WASHINGTON - Historic health care change in the balance, Democrats plowed fresh billions into insurance subsidies for consumers yesterday and added a $250 rebate for seniors facing high prescription drug costs, last-minute sweeteners to sweeping $940-billion legislation headed for a weekend vote.
Democrats set a Sunday showdown in the House, and President Barack Obama scuttled an Asian trip in favor of last-minute lobbying at the White House on his signature issue, playing host to a procession of wavering Democrats.
"It will make history and we will make progress by passing this legislation," predicted House Speaker Nancy Pelosi as Democrats unveiled final alterations to a bill - 16 tumultuous months in the making - meant to expand health care to 32 million uninsured, bar the insurance industry from denying coverage on the basis of pre-existing medical conditions, and trim federal deficits by an estimated $138 billion over the next decade. The bill would affect nearly every American and remake one-sixth of the national economy.
Beginning in 2014, most Americans would be required for the first time to purchase insurance, and face penalties if they refused. Millions of families with incomes up to $88,000 a year would receive government help to defray their costs. Large businesses would face fines if they did not offer good-quality coverage to their workers.
As Democrats trumpeted their bill, particularly its potential impact on the deficit, Republicans attacked it relentlessly as a government takeover of the health care industry financed by ever higher Medicare cuts and tax increases.
"The American people are saying, 'Stop' and they're screaming at the top of their lungs," said House GOP Leader John Boehner of Ohio. Citing reports that Obama had told members of the Hispanic caucus that his presidency depends on the bill's passage, he added, "I'm sorry, Mr. President, this isn't about you."
After weeks of secrecy-shrouded meetings, Democrats unveiled 153 pages of last-minute changes. To address concerns of House Democrats, subsidies were raised for consumers who would face a first-ever requirement to purchase coverage. To ease concerns among governors, more money was added for a dozen states, including New York, that already provide the level of Medicaid coverage that is required under the bill.
Seniors who experience a gap in coverage in the Medicare prescription drug program would receive a $250 rebate this year - an election-year bragging point for Democrats.
Beginning in 2011, pharmaceutical industry discounts would cover 50 percent of the costs of drugs seniors buy once they enter the gap in coverage. That share would rise to 75 percent over a decade.
To help pay for increased benefits, the legislation calls for a 3.8 percent Medicare payroll tax on dividends and interest once an individual's income reaches $200,000, or a couple's reaches $250,000.
If the House passes the legislation, the Senate takes it up under rules that let Democrats pass it with 51 votes instead of 60 needed to break a filibuster. Republicans say they will seek to block passage with parliamentary challenges and amendments.