Bonnary Lek, a manager at Discovery Communications headquarters, is examined by Discovery Wellness Center Medical Director Liz Sequeira during an appointment at the clinic in Silver Spring, Maryland December 3, 2009. Credit: Reuters/Jim Bourg

With President Barack Obama's sweeping healthcare overhaul headed for a final House vote this week, House Democratic Whip James Clyburn said Democrats were short for now of the 216 votes needed but he was confident they could find them.

We don't have them as of this morning, but we've been working this thing all weekend, we'll be working it going into the week, I'm also very confident that we'll get this done, Clyburn, the No. 3 House Democrat who is entrusted with lining up the party's votes, said on NBC's Meet the Press.

Senior White House adviser David Axelrod and spokesman Robert Gibbs appeared on a series of Sunday morning talk shows to say the stalled overhaul, Obama's top legislative priority, was headed for approval in the House this week.

I think we will have the votes to pass this, Axelrod said on CNN's State of the Union.

Obama delayed his first overseas trip of the year this week to help round up votes for healthcare reform, the focus of a long-running political brawl with Republican opponents that has consumed the U.S. Congress for the last nine months.

House Democrats are scrambling to win final passage of the Senate's healthcare bill among Democrats unhappy with key provisions -- including language on the ban on federal funding for abortion -- and nervous about November's elections in which Republicans could challenge their control of Congress.

This is the climactic week for healthcare reform, Gibbs said on CBS's Face the Nation program. The House will have passed the Senate bill a week from today.

In a two-step process, House Democrats want to approve the Senate's version of the bill and make changes sought by Obama and House Democrats through a separate measure passed under budget reconciliation rules.

Those rules require only a simple majority in the 100-member Senate, bypassing the need for 60 votes to overcome Republican procedural hurdles. The House and Senate hope to finish work on the second bill before starting a two-week Easter recess on March 26.

House Republican leader John Boehner agreed with Clyburn that Democrats do not have the votes yet to pass the healthcare bill and said he would try to keep it from happening.


If they had the votes, then it would be law, Boehner said of Democrats on CNN. We're going to do everything we can to make it difficult for them, if not impossible to pass the bill.

House Democrats have expressed concern about whether the Senate will follow up their vote and pass the reconciliation bill with the changes they are seeking.

Richard Durbin, the Senate's No. 2 Democrat, told NBC the House should have absolute assurance that when reconciliation comes over to the Senate side, we're going to pass it.

The overhaul would constitute the most dramatic changes to the $2.5 trillion healthcare system in more than four decades, extending coverage to more than 30 million uninsured Americans and banning insurance practices like refusing coverage to those with pre-existing medical conditions.

The changes in the reconciliation bill include expanding subsidies to make insurance more affordable and extending more state aid for the Medicaid program for the poor.

They also would eliminate a controversial Senate deal exempting Nebraska from paying for Medicaid expansion costs, close a doughnut hole in prescription drug coverage and water down a tax on high-cost insurance plans.

Republican Senator Lindsey Graham condemned Democratic plans to use reconciliation, which he called a sleazy process even though it has been employed frequently by Republicans when they controlled Congress.

If they use this device called reconciliation to deal out Republicans it will open up Pandora's box, Graham said on ABC's This Week, adding it would sink bipartisan efforts on climate change and immigration. It will poison the well.

The House Budget Committee will meet on Monday to take the first steps toward passage, and House Democrats are awaiting final cost estimates from the Congressional Budget Office before publishing the final changes to the bill.

Democrats hope to keep the total cost in the same neighborhood as the Senate bill's $875 billion price tag over 10 years, which includes deficit reduction of about $118 billion over the same period.

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.