Will House healthcare reform vote come next week?

With President Obama delaying a trip to Asia until March 21 to rally support for healthcare reform, House Democrats are stepping up the pace to get a bill to the Oval Office by the end of next week.

“I'm delighted that the president will be here for the passage of the bill," said Speaker Nancy Pelosi at a briefing Friday. "It's going to be historic,”

Pressed on that timing, she added: “We will take the time that we need to pass the legislation. ... I’m hoping that it will be in that time frame.”

But to get 216 House lawmakers to agree to approve a Senate bill that most of her caucus opposes, the speaker must convince House Democrats that they can count on the Senate to “fix” the bill, once it is signed into law.

Senate Republicans all week have been cautioning Democrats that the “fix” on their side of the Capitol is not assured. All 41 Republicans signed a letter promising to vote as a bloc to invoke “the Byrd rule” if Democrats try to move fixes not strictly related to the budget issues. It takes 60 votes to waive the Byrd rule; the Senate Democratic caucus has 59 members.

Turning up the pressure, the Republicans on Thursday released a statement from the Senate Parliamentarian’s office that “reconciliation instructions require the measure to make changes in law.” That means that the Senate cannot act on the House “fixes” until Mr. Obama signs the Senate’s version of healthcare reform into law.

“House Democrats are going to have to pass the Senate bill, get it signed, and then pray that the reconciliation fix goes through,” says Don Stewart, a spokesman for Senate Republican leader Mitch McConnell. “They’re going to be voting for the Cornhusker Kickback and all the rest, then have to say they voted for it before they voted against it.”

The rule that the Senate bill must be signed into law before the Senate can take up the reconciliation package does not preclude the House from crafting the fixes now. “The Senate rules are not the rules of the House,” says Michael Steel, a spokesman for Speaker Pelosi.

House Democrats are still negotiating assurance from Senate Democrats that the fixes will pass. “I think members are much more comfortable about the fact that this reconciliation will happen," said Pelosi at Friday’s briefing. "Nonetheless, there are certain assurances that they want – and that we will get for them – before I ask them to take the vote.”

Boosting trust between House and Senate Democrats over healthcare plans is also a motive in Obama’s decision to spend two more days in Washington before his Asia trip.

“The president is talking not just with members of the House on the vote they’re going to make but with members of the Senate to ensure that the
corrections that the president sees as so important are also enacted,” said White House spokesman Robert Gibbs at a briefing on Friday.

The fixes will include changes to make healthcare more affordable for the middle class; eliminating special deals, including a provision exempting Nebraska from paying to expand access to Medicaid; closing the “doughnut hole” for seniors in the prescription-drug entitlement; and changing the funding mechanism to rely less on an excise tax on so-called Cadillac insurance plans.

First, the Congressional Budget Office releases its cost score of the proposed fixes, expected as early as Friday. The legislative language on fixes will be released on the House Budget Committee’s website before it takes up the legislation, now scheduled for Monday. The full House will have 72 hours to study the package, before it comes to a vote.