Columbia, all of which already voluntarily provide at least some of the coverage that would be required.

Officials said one sticking point remained a Senate-passed provision establishing an independent commission with authority to force greater reductions in future Medicare payment to providers. House Democrats want to curtail the board’s powers, but rules may forbid any changes under the complex rules covering the Senate’s debate of the measure.

The cost of the overhaul is expected to total $950 billion or more over a decade. It would be covered by higher taxes on the wealthy as well as on some health care providers and high-cost insurance plans.

Several hundred billion dollars would also be cut from planned Medicare increases, much of the burden falling on companies that provide private coverage to seniors under Medicare Advantage.

Obama’s trip to Ohio was his third foray outside Washington since he vowed two weeks ago to do everything in his power to pass health care. In recognition of his audience, he stressed improvements in Medicare.

“So let me just tell you directly: this proposal adds almost a decade of solvency” to the program,” he said, although he made no mention of the planned reductions in provider payments that would take place.

He added it also would close a gap in prescription drug coverage know as a doughnut hole. “This proposal will over time help reduce the costs of Medicare that you pay every month. And this proposal would make preventive care free so you don’t have to pay out-of-pocket for tests that keep you healthy.”

Obama did not discuss details, and officials said final details of the prescription drug change remained unsettled. The White House has been seeking a $250 rebate in 2010 for seniors who experience the break in coverage. Beginning in 2011, two thirds of the higher costs they now pay when coverage is interrupted would be covered. The balance would be taken care of in installments over a decade.

Vice President Joseph Biden also traveled to Ohio, where he attended a fundraiser for first-term Rep. Steve Driehaus, D-Ohio.

Driehaus voted for the House version of a health care overhaul in November, and has not yet stated his position on the new measure. Biden made no mention of the legislation in his remarks.

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Eds: Associated Press reporters Ben Feller, Ricardo Alonso-Zaldivar, Erica Werner, Alan Fram, Chuck Babington, Ann Sanner and Sam Hananel contributed from Washington. Seanna Adcox contributed from South Carolina.