House likely to pass health care this week, officials say

WASHINGTON — Senior White House officials predicted Sunday that President Obama's health-care initiative will pass the House this week, and warned Republicans if they make it an issue in November elections they do so at their political peril.

"We're happy to have the 2010 elections be about the achievement of health-care reform," White House press secretary Robert Gibbs said. "That's a debate I think we're obviously comfortable having."

"Make my day," senior White House political adviser David Axelrod said. "Let's have that fight. I'm ready to have that, and every member of Congress ought to be willing to have that debate as well."

But top Republicans said they were not walking away from the struggle over health care, whether it passes or fails and ultimately spills over into the midterm congressional elections.

"We have a chance at winning Republican control of the House," House GOP leader John Boehner of Ohio said.

Sen. Lamar Alexander, R-Tenn., called the health-care vote "a political kamikaze mission" for Democrats, saying it has morphed into a "larger issue of the role of government in American lives."

The yearlong legislative fight over health care is drawing to a frenzied close as a multimillion-dollar wave of advertising that rivals the ferocity of a presidential campaign takes aim at about 40 House Democrats whose votes will help determine the fate of Obama's top domestic priority.

The coalition of groups opposing the legislation, led by the U.S. Chamber of Commerce, is singling out 27 Democrats who supported the health-care bill last year and 13 who opposed it. The organizations already have spent $11 million this month, with more spending to come.

In two weeks, the chamber-led group has bought more than $7 million in television advertising and plans to spend up to $3 million more. Americans for Prosperity, a group financed by oilman David Koch, also is jumping into the fray with an advertising campaign of nearly $1 million.

On the other side of the debate, new money from Pharma, the association of drugmakers, as well as contributions from labor unions and other groups, helped equalize the advertising fight. Officials said the groups backing the legislation will focus extensively on the insurance industry this week with this theme: "When insurance companies win, you lose."

Obama is calling lawmakers, too, and planned to travel to Ohio on Monday to open a weeklong campaign to close this act of the health-care debate.

Despite the White House bravado that health-care legislation will pass the House, most political oddsmakers predict it will be close and could go either way. And a key House Democratic leader cautioned Sunday that the votes aren't assured yet.

"No, we don't have them as of this morning," said South Carolina Rep. James Clyburn, the third-ranking Democratic leader in the House and the chief vote counter on the health-care issue. But he expressed assurance the measure would succeed.

The bill needs 216 ayes to pass the House, and most observers believe the Democrats remain about a half dozen votes short.

The Democrats' strategy calls for the House to pass the Senate legislation, followed by consideration of a package of fixes to that legislation known as a reconciliation bill. The fixes must meet specific budget requirements allowing it to be approved in the Senate with a simple majority vote. The approach avoids having to muster 60 votes to overcome a threatened GOP filibuster; Democrats control 59 seats.

House Democrats expect to receive a final cost estimate Monday, when the House Budget Committee is scheduled to vote on the reconciliation package. That measure then would go to the House Rules Committee, where Chairman Louise Slaughter, D-N.Y., could package it with the $875 billion measure the Senate passed on Christmas Eve. The package also is expected to include Obama's proposed overhaul of the student-loan system.

As the issue nears the homestretch, the president has delayed a trip to Indonesia and Australia so he can be here for the final push.

Republicans, on the other hand, liken the legislation to socialized medicine and want to start over.

Under the highlights of Obama's plan, tens of millions of uninsured Americans would gain access to health insurance. Insurers could not refuse coverage for anyone with a pre-existing health problem, and the government would subsidize premiums for those who couldn't afford them — including families of four earning up to $88,000 a year.

The measure passed the Senate late last year, but its legislation differed from the version that passed the House in November. As Democrats sought to craft a compromise, they lost their 60-vote supermajority in the Senate — meaning they no longer had the votes to cut off a filibuster.

The issue also has bogged down over complaints that some senators were given special incentives to support the legislation, such as more Medicaid funding in Nebraska sought by Democratic Sen. Ben Nelson.

Axelrod said Sunday that special treatment such as the "Cornhusker Kickback" would be eliminated unless the special provision involved more than one state.

"The principle we want to apply is that, are these applicable to all states?" Axelrod said.

Axelrod was interviewed on ABC News' "This Week," Gibbs on "Fox News Sunday," Boehner on CNN's "State of the Union," Alexander on CBS' "Face the Nation," and Clyburn on NBC's "Meet the Press."

Information from The New York Times and The Washington Post is included in this report.