Democrats to Press Health Bill With Simple Majority

Seeing no prospect of a bipartisan agreement on health care, Congressional Democrats said Friday that they would make another effort to pass sweeping health care legislation on their own.

If anything, Democrats said, their seven-hour meeting with President Obama and Republicans on Thursday confirmed their belief that it was futile to try to work with Republicans on a major health care bill because the philosophical differences between the parties were too profound.

Accordingly, Speaker Nancy Pelosi said, Democrats in the House and the Senate have begun work on a bill that they hope could be passed in the Senate by a simple majority.

Under the tentative plan sketched by Ms. Pelosi and other Democrats, the House would pass the health care bill approved in December by the Senate, and both chambers would approve a separate package of changes using a parliamentary device known as budget reconciliation. The legislation would revise the Senate health bill to reflect compromises between House and Senate Democrats and suggestions by Mr. Obama.

Democrats acknowledged that at the moment they did not have the votes for the reconciliation maneuver, which is intended to avoid the threat of a filibuster and the need for a 60-vote majority in the Senate.

“What you call a complicated process is called a simple majority,” Ms. Pelosi said. “And that’s what we’re asking the Senate to act upon.”

Democratic leaders said Republican intransigence could help them round up the votes of wavering centrists in their own caucus. Republicans adamantly oppose the health care bill, as well as the use of any parliamentary shortcuts.

The White House press secretary, Robert Gibbs, said Friday that Mr. Obama would “make an announcement next week about the way forward” on health care. Mr. Gibbs declined to provide details.

Ms. Pelosi described the steps she had in mind, saying: “What is the substance? That’s what we will be putting together, and we didn’t want to do that before we could hear from our Republican colleagues yesterday. Secondly, what is the Senate able to do with a simple majority? And then we will act upon that.

“I believe that we have good prospects for passing legislation,” said Ms. Pelosi, of California.

Senator Christopher J. Dodd, Democrat of Connecticut and an architect of the Senate health bill, said he was “not a great fan” of using the budget reconciliation procedure.

“But,” Mr. Dodd said, “the issue trumps the process. Would you drop doing health care altogether because you do not like the process? I don’t think so.”

Mr. Dodd said it was difficult for him to take seriously the latest Republican proposals because they would cover just three million uninsured people, about one-tenth as many as the Democrats’ legislation.

Ms. Pelosi mocked the Republican proposals, saying they were too limited to be effective.

“Incy Wincy Spider, little teeny tiny, you can’t do it,” the speaker said. “There are certain things, unless you do them together, it doesn’t have the impact, it doesn’t have the synergy, it doesn’t hold the insurance companies accountable.”

Mr. Dodd dismissed Republican demands that Democrats start from scratch.

“That may be an appropriate answer for a narrow constituency,” he said. “But it just does not make sense for most people, who have watched their rates go up in the last year.”

Democratic leaders hope that both chambers can complete action by March 26, when Congress is scheduled to begin its spring break. But, like many deadlines on this legislation, it could slip, leaving lawmakers to fight over health care in their midterm election campaigns.

White House officials and their allies in liberal advocacy groups are making an all-out push to persuade Congress and the public that budget reconciliation is a legitimate procedure used often in the last 30 years to pass major legislation, including President Ronald Reagan’s domestic agenda in 1981, an overhaul of welfare programs in 1996 and President George W. Bush’s tax cuts in 2001 and 2003.

Senator Charles E. Grassley of Iowa, the senior Republican on the Finance Committee, said he knew those precedents. But, he said, they amount to “peanuts compared with this total restructuring of one-sixth of the economy.”

The No. 2 Republican in the House, Representative Eric Cantor of Virginia, asked the House Democratic leader, Representative Steny H. Hoyer of Maryland, to renounce use of the budget reconciliation procedure for health care. But in an exchange on the House floor on Friday, Mr. Hoyer refused to do so.

Use of the procedure is “in the Republican tradition,” Mr. Hoyer said. In any event, he said, Senate rules requiring a 60-vote majority to cut off a filibuster “are impeding the work of the American people.”

Democrats said they would welcome Republican ideas that could be inserted into their legislation. But they made clear that they had no intention of changing the basic architecture of their bill, which would require people to carry health insurance and require many employers to help pay for it. Democrats would significantly expand Medicaid and would offer subsidies to help moderate-income people buy private insurance.

The cost to the government, roughly $950 billion over 10 years, would be offset with new taxes and fees and cutbacks in Medicare.

Democrats said they would take guidance from a White House proposal issued Monday, but would try to hash out a bicameral bill of their own to get the needed votes. Ms. Pelosi said she would try to work out details in meetings with her caucus next week.

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