Reporting from Washington — Democratic leaders on Capitol Hill worked throughout the day Thursday seeking intraparty agreements over abortion, federal insurance subsidies and other issues in a healthcare package they hope to send President Obama before the end of the month.
But senior Democrats acknowledged that they were not ready to move forward, and could miss a tentative deadline for a first vote next week.
"It's not done yet and that's an understatement," Senate Majority Leader Harry Reid (D-Nev.) told reporters at the Capitol.
House Speaker Nancy Pelosi (D-Calif.) said she wanted to give her members "at least one week" to review the package before they vote on it. "It may take longer," she said after House Democrats met behind closed doors for two hours with Nancy-Ann DeParle, head of the White House Office of Health Reform.
Democratic leaders believe that the House will have to vote first on the healthcare bill approved by the Senate last year without trying to change it. Leaders then plan to use a process known as budget reconciliation to push through the House and Senate a package of changes sought by House Democrats.
Because budget reconciliation measures cannot be filibustered under Senate rules, Democrats could move the package through the Senate with 51 votes instead of the 60 usually needed to cut off debate.
Democrats in the House and Senate have largely agreed on the basic shape of the reconciliation package, which parallels the healthcare blueprint outlined by President Obama last month.
And many Democrats are eager to finish the debate. "I think everybody understands we need to move on. We've got other things we've got to do," said Rep. Gerald E. Connolly (D-Va.), president of the Democratic freshman class in the House. "This is our last best chance."
The healthcare package is expected to boost subsidies for low- and moderate-income Americans who will be required to buy health insurance. It will scale back a new tax on high-end "Cadillac" health plans, which was a key part of the Senate bill.
It will phase out a gap in Medicare's drug coverage known as the doughnut hole. And it will provide additional aid to states to help expand their Medicaid programs, while eliminating special assistance for Nebraska that had been included in the Senate bill but stirred a storm of criticism.
But Democratic officials were still trying to assess the final cost of the changes, which are being analyzed by the nonpartisan Congressional Budget Office.
And tensions remain around some issues such as abortion. A group of conservative House Democrats threaten to oppose the healthcare legislation unless party leaders toughen restrictions on federal funding for insurance coverage of the procedure.