House Democrats who had withheld support of the health care legislation because of abortion concerns said Sunday afternoon that they would back the bill, all but assuring that Democrats would have the 216 votes needed for passage.
The White House and Congressional Democratic leaders announced the deal, and rank-and-file Democrats who had worried that the bill would somehow allow the use of federal money to pay for abortions or for insurance coverage of the procedure appeared at a news conference to say those concerns had been addressed.
“I am pleased to announce we have an agreement,” said Representative Bart Stupak, Democrat of Michigan and a leader of the Congressional Pro-life Caucus. “We’re well past 216, yes”.
The White House announced that after passage of the health-care legislation, President Obama would sign an executive order that will reaffirm the measure’s “consistency with longstanding restrictions on the use of federal funds for abortion”. But a number of groups that oppose abortion rights said that an executive order was insufficient in part because of a lack of trust in the Obama administration. Even before Mr. Stupak’s news conference ended, the House Republican Leader Representative John A. Boehner of Ohio issued a statement saying: “The law of the land trumps any Executive Order, which can be reversed or altered at the stroke of a pen by this or any subsequent President without any congressional approval or notice”. And Mr. Boehner warned that a vote for the health care bill was a vote for taxpayer-financed abortions.
Mr. Stupak rejected that claim. Mr. Stupak also noted that the United States Conference of Catholic Bishops still wanted statutory language barring the use of federal money for abortions. “I know it’s Lent,” he said, but added that the bishops could not supply the 60 votes needed in the Senate to approve such a law. “This has the full force of law,” he said of the executive order.
But Mr. Stupak said the order would make clear there is “no public funding for abortion” and that community health centers, which will get billions in new federal financing under the health care bill, cannot perform the procedure.
Kaptur, Democrat of Ohio, said, “The health care bill that will move forward today is actually a bill about life.” Also with Mr. Stupak and Ms. Kaptur at the news conference were Steve Driehaus and Kathy Dahlkemper, who noted that she considered the bill now a “full life” or “whole life piece of legislation”.
Before Mr. Stupak’s news conference, Democrats and Republicans had engaged in fierce parliamentary jousting on the House floor Sunday afternoon.
On the House floor, Republicans angrily denounced the legislation and battled furiously with Democrats over procedural issues related to the proposed rule to set terms of debate on the landmark legislation.
Representative David Dreier of California, the senior Republican on the Rules Committee, insisted that if Democrats prevailed the only certain outcome of Sunday’s votes was that the Senate-passed health care bill would be signed into law by President Obama.
Many House Democrats oppose the Senate bill because it contains a number of provisions that were aimed at winning the support of individual senators, like extra federal Medicaid money for Nebraska. House Democrats are planning to approve the Senate bill and then immediately approve a package of revisions to it included in an expedited budget reconciliation bill. Mr. Dreier tried to make his point, saying, “We now know with absolute certainty,” only to be cut off by Representative Louise M. Slaughter of New York, the chairwoman of the Rules Committee. “No, you don’t know that,” Ms. Slaughter shouted. But Mr. Dreier had the floor. “ I encourage everyone to read the rule,” he said, “because the only thing we are guaranteed” is that the Senate bill will become law.
Outside the Capitol, hundreds of opponents of the legislation protested, carrying signs and chanting angry slogans.
Even on Sunday morning, the vote was clearly too close to call. Rep. John Larson, the chairman of the Democratic caucus, told ABC’s “This Week” program that the votes were in hand. “We have the votes now — as we speak,” he said about the 216 votes. But at the same time, Rep. Debbie Wasserman Schultz, the deputy Democratic House whip, told “Fox News Sunday” that the Democrats “don’t have a hard 216 right now”.
Shortly before midnight on Saturday, the House Rules Committee completed its work and proposed the parameters for Sunday’s floor fight, which will entail two hours of formal debate on the legislation. The committee, controlled by Democrats, also limited the ability of Republicans to disrupt the proceedings and allowed for the vote to be postponed if Democrats chose to do so.
President Obama, in an emotional address Saturday afternoon at the Capitol, exhorted rank-and-file House Democrats to approve the bill, telling them they were on the edge of making history. “Every once in a while a moment comes where you have a chance to vindicate all those best hopes that you had about yourself, about this country,” he said. “This is one of those moments”.
