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Democrats make final healthcare push

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With the clock ticking down to Sunday’s vote on the $940-billion healthcare package, President Obama and House Speaker Nancy Pelosi (D-San Francisco) labored Friday to sustain their momentum in the face of continuing dissent in Democratic ranks over abortion and other issues.

The president and his allies picked up support Friday from several key uncommitted House Democrats, including at least three who voted against the House healthcare legislation last year.

And several Democrats facing tough reelection campaigns -- including Rep. Dina Titus of Nevada -- also announced they would continue to support the healthcare overhaul.

“A lot of people are telling me this decision could cost me my job,” Rep. John Boccieri (D-Ohio), a freshman from a Republican-leaning district who voted no in November, said outside the Capitol on Friday, surrounded by families of people who struggled to get medical care.

“There’s too many politicians who are worried about their future instead of the future of the families who are standing behind me,” Boccieri said.

With little margin for error, Democratic leaders spent Friday trying to lock down more wavering Democrats, while a group of the party’s social conservatives pushed for more restrictions on abortion services in the healthcare overhaul. They appeared to be within a handful of votes of the 216 needed to pass the legislation.

“We have a number of issues,” Pelosi told reporters at the Capitol, even as she predicted that Democrats would have the votes they need Sunday.

Pelosi lost one closely watched lawmaker Friday, when Rep. Jason Altmire (D-Pa.) announced he would not switch his “no” vote from last year. “The cost of inaction on healthcare is great, but it would be an even bigger mistake to pass a bill that could compound the problem of skyrocketing healthcare costs,” he said.

The last-minute movements -- together with House leaders’ continuing efforts to address members’ concerns -- underscored just how fluid the vote count remained as Pelosi worked to woo some lawmakers while protecting others in jeopardy of losing their seats by giving them the option of voting against the bill.

Republicans, meanwhile, kept up their attacks on the legislation, pointing to provisions they said could understate its ultimate cost.

GOP leaders also highlighted the special deals that some Democratic lawmakers had negotiated to benefit their states or districts. “Some of the sweetheart deals are still in this bill,” House Minority Leader John A. Boehner (R-Ohio) said.

As pressure mounted, Obama, who held a healthcare rally in northern Virginia on Friday morning, telephoned Democratic lawmakers personally throughout the day.

He planned to meet with House Democrats on Saturday afternoon. Senate Majority Leader Harry Reid (D-Nev.), who will try to shepherd the last piece of the healthcare legislation through the Senate next week, also planned to attend the meeting.

Democrats are plotting a complex procedural path over the next week starting in the House, where lawmakers on Sunday are expected to take up the healthcare bill passed by the Senate last year as well as a package of fixes to that bill.

Assuming that both pass, the Senate would then begin debating the package of fixes next week. By using a process known as budget reconciliation, Senate Democrats believe they will be able to avoid a Republican filibuster and pass the fixes with a simple majority.

The total package is expected to cover an additional 32 million people by 2019 while reducing the federal budget deficit by $138 billion over the next decade, according to a preliminary estimate by the nonpartisan Congressional Budget Office.

That is because the $940-billion price tag for expanding coverage over the next decade is offset by a series of cuts to providers and insurance companies paid by Medicare, as well as several new taxes, including a Medicare tax on investment income for individuals making more than $200,000 and couples making more than $250,000.

The budget estimates released Thursday have rallied some fiscally conservative Democrats behind the legislation.

But Democratic leaders are still trying to defuse the same debate over abortion that almost derailed healthcare votes in the House and Senate last year.

Friday, a group of socially conservative Democrats led by Rep. Bart Stupak of Michigan demanded a vote on a resolution that could prohibit women from buying a health plan that covers abortion services if they receive any federal insurance subsidies.

Millions of low- and middle-income Americans who would be required to buy insurance if they do not get it through their employer could be eligible for these subsidies.

Leading antiabortion groups, including the Family Research Council and the U.S. Conference of Catholic Bishops, have demanded this restriction.

The Senate healthcare bill now requires any woman who buys an insurance plan with the help of a federal subsidy to send her insurer a separate check to pay for any abortion benefit that is included in the health plan.

Many conservative lawmakers and religious groups have said that arrangement is sufficient to ensure that there is no public funding of abortion.

Friday, Pelosi seemed to reject Stupak’s proposal. “This bill is about healthcare, not about abortion. . . . We all agree that there should be no federal funding of abortion,” she said. But Democratic officials continued to explore options, potentially by arranging a separate vote on abortion restrictions.

Party leaders were scrambling to put out other brush fires, including concerns raised by some rank-and-file Democrats that the package would not eliminate regional disparities in Medicare payments to doctors.

Rep. Jim Costa (D-Fresno) said his vote could hinge on whether he gets assurances about giving flexibility to agricultural employers in how they offer insurance to their workers.

Tensions also flared on the House floor, where freshman Rep. Jason Chaffetz (R-Utah) gave an unusual speech accusing Tennessee Democrats Bart Gordon and John Tanner of trading their votes for future administration appointments.

That drew an angry rebuttal on the floor from both men, who denied the charge and said they would not accept the positions. “It is a total fabrication,” Tanner said.

Tanner has not indicated how he will vote Sunday. Gordon has said he will back the overhaul.

noam.levey@latimes.com

janet.hook@latimes.com

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