House Democrats clear the way for health-care vote

WASHINGTON — House Democrats cleared the way Wednesday for a pivotal floor vote on health care overhaul as early as the weekend, after tweaking their 1,900-page bill to crack down harder on insurance companies.

"Americans are ready for comprehensive health insurance reform and the House will soon act," Speaker Nancy Pelosi, D-Calif., said in a statement that accompanied dozens of last-minute changes to the bill, released Tuesday night.

Publication of the changes started a 72-hour legislative clock, meaning that a floor vote could take place as early as Saturday.

But with no Republican backing for the measure, Democrats will need overwhelming support from their own. A festering intra-party disagreement over how to prevent federal funds from being used to pay for abortion remained unresolved Wednesday morning.

And in the Senate, progress on health care legislation was still on hold.

The 10-year, $1.2 trillion House bill is estimated to expand coverage to about 96 percent of eligible Americans. Beginning in 2013, it would provide government subsidies to extend coverage to tens of millions who now lack it, and ban insurance company practices such as denying coverage to people with pre-existing medical problems.

For the three years before the federal aid starts flowing, the bill would set up a temporary "high-risk pool" through which people who have been denied coverage because of poor health could obtain a government-subsidized policy.

The bill would set up health insurance "exchanges" through which self-employed people and small businesses could buy coverage, either from a private insurer or a new government plan that would compete. All the plans sold through the exchange would have to follow basic consumer protection rules, making it easier to shop and compare among them. The majority of Americans covered under big employer plans would not see dramatic changes.

The House bill would be paid for by boosting taxes on upper income earners and cutting Medicare payments to health insurance companies, hospitals and other medical providers. Democrats also moved Tuesday to close a biofuel tax credit loophole, raising about $23 billion to help pay for the legislation.

The major last-minute changes to the House bill hardened the battle lines in the confrontation between Democrats and the health insurance industry. Insurers have sought above all to block creation of a government insurance plan, which happens to be the top legislative goal for liberals.

Other changes to the bill, such as enhanced status for the government's office of minority health, were intended as sweeteners for supportive lawmakers.