Decision Day For Health Care In The House

President Barack Obama's landmark health care overhaul moved toward a vote in the House Saturday after anti-abortion lawmakers won a chance to knock out language that would let federally subsidized health care plans cover abortions.

Democratic leaders were hopeful they could pass the bill, giving Obama his biggest victory since last November's historic election, no matter how the abortion issue is decided. Obama planned a rare Saturday visit to Capitol Hill in an effort to cement a majority to pass legislation that is certain to be seen as a test of his presidency.

The bill would cost more than $1 trillion over the next decade. It would provide health coverage to tens of millions of Americans who don't have it now, require most employers to offer it to their workers and prohibit insurance companies from denying coverage based on a person's medical history.

"The status quo is unaffordable and unsustainable. Health care reform benefits all of us," said Rep. Allyson Schwartz, D-Pa., as debate opened on the House floor.

Republicans were united in their opposition to the bill.

"The American people need to understand this is about a government takeover of the whole health care system," said Rep. Paul Broun, R-Ga.

The most contentious issue in the 10-year, $1.2 trillion House bill is a new government-run insurance plan that would be offered alongside private coverage within new purchasing marketplaces, or "exchanges," where individuals and small businesses could shop for and compare options.

The abortion agreement was reached at midnight Friday after hours of intense negotiations brokered by House Speaker Nancy Pelosi, D-Calif. Democratic Reps. Bart Stupak of Michigan, Brad Ellsworth of Indiana and other abortion opponents fought for and won an opportunity to insert tougher restrictions into the legislation during debate, despite fervent opposition from pro-choice liberals who are a driving force behind the overall bill.

"We wish to maintain current law, which says no public funding for abortion," Stupak said.

Federal law currently prohibits the use of federal funds to pay for abortions except in cases of rape, incest or situations in which the life of the mother is in danger. Left unresolved is whether individuals would be permitted to use their own funds to buy insurance coverage for the procedure in the federally backed insurance exchange envisioned under the legislation.

The Planned Parenthood Federation of America contended his amendment would actually go further and bar access for many women to a legal medical procedure.

"As a health care provider, Planned Parenthood would very much like to see health care reform passed," said Cecile Richards, the group's president. But the abortion language "would put women's health in jeopardy and undermine real health reform," she said.

The leadership's hope is that no matter how the vote on the abortion measure turns out, Democrats on both sides of the abortion divide will then unite to give the health care bill a majority over unanimous Republican opposition.

With Democrats' command of the necessary votes looking tenuous, Obama threw the weight of his administration behind the effort to round up support. He and top administration officials worked the phones to pressure wavering lawmakers.

Rep. Jason Altmire, D-Pa., said he heard from Obama, White House Chief of Staff Rahm Emanuel, Health and Human Services Secretary Kathleen Sebelius and Education Secretary Arne Duncan.

Their message: "This is a historic moment. You don't want to end up with nothing," said Altmire, who remained undecided.

Democratic leaders hoped to hold the vote Saturday evening, but Majority Leader Steny Hoyer of Maryland said it could be delayed.

Democrats hold 258 seats in the House and can afford 40 defections and still wind up with 218, a majority if all lawmakers vote. But all 177 Republicans were expected to vote "no," and Democratic leaders faced a series of complications trying to win the needed votes for their complex and controversial legislation that would affect one-sixth of the economy and touch the lives of countless Americans.

In the GOP's weekly radio address, Mississippi Gov. Haley Barbour said Democrats should scrap their ambitious legislation and concentrate on modest health care changes that could find bipartisan support.

"The House Democrats' health care bill should be withdrawn and reworked," he said.

Last Tuesday's elections - in which Democrats lost two governors' races - sent a message that voters care about jobs, not growing the size of government, Barbour said.