WASHINGTON (AP) - One by one, House Democratic fence-sitters
began choosing sides Friday, and the long, turbulent struggle over
landmark health care legislation tilted unmistakably in President
Barack Obama's direction.
In full campaign mode, his voice rising, the president all but
claimed victory, declaring to a cheering audience in Virginia, "We
are going to fix health care in America."
With the showdown vote set for Sunday in the House, Obama
decided to make one final, personal appeal to rank-and-file
Democrats, arranging a Saturday visit to the Capitol. Republicans,
unanimous in opposition to the bill, complained anew about its cost
and reach.
Under a complex - and controversial - procedure the Democrats
have devised, a single vote probably will be held to send one bill
to Obama for his signature and to ship a second, fix-it measure to
the Senate for final passage in the next several days.
Democratic leaders and Obama focused last-minute lobbying
efforts on two groups of Democrats, 37 who voted against an earlier
bill in the House and 40 who voted for it only after first making
sure it would include strict abortion limits that now have been
modified.
Reps. John Boccieri of Ohio, Scott Murphy of New York and Allen
Boyd and Suzanne Kosmas of Florida became the latest Democrats to
announce support for the bill after voting against an earlier
version that passed, bringing the number of switches in favor of
the bill to seven.
On the other side of the ledger, Rep. Michael Arcuri of New York
and Stephen Lynch of Massachusetts became the first Democratic
former supporters to announce their intention to oppose the bill.
Lynch said he did so despite a telephoned appeal from Vicki
Kennedy, whose late husband, Sen. Edward M. Kennedy, championed
health care for decades.
Rep. Anh Cao of Louisiana, the only Republican to support the
earlier measure, has also announced his opposition.
The historic legislation, affecting virtually every American and
more than a year in the making, would extend coverage to an
estimated 32 million Americans who lack it, forbid insurers to deny
coverage on the basis of pre-existing medical conditions and cut
federal deficits by an estimated $138 billion over a decade.
Congressional analysts estimate the cost of the two bills
combined would be $940 billion over a decade.
For the first time, most Americans would be required to purchase
insurance, and they would face penalties if they refused. Billions
of dollars would be set aside for subsidies to help families at
incomes of up to $88,000 a year afford the cost. And the
legislation also provides for an expansion of Medicaid that would
give government-paid health care to millions of the poor.
Republicans resorted to unusually personal criticism in their
struggle against the bill, calling Kosmas a "space cadet" after
she announced her position and labeling Pennsylvania Rep. Jason
Altmire a "drama queen" for waiting to announce his opposition.
They also suggested the administration had adjusted water
allotments to an agricultural region of California to secure the
support of two lawmakers but offered no evidence of any link
between the two events. Democrats disputed the charge.
In addition, they sought to tarnish Democratic claims of deficit
savings, circulating a Congressional Budget Office estimate that
deficits would rise by $59 billion once the costs of raising doctor
fees under Medicare were added in. The House has already approved
the increase in fees, and the bill is awaiting action in the
Senate.
Apart from Lynch, several lawmakers who supported the earlier
version after the strict abortion limits were incorporated
announced they would vote in favor of the new bill. And there was
talk among others of finding a largely symbolic way that would
allow them to follow. Rep. Marcy Kaptur of Ohio said in an
interview she would support the bill if Democratic leaders would
first allow a stand-alone vote on tougher abortion restrictions,
even though that vote evidently would not affect the health care
measure itself.
The political ramifications remained to be fought out in
November.
Arcuri's announcement of opposition reaped a threat from his
former allies at the Service Employees International Union, which
vowed to try to unseat him in this fall's Democratic primary in
favor of "someone who shares our progressive values."
Boccieri's decision to support the bill drew a tart response
from the House Republican campaign committee, which issued a
warning - "Ohio Dem Uses Press Conference to Announce End of Stint
in Congress" - that predicted the first-term lawmaker's political
demise.
One day after Democrats released 153 pages of revisions to their
bill, they were back at it, responding to fresh concerns from some
of the rank and file about disparities in payment levels to
Medicare providers in different areas of the country.
"I'm a 'no' unless they fix it," said Rep. Peter DeFazio,
D-Ore. "We spent months working this out. If we don't get it in
this bill, we will never get it." Speaker Nancy Pelosi, D-Calif.,
said changes were in the works.
Republicans said, as they have from the outset, that Democrats
were angling for a government takeover of health care. They also
said the cost of the bill would be covered by $900 billion in
higher taxes and cuts in future Medicare payments.
The Republicans circulated a letter from Caterpillar Vice
President Gregory S. Foley to House leaders, warning that passage
of the legislation would raise the company's health care costs by
"more than 320 percent (over $100 million) in the first year alone
and put at risk the coverage our current employees and retirees
receive."
The insurance industry said the latest Democratic legislation
would decimate a private alternative to traditional Medicare that
counts 10 million subscribers. It will "end Medicare Advantage as
we know it," said Robert Zirkelbach, a spokesman for American
Health Insurance Plans." He said Democrats were cutting $200
billion over a decade in projected federal subsidies, and he
predicted premiums for seniors would rise as a result.
The government subsidizes private plans at a higher rate than
traditional Medicare, and the cuts are aimed at reducing the
difference.
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Associated Press writers Erica Werner, Ricardo Alonso-Zaldivar,
Chuck Babington and Alan Fram contributed to this report.

(Copyright 2010 by The Associated Press. All Rights Reserved.)