Democrats clear impasse blocking health care vote

WASHINGTON (AP) - Capping months of struggle, House Democrats cleared an abortion-related impasse blocking a vote on sweeping health care legislation late Friday and officials expressed optimism they had lined up the support needed to pass President Barack Obama's top domestic priority.

A vote was expected on the legislation on Saturday, after Obama's scheduled midmorning trip to the Capitol complex to make one final pitch for its approval. The bill is designed to spread coverage to tens of millions who now lack it and ban insurance industry practices such as denying coverage on the basis of pre-existing medical conditions.

Under the late-night arrangement covering abortion, Reps. Bart Stupak of Michigan, Brad Ellsworth of Indiana and other abortion opponents were given an opportunity to try and insert tougher restrictions into the legislation during debate on the House floor.

Those proposals are likely to pass, assuming Republican abortion opponents vote for them.

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

The plan emerged from hours of meetings presided over by House Speaker Nancy Pelosi and involving lawmakers on both sides of the abortion issue and officials from the U.S. Conference on Catholic Bishops. It effectively ended a standoff that dated to last summer, when the issue arose in one of three committees that debated the legislation.

There was no immediate reaction from prominent abortion rights supporters called to the late-night negotiations in the Capitol.

Separately, Pelosi and the leadership sought to ease concerns among Hispanic holdouts on the legislation.

"We're very close" to having enough votes to prevail, Majority Leader Steny Hoyer of Maryland said in a midday assessment, although he cautioned at the time that a scheduled Saturday vote could slip by a day or two and sought to pin the blame on possible Republican delaying tactics.

"Nice try, Rep. Hoyer, but you can't blame Republicans when the fact is you just don't have the votes," shot back Antonia Ferrier, spokeswoman for the GOP leader, Rep. John Boehner of Ohio.

Hours later, Democrats were still trying to get them.

In a midnight-hour appearance before the House Rules Committee, Stupak said he hoped the House would pass a ban on any abortion benefit from being offered in a government-run insurance option that is envisioned under the bill, except in instances of rape, incest or when the life of the mother was in danger.

Separately, he said that he and his allies wanted a similar ban on coverage under comprehensive policies offered by private insurers in a federally regulated exchange that would be created. Individuals would be able to buy supplemental abortion coverage as long as they used their own money, and not federal subsidies designed to make insurance affordable.

"We are not writing a new federal abortion policy," he said, adding that his intent was to transplant into the health insurance bill restrictions that apply to other federal programs.

Ellsworth added, "From day one, my goal has been to ensure federal tax dollars are not used to pay for abortions and to provide Americans with pro-life options on the exchange. And I am proud to be part of an effort to help make this goal a reality."

Stupak also said attempts during the evening to reach a compromise that both sides could support had ultimately collapsed.

"I think we have a fundamental disagreement in this issue. That's a reality," California Rep. Henry Waxman, a supporter of abortion rights, said after hours of closed-door talks on the issue.

In a struggle that combined the fate of Obama's signature policy initiative and a 2010 campaign issue, bipartisanship was not an option.

GOP leaders boasted that all 177 House Republicans stood ready to oppose the $1.2 trillion bill, which would create a new federally supervised insurance marketplace where the uninsured or those without employer-provided coverage could purchase it.

Consumers would have the option of picking a government-run plan, the most hotly contested item in the legislation and the basis for the Republican claim that Democrats were planning a government takeover of the insurance industry.

Democrats said their bill was designed to spread coverage to millions who lack it, ban insurance industry practices such as denying coverage on the basis of pre-existing medical conditions and restrain the growth of health care spending nationally. The Congressional Budget Office said that if enacted, the measure would extend coverage to 96 percent of all eligible Americans within 10 years.

Obama and others in his administration spent part of the day lobbying intensely for its passage.

Rep. Jason Altmire, a second-term Democrat from western Pennsylvania, said he received calls during the day from the president, White House Chief of Staff Rahm Emanuel, Health and Human Services Secretary Kathleen Sebelius and Education Secretary Arne Duncan. Their message was "this is a historic moment. You don't want to end up with nothing," he said.

Altmire added his callers emphasized the legislation would change once it left the House, but if it's defeated now the drive to enact sweeping changes would be over for the foreseeable future. He said he remained undecided on his vote.

Several Democrats have already announced their opposition, most of them moderate to conservative members of the so-called Blue Dog Coalition.

Democrats hold 258 seats in the House and can afford 40 defections and still wind up with 218, a majority if all lawmakers vote.

The controversy surrounding illegal immigrants remains "a work in progress," Rep. Nydia Velazquez, a New Yorker and chairwoman of the Hispanic Caucus, said after a midday meeting in Pelosi's office.

As drafted, the legislation permits illegal immigrants to purchase coverage with their own money inside the insurance exchange that would be created - a provision that the 23-member Hispanic Caucus wants retained in any final compromise that reaches Obama's desk.

One lawmaker who attended the session, speaking on condition of anonymity to discuss the private talks, said members of the Hispanic Caucus sought and received assurances from Pelosi that she and the leadership would support them as the bill made its way through the House and ultimately to the president's desk. But this lawmaker said the speaker was not able to get a pledge in return that the Hispanics would all vote for the bill regardless of how their issue was ultimately settled.

Despite the uncertainty, Hispanic lawmakers generally have a strong incentive to support the legislation. According to the Census Bureau, nearly 31 percent of Hispanics are uninsured, roughly double the rate of 15 percent for the U.S. population as a whole.

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Associated Press writers Ken Thomas and Erica Werner contributed to this report.