Congressional Democrats drew closer on Thursday to agreement on a broad healthcare overhaul that could lead to a final vote in the next few weeks, but vowed not to be bound by White House deadlines.
Senate Democratic leader Harry Reid said there are still issues to work out in the reform package, and House of Representatives Speaker Nancy Pelosi said she was addressing the concerns member-by-member.
Still, Democrats said they were close to hammering out the final changes on healthcare issues like taxes and consumer affordability that could break months of legislative gridlock on President Barack Obama's top domestic priority.
We have a pretty good idea of where we are going on it, Pelosi told reporters after Nancy-Ann DeParle, director of the White House Office of Health Reform, briefed members on the changes sought by Obama.
We have to, member-by-member, address the concerns that they raise, Pelosi said.
Obama has pushed hard for a quick final vote on the healthcare overhaul, which has ignited a long-running political brawl with Republican opponents and consumed the U.S. Congress for the last nine months.
Obama met at the White House with members of the black and Hispanic congressional caucuses to keep up his lobbying effort, and will hit the road again next week to sell his plan.
But congressional leaders, who have repeatedly missed deadlines for finishing the overhaul, resisted the latest White House target of finishing work before Obama leaves on an overseas trip on March 18.
Democrats still hope to approve the legislation to expand coverage to more than 30 million uninsured Americans and regulate insurance industry practices before leaving for a two-week Easter recess on March 26.
We're not going to set any arbitrary deadlines, Reid said after meeting with Senate Democrats. White House spokesman Robert Gibbs acknowledged it might take Congress a few extra days to finish the bill.
Democrats are awaiting a final cost estimate from the Congressional Budget Office on the changes. They hope to keep the total cost at about $950 billion over 10 years -- up from the Senate bill's $875 billion price tag -- and have the bill reduce the deficit by about $100 billion over the same period.
Once the bill and cost estimates are complete, Pelosi said she will give House members one week to study the proposal. But it is not something that we want to drag out, she said.
Pelosi faces a huge challenge in lining up 216 votes for final passage among Democrats unhappy with key provisions -- particularly language on the ban on federal funding for abortion -- and nervous about November's elections in which Republicans could challenge their control of Congress.
Under a two-step process, House Democrats plan to approve the Senate's version of the bill and make the changes sought by Obama and House Democrats through a separate measure.
That second bill would be passed under budget reconciliation rules requiring only a simple majority in the 100-member Senate, bypassing the need for 60 votes to overcome Republican procedural hurdles.
Reid notified Republicans of the plan and noted they had used the process many times when they were in the majority. We will finish the job, he told them in a letter.
Republicans said the Senate parliamentarian had ruled that Obama would have to sign the Senate bill into law before Congress could act through reconciliation.
The changes are meant to ease Obama's and House Democrats' concerns about the Senate's version of the bill. They would include expanding subsidies to make insurance more affordable and more state aid for the Medicaid program for the poor.
They would eliminate a controversial Senate deal exempting Nebraska from paying for Medicaid expansion costs, close a doughnut hole in prescription drug coverage and modify a January deal on a tax on high-cost health insurance plans.
The bill would extend taxes for Medicare, the federal health insurance program for the elderly and disabled, to unearned income.
The House and Senate approved separate healthcare reform bills last year, but efforts to merge them into a final product collapsed in January when Democrats lost their crucial 60th vote in a special Senate election in Massachusetts.
Health insurer shares rose. The Morgan Stanley Healthcare Payor index was up about 1.5 percent and the S&P Managed Health Care index rose about 1.6 percent.
Key issues such as abortion and student loans, remain unresolved. About a dozen anti-abortion Democrats threaten to vote against the final measure unless it strengthens the Senate bill's ban on federal funding for abortions.
We have a situation on abortion which neither side is particularly happy about. So I don't know how we'll resolve it, but we'll keep looking, said Henry Waxman, chairman of the House Energy and Commerce Committee.
Democrats are undecided on whether to attach to the reconciliation package Obama's proposed revamp of the federal student loan program that would boost aid for the neediest students. Reconciliation can only be used on one bill this year and Democrats fear attaching the student-loan provision to the healthcare bill could hurt its chances of approval.
(Additional reporting by Susan Heavey, Thomas Ferraro and Richard Cowan; editing by Cynthia Osterman)