Abortion-Rights Foes, Blue Dog Dems Largest Obstacles To Passing Health Reform in House

March 1, 2010 — The future of health care reform efforts in the House largely rests with abortion-rights opponents and the fiscally conservative Blue Dog Coalition, both of "whose indecision signals the difficulties" House Speaker Nancy Pelosi (D-Calif.) faces in gathering enough votes to pass the legislation, the New York Times reports. Since last week's bipartisan health summit, Democrats are increasingly leaning toward passing President Obama's health reform proposal without any Republican support. Because Obama's plan is based on the Senate reform bill (HR 3590) and includes several differences from the House legislation (HR 3962), Pelosi faces the challenge of holding together the House Democratic caucus and, at the same time, persuading some members who voted against the House bill last November to switch their votes (Stolberg/Pear, New York Times, 2/27).

Under the strategy being considered, the House would pass the Senate's bill, and then both chambers would use the budget reconciliation process to approve supplemental legislation with changes favored by House Democrats. Senate rules require only a simple majority to pass a bill through reconciliation, which would help Democrats avoid a Republican-led filibuster, the Baltimore Sun reports (Levey/Hook, Baltimore Sun, 2/27).

However, some House Democrats have reservations about passing the Senate version because of its language on abortion coverage and because of concerns about their prospects for re-election, the Times reports. Thirty-one of the 39 Democrats who voted against the House bill represent districts that voted for Sen. John McCain (R-Ariz.) in the 2008 presidential election, and 14 of the 39 are freshman, who generally are considered more vulnerable to election challenges. According to the Times, about 40 of the 219 Democrats who initially voted for the House bill did so partly because they were swayed by the inclusion of an amendment that would prohibit insurance plans that receive federal subsidies from offering abortion coverage. Some of these Democrats "will almost certainly" switch their vote on health reform legislation because of the Senate abortion language, which is less restrictive, the Times reports.

Rep. Dennis Cardoza (D-Calif.), who is also a member of the Blue Dog Coalition, said Obama's proposal does not include the antiabortion language he would prefer and does not go far enough in reducing health care costs. Cardoza said that he voted for the House bill "with serious reservations," adding that he is unsure of how he will vote in the future. "I think we can do better" than Obama's proposal, he said. Pelosi also is facing resistance from some of the most senior Democrats, including Reps. Ike Skelton (Mo.), who is facing a tough re-election challenge (New York Times, 2/27).

Still, the White House and Democratic leaders are optimistic that they can gather the necessary votes, the Washington Post reports. In an appearance on NBC's "Meet the Press" Sunday, White House Office of Health Reform Director Nancy-Ann DeParle said that she believes Democrats can get enough votes and again signaled that Obama could be moving toward trying to pass the legislation without GOP support. Obama is planning to disclose his preferred strategy sometime this week, the Post reports (Kornblut, Washington Post, 3/1). During his weekly Internet and radio address Saturday, Obama said he is willing to compromise with Republicans on health reform if they are "serious about coming together to resolve our differences and get this done," but he said the overhaul must move ahead with or without their support (AP/Boston Globe, 2/28).