Some House foes eyeing vote switch on health care reform

WASHINGTON -- Ten House Democrats indicated in an Associated Press survey Monday they have not ruled out switching their "no" votes to "yes" on President Barack Obama's health care overhaul, brightening the party's hopes in the face of Republican opposition.

The White House tried to smooth the way for them, showing its own openness to changes in the landmark legislation and making a point of saying the administration is not using parliamentary tricks or loopholes to find the needed support.

Democratic leaders have strongly signaled they will use a process known as "budget reconciliation" to try to push part of the package through the Senate without allowing Republicans to talk it to death with filibusters. The road could be even more difficult in the House, where Speaker Nancy Pelosi is struggling to secure enough Democratic votes for approval, thus the effort to attract former foes.

The White House said Obama will outline his final "way forward" in a Washington speech Wednesday, and he is expected to embrace a handful of Republican ideas for making health care more efficient.

Few in Washington think those gestures will be enough to persuade a single House or Senate Republican to embrace the legislation. But they could give wavering Democrats political cover by showing the party has been willing to compromise, ammunition against campaign accusations this fall that they rammed the bill through Congress with no regard for other views.

The proposal would impose new restrictions on insurance companies and order health insurance coverage for as many as 30 million Americans who now lack it, among many other changes.

Persuading lawmakers to change their votes is a tough sell. Elected officials are loath to vote two ways on a controversial issue, feeling such a switch draws more resentment than support. Democratic leaders stress that the legislative package soon to reach the House will be less expensive than the one that passed in November and will contain no government-run insurance program to compete with private insurers.

In interviews with the AP, at least 10 of the 39 Democrats -- or their spokesmen -- either declined to state their positions or said they were undecided about the revised legislation, making them likely targets for intense wooing by Pelosi and Obama.

Three of them -- Brian Baird of Washington, Bart Gordon of Tennessee and John Tanner of Tennessee -- are not seeking re-election this fall.

The others are Rick Boucher of Virginia, Suzanne Kosmas of Florida, Frank Kratovil of Maryland, Michael McMahon of New York, Walt Minnick of Idaho, Scott Murphy of New York and Glenn Nye of Virginia. Several lawmakers' offices did not reply to the AP queries.

Both parties have used the "reconciliation" strategy to pass big bills before, but Republicans call the health care push an unwarranted departure from standard practices.

Top Democrats are reminding colleagues and voters at home that the Senate already has passed its version of the health care bill on Christmas Eve with a super-majority of 60 votes, which squelched a GOP filibuster without resorting to reconciliation rules. The new plan calls for the House to pass that same bill and send it to Obama for his signature.

But that is contingent on a Senate promise to make several subsequent changes. Those would have to be approved under the special budget reconciliation rules, because Democrats now control only 59 of the Senate's 100 votes -- one shy of the number needed to stop a bill-killing filibuster.

Democratic leaders have asked colleagues not to use the term "reconciliation" but instead to refer to the process as "majority vote," said Rep. Allyson Schwartz, D-Pa. They also are frequently using the term "up or down vote."

The political math in the House is daunting.

The House version of health care passed 220-215 in November, with 39 Democrats voting against it. Since then, defections, resignations and a death have taken away yes votes.

With four House seats now vacant, Pelosi would need 216 votes to approve the Senate-passed version, which replaces the jettisoned House bill. That's exactly the number she has now if no other members switch their votes.

But many lawmakers expect further defections, especially members who oppose legalized abortion and feel the Senate language is too permissive in regulating federal funds for those operations.

For every yes vote that switches to no, Pelosi and the White House must persuade one of the 39 Democrats who voted "nay" in November to switch to yes.

Obama's announcement on Wednesday is expected to be a freshened blueprint of what he wants to see in a final health care bill, updated with ideas that at least have the fingerprints of Republicans.

The plan will replace the one Obama posted one week ago, but will not be written in legislative language.

Obama's move underscores his ever-growing role in shaping what he hopes will be a far-reaching revision to the nation's health care system, a goal that has eluded other presidents dating to Theodore Roosevelt.

Politically, it would also allow him to say that he was listening to Republicans at his ballyhooed bipartisan summit last week and that he has since responded by including more areas of common ground.

But Republicans have shown no sign of backing his proposal no matter how it is changed.

Obama also will outline how he wants the process to unfold in Congress. Officials signaled it will involve Senate reconciliation rules unless there's a stunning last-minute overture from Republicans.

White House spokesman Robert Gibbs would not confirm that plan Monday. But he repeated that health care deserves an up-or-down vote and that Republicans have used reconciliation on major legislation.

When asked if the public cares about legislative process, Gibbs said: "I think the American people care about what's in the bill."

Since Thursday's summit, Obama has been involved in a series of meetings in which the new White House proposal is being shaped.

Gibbs said Obama has worked to get votes in every round of the health care debate. "I don't doubt that he will ... do the same thing this time to get the votes necessary to pass health care," Gibbs said.

Rep. Eric Cantor of Virginia, the House's second-ranking Republican, made it clear that Republicans see a Democrats-only bill as an election-year issue.

"If Speaker Pelosi rams through this bill," he said this weekend, Democrats "will lose their majority in Congress in November."

Meanwhile Monday, Obama's argument that private insurance plans serving one-fourth of Medicare recipients are significantly overpaid got support from a report to Congress by nonpartisan technical advisers. Democrats have targeted Medicare Advantage plans for a big chunk of the cuts that would free funds to cover the uninsured.

The report by the Medicare Payment Advisory Commission found that last year Medicare spent about $14 billion more for seniors enrolled in private plans than would have been the case if those beneficiaries had stayed in the traditional program. One consequence was that all Medicare recipients --whether in private plans or the traditional program-- ended up paying an additional $3.35 a month in premiums to cover the costs.

The Senate health care bill that Obama supports would replace the current payment formula for the private plans with an approach based on competitive bidding.

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Associated Press writers Ben Feller, Erica Werner, Alan Fram and Ricardo Alonso-Zaldivar in Washington; Brian Witte in Annapolis, Md.; Valerie Bauman in Albany, N.Y.; Rebecca Boone in Boise, Idaho; Meghan Barr in Cleveland; Melissa Nelson in Pensacola, Fla.; Robert Lewis in Richmond, Va., Erik Schelzig in Nashville, Tenn.; Angela K. Brown in Fort Worth, Texas; Dirk Lammers in Sioux Falls, S.D., and Melinda Deslatte in Baton Rouge, La., contributed to this report.