Propelled by a strong deficit-reduction estimate by the Congressional Budget Office, House Democrats are pressing ahead toward a showdown vote this weekend on what they hope will be the final version of a health overhaul package.

Meanwhile, President Obama has decided to scrap his trip to the Pacific and stick around, at least for now, to shepherd his top domestic priority through the House and, possibly, the Senate next week.

“Our international alliances are critical to America’s security and economic progress, but passage of health insurance reform is of paramount importance, and the president is determined to see this battle through,” White House press secretary Robert Gibbs told reporters.

Back at the other end of Pennsylvania Avenue, Democrats were celebrating the news from the CBO. It showed the changes they have been working on for weeks would actually result in even bigger savings than the health bill passed by the Senate in December.

“This bill is the biggest deficit reduction bill that any member of Congress is going to have the opportunity to vote on,” said House Majority Leader Steny Hoyer, sounding almost giddy at a midday news conference. “$138 billion reduction in the next 10 years; and over the next 20 years … a $1.4 trillion reduction in the deficit,” he said.

Rounding Up Votes

Clearly House Democratic leaders are hoping the news on the bill’s costs will help win over those last few votes they’ve so far not been able to round up. But just in case not, they brought to their news conference some actual constituents.

One was Ed Morris, who owns a fitness center in Franklin, N.C. He says over the past several years his health insurance premiums have tripled. He said the new bill could help him get less expensive insurance. “So I’m here as a small-business owner to urge my congressman, Heath Shuler, and really all the members of Congress, both Democrats and Republicans, to do the right thing.”

So far, Shuler, a conservative Democrat, has been in the “no” column on the bill. So, for that matter, have been all the Republicans in both the House and the Senate.

And that doesn’t seem about to change, to listen to their rhetoric. “Republicans in the House and Senate have worked closely together over the last year, and we’re going to continue to work closely together and to do everything that we can do to make sure that this bill never, ever, ever passes,” said House Minority Leader John Boehner.

House Speaker Nancy Pelosi all but conceded that she doesn’t yet have the 216 votes she needs. In part, she blamed Republican scare tactics. She said the reluctance of members to vote for the health bill “does show the impact of a campaign of misrepresentation, of fear that is going out there. There is no limit to what the other side will do to protect the insurance companies.”

Changes To The Bill

But it doesn’t help that the House actually has to pass two separate bills to get the overhaul through. One is the bill the Senate passed on Christmas Eve. Then there’s the new bill, the so-called budget reconciliation bill, which will make the changes House Democrats want.

For example, said Pelosi, “We did not believe the Senate bill had enough on affordability; so there’s more affordability for the middle class in the reconciliation package that will pass.” In other words, there are larger subsidies for people with middle incomes who will be required to purchase insurance.

House Democrats also didn’t like the Senate’s excise tax on generous insurance plans, the so-called Cadillac tax. That’s been scaled back, too, says Pelosi. “The higher end of that is left in the plan; I call it the platinum Rolls-Royce piece of it.”

For people on Medicare, there will be more help with prescription drug costs – closing the so-called doughnut hole gap in current drug insurance plans. But working people will pay more for Medicare; at least well-off working people. The bill would extend the Medicare tax to unearned income for those earning more than $200,000 a year.
But there are some changes the bill does not make. For example, it does not include Obama’s proposed board to oversee insurance rate increases. That apparently would not be allowed under the constrained rules governing budget bills.

Assuming the House does pass the bills on Sunday the first bill, the Senate-passed bill will go directly to the president for his signature. The second measure, the budget bill, must go to the Senate. Lawmakers there plans to spend next week debating it.