The president declared: “We have been debating health care for decades. It has now been debated for a year. It is in your hands”.
With the ground shifting by the hour, House Democratic leaders dropped a plan to approve the Senate health bill without taking a direct vote on it. That proposed maneuver had outraged Republicans and caused consternation among some Democrats.
Thousands of opponents of the bill circled the Capitol chanting angry slogans. Some of the anger was directed at black lawmakers, including several who said that some demonstrators had hurled racial insults at them. At the Capitol rallywith Mr. Obama, the Senate majority leader, Harry Reid of Nevada, assured House Democrats that their Senate colleagues would act quickly on the reconciliation bill, including final revisions to the health care measure. “I have the commitments of a significant majority of the United States Senate to make that good law even better,” he said. The House Republican leader, John A. Boehner of Ohio, said the Republicans could still prevail. “The American people are making their voices heard, here on Capitol Hill and across America,” he said. “It’s time for Washington Democrats to listen”.
In his speech, Mr. Obama drew chortles from lawmakers — and laughed at himself — when he suggested that perhaps Republicans were hoping to spare Democrats political pain by blocking the bill.
“Mitch McConnell, John Boehner, Karl Rove, they are all warning you of the horrendous impact if you support this legislation,” the president said, referring to the Senate and House Republican leaders and a top adviser to former President George W. Bush. “Now, it could be that they are suddenly having a change of heart and they are deeply concerned about their Democratic friends; they are giving you the best possible advice in order to ensure that Nancy Pelosi remains speaker and Harry Reid remains leader and all of you keep your seats,” Mr. Obama joked. “That’s a possibility”. He continued, “But it may also be possible that they realize that after health reform passes and I sign that legislation into law, it’s going to be a little harder to mischaracterize what this legislation has been all about”.
The Congressional Budget Office on Saturday released a new cost analysis of the legislation based on a package of changes unveiled by the Democrats earlier in the day. The new assessment shows the total cost of new insurance coverage provisions in the bill to be $938 billion over 10 years, with the expense more than offset by revenues from new taxes and fees and reductions in spending on government programs including Medicare, so that the legislation would reduce future federal deficits by $143 billion. The previous budget office estimate showed a total cost of $940 billion for the coverage provisions, and $138 billion in deficit reduction. At a news conference on Saturday, 13 House Republican freshmen assailed the measure. “Let’s kill this bill,” said Representative Cynthia M. Lummis, Republican of Wyoming.
The late-hour maneuvering on abortion mirrored a similar process in November before the House adopted its version of the health care legislation.
In November, Mr. Stupak had also succeeded in winning approval of tight limits on insurance coverage of abortions in the House bill. The current package now includes language from the bill passed in the Senate and negotiated by two Democrats, Senators Bob Casey of Pennsylvania and Ben Nelson of Nebraska, who have built up solid credentials in their political careers as abortion opponents. Mr. Stupak and many of the lawmakers insisting on the tighter restrictions are Catholic, as is Ms. Pelosi, and all have cited their faith in justifying their position on the legislation.
In a sign of the emotion around the issue, Representative Dale E. Kildee, Democrat of Michigan, who is Catholic and opposes abortion, announced his support for the legislation in a statement pointing out that he had once studied for the priesthood. He said he had consulted his priest and concluded that the abortion restrictions in the Senate bill were sufficient.
Democratic leaders said they hoped an executive order by Mr. Obama would clarify that the legislation was not intended to change existing federal law and policy that generally bar the use of taxpayer money for abortions.
But Representative Anh Cao of Louisiana, the only Republican who voted for the bill in November, said he could not support the current measure because of its “expansion of abortion, an absolute moral evil”.
Democratic lawmakers and top aides have been working round the clock trying to address flare-ups over elements of the bill. They said they had worked out an agreement to resolve one of the last remaining issues: a dispute over geographic disparities in Medicare payments.
The agreement could lead to higher payments to doctors and hospitals in states like Iowa, Minnesota, Oregon, Washington and Wisconsin, where Medicare rates are relatively low but studies suggest that the quality of care is high. “The current geographic variation in Medicare reimbursement rates is inequitable,” Ms. Sebelius said.
Carl Hulse contributed reporting
The New York Times
