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      WASHINGTON (AP) - Rank-and-file Democrats in Congress remain
wary of health care legislation in spite of President Barack
Obama's closing argument for overhauling the system, well aware
that success is far from assured and political perils abound.

      "I think he has succeeded in prying open a window of
opportunity, but it's a very narrow window," said first-term Rep.
Gerry Connolly, D-Va. "And he and the leadership here had better
clamber through that narrow window while they can."

      In a speech Wednesday at the White House, Obama called on
lawmakers to end a year of legislative struggle and angry public
debate and enact legislation ushering in near-universal health
coverage for the first time in the country's history. He called for
an "up-or-down vote" within weeks under rules denying Republicans
the ability to block the bill with a filibuster.

      "At stake right now is not just our ability to solve this
problem, but our ability to solve any problem," the president
said. "And so I ask Congress to finish its work, and I look
forward to signing this reform into law."

      Appearing before a select audience, many of them wearing white
medical coats, Obama firmly rejected calls from Republicans to
draft new legislation from scratch.

      "I don't see how another year of negotiations would help," he
said. "I believe the United States Congress owes the American
people a final vote."

      Lawmakers were almost finished merging House and Senate versions
of sweeping overhaul legislation when a special election last month
cost Democrats their filibuster-proof Senate majority, throwing the
effort into disarray. Obama is attempting to revive it with one
final push, but with Republicans united in opposition, there is no
certainty about the outcome.


      The lift appears heaviest in the House, where the legislation
passed by a narrow 220-215 margin in November. Since then several
Democrats have defected or departed, and all 254 who remain are
eyeing November midterm elections and a restive electorate
clamoring for more jobs and skeptical of the health overhaul
effort.

      "It's fragile," Rep. Joe Courtney, D-Conn., said of the mood
in the House. "It's getting close to the election."

      Thirty-nine Democrats voted "no" on the House bill, and House
Speaker Nancy Pelosi, D-Calif., will probably need some of those to
switch their votes. The legislative package now under consideration
has less restrictive language on federal funding of abortion than
approved by the House, something that Rep. Bart Stupak, D-Mich.,
leader of the anti-abortion Democrats, said could cost 10 to 12
votes.

      Stupak repeated that assertion Thursday in an interview on ABC's
"Good Morning America," saying that "we're not going to vote for
the bill with that language in there."

      Stupak said, "I want to see health care, but we're not going to
bypass some principles that we believe strongly about."

      Health and Human Services Secretary Kathleen Sebelius, appearing
on the same show, said she hoped that "when the bill is in its
final form and people have a chance to look at it, I think they
will understand that this bill does not change the status quo on
abortion."

      "There will be no federal financing of abortion," she said.


      One problem is, the House likely would have to accept the Senate
version under the procedures that Democratic leaders are planning
to employ.


      Underscoring the pressure, many of the "no" voters made
themselves scarce Wednesday while others said they had to wait to
study Obama's plan before stating their position. "I haven't seen
the president's proposal so I'm going to look at it," said
first-term Rep. Scott Murphy, D-N.Y


      Nonetheless, Pelosi vowed to answer the president's call.

      "Our families and businesses deserve reform that will create
millions of jobs, strengthen Medicare, reduce our deficit and no
longer deny care or drop coverage to those who need it most,"
Pelosi said. "We must act now."


      Republicans said Democrats would be sorry.

      "Americans do not want a trillion-dollar government takeover of
health care stuffed with tax hikes, Medicare cuts and giveaways to
Washington special interests," said House Republican leader John
Boehner, R-Ohio. "Not today, not tomorrow, not ever."

      Obama's endorsement of an up-or-down vote sealed Democrats'
intention to move forward under rules allowing for a simple
majority vote in the Senate, thereby circumventing Republicans, who
now command enough votes to deny Democrats the supermajority
normally needed to act. But House Democrats want assurances that if
they pass the Senate-approved bill as planned, the Senate will pass
a package of changes to fix things House Democrats don't like, such
as a special Medicaid deal for Nebraska.

      "A big issue for the House is just having suspenders with belts
on the plan to ensure we don't get left holding the bag with just
the Senate bill by itself," Courtney said.

      It will take major efforts by Obama and Democratic leaders in
the weeks ahead to put those concerns and others to rest. Obama has
already made plans to try to sell the legislation directly to the
public in states home to opposed or wavering lawmakers, with visits
planned Monday to Philadelphia and Wednesday to St. Louis.

      At its core, the legislation still is largely along the lines
Obama has long sought. It would extend coverage to tens of millions
of uninsured Americans while cracking down on insurance company
practices such as denying policies on the basis of pre-existing
medical conditions. An insurance exchange would be created in which
private companies could sell policies to consumers.


      Much of the cost of the legislation, nearly $1 trillion over a
decade, would be financed by cuts in future Medicare payments and
higher payroll taxes on individuals earning more than $200,000 and
couples more than $250,000.


      In his latest changes Obama added some Republican ideas raised
at last week's bipartisan summit, including renewed efforts on
changes in medical malpractice and rooting out waste and fraud from
the system.


      Associated Press writers David Espo, Ricardo Alonso-Zaldivar,
Charles Babington and Alan Fram contributed to this report.
      

Gallery

Health

Rank-and-file Democrats in Congress remain
wary of health care legislation in spite of President Barack
Obama's closing argument for overhauling the system, well aware
that success is far from assured and political perils abound.

Some Dems are wary of Obama's final health push

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