WASHINGTON — Amid intense lobbying by the Obama administration, House Democratic leaders struggled Friday for the final votes needed to pass sweeping health care legislation, weighing fresh concessions to abortion foes and working to ease concerns among Latino holdouts.
"We're very close" to having enough votes to prevail, said Majority Leader Steny Hoyer of Maryland, although he added a vote scheduled today could slip by a day.
GOP leaders boasted that all 177 House Republicans stood ready to oppose the $1.2 trillion bill, which would create a federally supervised insurance marketplace where the uninsured could purchase coverage.
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.
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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 citizens within 10 years.
Several Democrats have announced their opposition. Democrats hold 258 seats in the House and can afford 40 defections and still wind up with 218, a majority if all lawmakers vote.
House Speaker Nancy Pelosi and the leadership struggled to resolve controversies over the bill's treatment of illegal immigrants and insurance coverage for abortion, issues that transcend health care and have long divided the Democratic caucus, as they do the nation.
Federal law prohibits the use of federal funds to pay for abortions except in the case of rape, incest or situations in which the life of the mother is in danger. That left unresolved 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.
A compromise proposal backed by Rep. Brad Ellsworth, D-Ind., would allow it, so long as abortions weren't paid for from federal funds used to subsidize insurance policies bought by lower-income individuals and families.
That was enough to satisfy some, but other abortion foes objected, backed by the U.S. Conference of Catholic Bishops, and Democrats weighed concessions that could satisfy them without losing votes from abortion rights Democrats.
It was not clear what changes were under consideration, but officials said they would involve more restrictions on the availability of abortions.
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 mid-day meeting in Pelosi's office.
The legislation permits illegal immigrants to buy 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.
The bill would be paid for by cuts in payments to Medicare providers and a surcharge of 5.4 percent on income tax filers with income of $500,000 for individuals and $1 million for couples.