President Barack Obama delivers remarks on health insurance reform at Walter F. Ehrnfelt Recreation and Senior Center in Strongsville, Ohio, March 15, 2010. Credit: Reuters/Jim Young

Representative Dennis Kucinich, one of the most liberal members of Congress and an ardent supporter of nationalized healthcare, became the first House Democrat to switch from no to yes on the overhaul.

This is a defining moment for whether or not we'll have any opportunity to move off square one on healthcare, Kucinich said in announcing his switch two days after Obama lobbied him on an Air Force One flight to Kucinich's home state of Ohio.

Kucinich, who voted against the reform bill for not being liberal enough when the House approved its version in November, said he realized the weekend vote on the Senate's version of the bill would be very close.

Even though I don't like the bill, I've made a decision to support it in the hope that we can move to a more comprehensive approach once this legislation is done, he told reporters.

Kucinich is the first of 37 House Democrats who voted against the overhaul in November to flip to the yes column, but Obama and House leaders are frantically searching for more as they try to round up the 216 votes needed for passage.

That's a good sign, Obama told reporters in the Oval Office. Asked what he had told Kucinich, Obama said, I told him 'thank you.'

Kucinich, a former presidential candidate known for his strong liberal views, is unlikely to bring a lot of followers along with him as most of the Democratic opposition came from moderates.

House Democrats are struggling to finish the legislative language on the final changes they seek to the Senate-passed bill and hope to publish them on Wednesday, along with cost estimates from the Congressional Budget Office.

Under the procedure planned for passing the reform overhaul, the House would vote this weekend on whether approve the Senate's version of the bill. The changes sought by Obama and House Democrats would move through a separate measure.


Republicans have criticized Democrats for considering using a process to avoid a direct vote on the Senate-passed bill, which is unpopular with House Democrats. Instead, they would declare the Senate bill passed once the House votes to approve changes it wants.

They want to hide what they're doing from the American people -- who they seem to view as an obstacle, Republican Senate leader Mitch McConnell said.

The House changes would then be approved by the 100-member Senate under budget reconciliation rules that require only a simple majority, bypassing the need for 60 votes to overcome Republican procedural hurdles.

The overhaul would extend coverage to more than 30 million uninsured Americans and ban insurance practices like refusing coverage to those with pre-existing medical conditions.

Health insurer shares were down on Wednesday while the broader market rose slightly. The Morgan Stanley Healthcare Payor index was down 0.3 percent and the S&P Managed Health Care index dropped 1.3 percent.

As many as two dozen undeclared Democrats could decide the overhaul's fate and end a political brawl that has consumed the U.S. Congress for months and put a dent in Obama's personal approval ratings.

Democratic leaders say they are confident they can find the 216 votes needed. The House passed its version of healthcare in November with only three votes to spare, and a dispute over abortion language could cost Democrats up to a dozen bill supporters this time.

If I can vote for this bill, there are not many people who shouldn't be able to support it, Kucinich said.