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Speaker Pelosi bets House on health care reform

Health care vote today after year-plus of debate

Carolyn Lochhead, Chronicle Washington Bureau

March 21, 2010

In January's darkest days, after Democrats had lost their filibuster-proof Senate majority, President Obama publicly hinted that he might vastly scale back his ambitions on health care, and top House Democrats all but declared the project dead. But House Speaker Nancy Pelosi said no.

"We will go through the gate," she said. "If the gate is closed, we will go over the fence. If the fence is too high, we will pole-vault in. If that doesn't work, we will parachute in. But we are going to get health care reform passed for the American people."

Today, thanks largely to a San Francisco Democrat driven by a profound faith in Catholicism and in the ideals of the Democratic Party, Democrats stand on the brink of enacting a $940 billion health care overhaul that they have dreamed of but failed to achieve for more than half a century.

Pelosi is gambling everything on what is expected to be a razor-thin vote: her speakership, Obama's presidency and the political careers of Democrats in swing districts. Polls show the public deeply divided and tilting against the legislation.

Elections loom

After more than a year of rancorous debate, fierce, unified GOP opposition and messy legislative maneuvering that has sapped Obama's political capital, Democrats hope to shift the national discussion to extending health care coverage to 32 million uninsured Americans.

The debate will continue to rage until November when Democrats expect losses in the midterm elections. Even blue-state incumbents such as California Democratic Sen. Barbara Boxer are in jeopardy. Callers jammed the phones Saturday of California Democratic Reps. Dennis Cardoza of Atwater (Merced County) and Jim Costa of Hanford (Kings County). Rep. Jerry McNerney, D-Pleasanton, moved to the yes side.

House Republican leader John Boehner of Ohio threatened grave repercussions in November. Yet Republicans now find themselves fighting all but a fait accompli, and advocating repeal of benefits that will begin rolling out in six months, such as allowing children to remain on their parents' policies up to age 26.

"This health care bill will ruin our country," Boehner told supporters Saturday, calling today's vote "Armageddon." On Friday he warned, "If anyone thinks the American people are going to forget this vote, just watch."

Meanwhile, Pelosi hailed the feast of St. Joseph, a Catholic saint known as "the worker" and dear to Italian Americans, which was Friday. "It is a day that we remember and pray to St. Joseph to benefit the workers of America," she said. "And that is exactly what our health care bill will do."

Trust in speaker

Obama rallied Democrats one more time on Capitol Hill, but some said it was Pelosi who won them over. "He's active," said Rep. Alan Grayson, D-Fla., "but I think what really matters is that people trust the speaker and they listen to what she has to say."

Pelosi has bluntly warned members that no excuses - on abortion, immigration or anything else - will be tolerated, and that a no vote is a no on the Democratic Party's premier issue on a par with the enactment of Medicare in 1965 and Social Security in 1935.

Democratic leaders huddled with anti-abortion waverers who wanted Obama to issue an executive order affirming no taxpayer funding of abortion, but House Majority Leader Steny Hoyer, D-Md., said he has the votes.

Passage would cement Pelosi's place as one of the most effective House speakers in history for moving the biggest, most controversial and most complex pieces of policy in modern times.

Speaker Tom Foley failed in 1994 when former President Bill Clinton's effort crashed amid Democratic disarray. Success eluded Sen. Edward Kennedy, the late Democratic icon whose last public letter called on Democrats to fulfill his lifelong quest of health care reform.

Impassioned, relentless and patient, Pelosi has prowled the wonkiest legislative weeds and rallied her disheartened troops to a larger vision. She oversaw endless hours of bickering at meetings and demonstrated a mastery of both policy details and parochial political needs.

"I've seen four presidents and I don't know how many speakers and leaders of the House here and in California, and governors - she's one of the very best leaders I've ever seen," said Rep. John Garamendi, D-Walnut Grove (Sacramento County). "I've watched her when the caucus is about to explode. She'll stand up and she'll pull us all back together and explain once again why we're doing all these things. She raises the issue to that point of purpose and in the next breath will be down to the details, here's how that purpose is accomplished. I've never seen another leader do it as well."

Inside: Protesters hurl racial epithets at black lawmakers. A13

Haven't we been here before?

The House already passed far-reaching health reform legislation last November. The Senate then endorsed its own bill on Christmas Eve. So what happened?

The death of Sen. Edward Kennedy, D-Mass., halted and transformed the legislative process. Kennedy's successor, Republican Scott Brown, deprived the Democrats of the 60th vote they need to defeat GOP filibusters. The House and Senate bills were very different and for a bill to become law, both chambers must pass identical versions. But Senate Democrats were now short one vote. House members are being asked to give their stamp of approval to the Senate bill in order to get legislation to President Obama that he can sign.

The House will also take up a "fix-it" measure designed to add the House's changes to the Senate approach.

On Saturday, Pelosi abandoned a controversial "deem as passed" procedure that had become a flash point of public anger. Instead, the House will cast three votes today: the first to set the rules for floor debate; the second on House changes to the underlying Senate legislation - the "fix-it" bill; and the third on final passage of the overall health reform measure.

Senate Majority Leader Harry Reid, D-Nev., said he has more than 51 votes to pass the House "fix-it" changes in a special process that skirts a GOP filibuster.

Carolyn Lochhead was the Washington correspondent for the San Francisco Chronicle, where she covered national politics and policy for 27 years. She grew up in Paso Robles (San Luis Obispo County) and graduated from UC Berkeley cum laude in rhetoric and economics. She has a masters of journalism degree from Columbia University. Twitter: @carolynlochhead

President Barack Obama, left, with Speaker of the House Nancy Pelosi, D-CA., right, during his visit to Capitol Hill to meet with House Democrats, in Washington, Saturday, March 20, 2010. Pablo Martinez Monsivais/AP

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