Democrats pushed hard to revive President Barack Obama's stalled health care overhaul on Friday — and pointed to glimmers of hope — but the long odds facing them seemed little changed after Obama's extraordinary summit with both parties' leaders.
At the White House, press secretary Robert Gibbs said Obama would unveil a "way forward" next week on legislation that has been his foremost domestic priority. Obama, who will first discuss the strategy with Democratic congressional leaders, said at Thursday's bipartisan marathon that he's open to several Republican ideas, including medical malpractice changes.
There were signs of intensified activity on Capitol Hill.
White House Chief of Staff Rahm Emanuel and top adviser David Axelrod discussed health care in an early evening meeting with House Speaker Nancy Pelosi, D-Calif. And a spokesman for Sen. Tom Coburn, R-Okla., said White House officials have asked the senator to submit details of suggestions he made at Thursday's meeting on rooting out fraud from the medical system.
In addition, a pair of retiring Democrats who opposed the legislation when the House approved it in November appeared willing to reconsider. And some supporters of a House provision strictly banning federal financing for abortion — a complicated sticking point — indicated an openness to different language.
The outcome could affect nearly all Americans, remaking the way they pay for health care, the kinds of care they're likely to receive and where they're likely to get it. Or there could be smaller changes — or none — outcomes the Democrats say will lead to crushing budget problems and tens of millions of people still being left out. Republicans see problems in the health care system, too, but recommend less-far-reaching prescriptions.
Despite the signs of movement, a day after television cameras brought the nation Obama's unusual daylong discussion with top Republicans and Democrats there were no clear indications of a major change in Congress. The equation remained the same: Democratic leaders, especially in the House, will have to scramble to find votes to pass any health legislation and they're almost certainly going to have to do it without Republican support.
And there are Democratic doubts, as well.
"People who voted 'yes' would love a second bite at the apple to vote 'no' this time, because they went home and got an unpleasant experience" because of their votes, said Rep. Jason Altmire, a moderate Democrat from Pennsylvania. "On the other hand," he added, "I don't know anybody who voted 'no' who regrets it."
Top Democrats spoke of plunging ahead anyway.
Pelosi said she saw "good prospects for passing" health legislation and contended Thursday's meeting showed a GOP content to accept the status quo of insurance companies bullying consumers.
The Democrats seem ready to use "reconciliation," a seldom-used procedure that could let them push legislation through the Senate with a simple majority. Until now, Republicans have used a filibuster to force Democrats to find 60 votes in the 100-member Senate — one more than they have.
Republicans say reconciliation should be used for budget changes, not a dramatic reshaping of national health care policy. With polls showing some voters consider the process unfair, some moderate Democrats have expressed a reluctance to support it. Rep. Stephanie Herseth Sandlin, D-S.D., said Friday she will be a "definite no" if it is used.
But in an interview with The Associated Press, Sen. Mary Landrieu, D-La., said she was open to using the process "because the Republicans have just decided that they don't want to negotiate."
Spokesmen for the House and Senate Republican leaders said Friday their party does not plan a formal response to Obama, having made clear a belief that Democrats should scrap their bills.
The primary problem for Democratic leaders is the House. That chamber approved its bill 220-215 in November. But one of those "yes" votes came from the only Republican who supported the bill, Rep. Joseph Cao of Louisiana, who now says he will oppose the bill. Three other "yes" votes came from Reps. John Murtha, D-Pa., who died this month, Robert Wexler, D-Fla., who has left the House, and Neil Abercrombie, D-Hawaii, who retires this weekend to run for governor of his state.
In fact, Democrats following the legislation say House Democratic support for the legislation has sunk to 200 votes or less in recent weeks, following the stunning GOP victory in last month's special Massachusetts Senate election and the bill's modest showing in polls.
Providing the Democrats with some hope were indications that two retiring party members who voted against the legislation would consider switching. Rep. Brian Baird, D-Wash., said he is now "totally undecided" and liked how Thursday's summit showed Obama had reached out to Republicans for support. And Rep. Bart Gordon, D-Tenn., said it was time to look at "everything fresh."
There were even signs of possible flexibility among Democratic foes of federally financed abortion, many of whom have threatened to oppose the health measure if House-approved restrictions are eased. Altmire did not rule out supporting slightly less strict Senate abortion curbs if they are part of an overall health measure he liked.
But abortion remained an unresolved issue, with the U.S. Conference of Catholic Bishops reiterating Friday that it was opposing the overall Senate bill on the grounds that it would open the door to some federal support for abortion.
And for every Democrat touting optimism about the overall bill, there was another expressing wariness about legislation that polls show gets mixed reviews from the public.
Rep. Gene Taylor, D-Miss., said he chatted at the House gym Friday morning with fellow conservative Democrats and found that Obama's session had produced no new momentum.
"I don't think it made a nickel's worth of difference," he said, adding, "It's fair to say the trend is going against the bill."
At the summit, Obama said he was open to several Republican ideas — including medical malpractice changes to address the issue of defensive medicine. He is also open to other ideas, such as programs that encourage hospitals and doctors to promptly admit mistakes, offer financial restitution and fix problems to prevent more patients from being harmed.
The legislation would curb insurance industry practices like denying coverage to people who are already sick, extend coverage to about 30 million uninsured people,and help many low-income people pay for it, financed by Medicare cuts and new taxes on higher earning Americans and health providers.
At least for now, Democrats envision prevailing by getting the House to pass a Senate health bill, and also sending Obama a separate measure making changes in the Senate package. The alterations include deleting a politically toxic provision that would have Washington finance expanded Medicaid coverage in Nebraska, easing a new tax on high-priced insurance policies and making federal subsidies for poorer people more generous.