WASHINGTON — With time and tempers short, everyone's playing hardball in the drive to pass — or stop — President Obama's massive health care legislation by the weekend. Business groups are spending $1 million a day to depict the bill as a job killer in television ads in the home districts of 26 wavering House Democrats. A new ad barrage from supporters of the legislation went up Tuesday in 11 districts, some overlapping. And unions are threatening some of those lawmakers to come through for Obama — or pay the price in the fall elections.
Obama has summoned members to the White House one by one for private, face-to-face persuasion, and has also met larger groups. White House aides said he plans at least one more public health care event this week, including remarks in Fairfax, Va., on Friday.
"We here in Congress are giving a new meaning to March madness," Sen. Lisa Murkowski, R-Alaska, an opponent of the legislation, said Tuesday.
At stake is a bill that would cover about 30 million uninsured people, end insurance practices such as denying coverage to those with a pre-existing conditions, require almost all Americans to get coverage by law and try to slow the rising cost of medical care nationwide. The comprehensive legislation could affect nearly every American, from those undergoing annual checkups to people facing major surgery.
Activists across the political spectrum are energized. Tea party volunteers, who rallied Tuesday in Washington, are planning to flood congressional offices with e-mails opposing the legislation as a step toward socialism. And some on the political left have joined in calling for the bill's defeat because it leaves out a federal insurance option.
Pressure is on
In the spotlight are 39 Democrats who voted against the House's original health care measure Nov. 7. Democrats hold 253 of the House's 431 currently filled seats, and 216 votes are needed for passage. The bill won't pass unless some of those 39 switch their positions.
In her efforts to complete action on the massive health care overhaul that is Obama's top domestic priority, House Speaker Nancy Pelosi, D-Calif., is considering the use of a little-understood mechanism that essentially lets the House approve one bill by passing another.
At a news conference Tuesday, Pelosi said she had not yet decided on her legislative strategy for bringing the bill to a vote, but she did not rule out the controversial shortcut. "We will do what is necessary," Pelosi said.
The procedure is known as a "self-executing" rule. It has been used at least half a dozen times in the past — often to give political cover to members voting on politically contentious matters, as with the 1989 bill to ban smoking on airplane flights of less than two hours.
Since they no longer have a big enough majority in the Senate to stop Republican filibusters, Democrats plan to have the House approve the version of health care passed by the Senate on Christmas Eve. But that bill contains provisions that are highly unpopular with some House Democrats, so it is being paired with a second bill revising the Senate provisions that House Democrats don't like.
The "self-executing" rule would permit House Democrats to approve the Senate bill indirectly, without having to cast a recorded vote in favor of it.
The maneuver is a kind of legislative fig leaf to spare House Democrats from directly voting to approve a Senate bill many of them had bitterly criticized. While Republicans also used the tactic when they controlled the House, they are indignant that Democrats would employ it on legislation of such significance.
Spending on ads
An estimated $200 million has been spent for political advertising on health care since the beginning of last year, with groups favoring Obama's overhaul holding a slight edge. In the final stretch, however, opponents have gotten the upper hand and supporters are rushing to catch up.
A coalition of business groups led by the U.S. Chamber of Commerce went up with ads last week. The group is now spending an estimated $1 million a day, enough for 25 to 40 television ads, said Evan Tracey, president of Kantar Media-CMAG, which tracks political advertising. The ads frame the health care bill as a drag on the economy, raising taxes and saddling companies with expensive new mandates.
Liberal groups are hoping they won't be too late. Health Care for America Now and several labor unions have announced a $1.7 million ad buy focusing on the districts of 17 undecided Democrats. Their ads portray the health insurance industry as a profit-hungry predator.
"The ads are designed to get people fired up, so that members feel it coming back from their districts," said Tracey. "Members are on notice that they may be voting on this now, but their constituents will be voting on it in November."