Obama delays trip for final healthcare push

President Barack Obama addresses the Export-Import Bank's Annual Conference in Washington March 11, 2010.

WASHINGTON (Reuters) - President Barack Obama on Friday delayed an overseas trip to focus on the final drive for healthcare reform as the House of Representatives prepared to vote on the sweeping overhaul next week.

Obama pushed back a scheduled March 18 departure on his first overseas trip of the year to March 21 to help rally support in the days before the House vote.

The House Budget Committee will meet on Monday to take the first steps toward passage of the healthcare overhaul, Obama's top legislative priority, with final votes planned in the full House by the end of the week.

"I'm delighted that the president will be here for the passage of the bill," House Speaker Nancy Pelosi said. "It's going to be historic."

Obama has been pushing hard for a quick final vote on the healthcare overhaul, which has ignited a long-running political brawl with Republican opponents and consumed the Congress for the last nine months.

Democrats hope to finish the legislation to expand coverage to more than 30 million of the estimated 46 million uninsured Americans and regulate insurance industry practices before leaving for a two-week recess on March 26.

Health insurer shares dropped on Friday even though the broader market was little changed. The Morgan Stanley Healthcare Payor index ended 1.4 percent lower and the S&P Managed Health Care index dropped 1.8 percent.

House Democrats said on Friday they have largely worked out the final changes to the healthcare overhaul and are awaiting final cost estimates from the Congressional Budget Office.

They hope to keep the total cost in the same neighborhood as the Senate bill's $875 billion price tag over 10 years and deficit reduction of about $118 billion over the same period.

NO PUBLIC OPTION

The final package will include Obama's proposed revamp of the federal student loan program that would boost aid for needy students, Pelosi said, but will not include a government-run public insurance option. She said the public option does not have the votes to get through the Senate.

"I'm quite sad that a public option isn't in there," Pelosi said. The provision, designed to create more competition for insurers and choice for consumers, was included in a House bill passed in November but rejected by moderate Senate Democrats.

Pelosi faces a huge challenge in lining up 216 House votes for final passage among Democrats unhappy with key provisions -- particularly language on the ban on federal funding for abortion -- and nervous about November's elections in which Republicans could challenge their control of Congress.

But House Democrats, who passed their overhaul in November with only three votes to spare, said they were confident they could muster the votes for passage next week even if they lose support by a handful of anti-abortion Democrats.

"There has been a tidal change in the last 72 hours or so," Democratic Representative Anthony Weiner said. "The very idea that we are talking about the endgame tactical stuff is a sign there is increasing confidence we're going to get this done."

Under a two-step process, House Democrats plan to approve the Senate's version of the bill and make changes sought by Obama and House Democrats through a separate measure.

That second bill would be passed under budget reconciliation rules requiring only a simple majority in the 100-member Senate, bypassing the need for 60 votes to overcome Republican procedural hurdles.

Republicans have condemned the use of reconciliation to pass healthcare, although they often used the process themselves when they controlled Congress.

"The reason all this arm-twisting and deal-making and parliamentary maneuvering is going on is because the people hate this bill," Senate Republican leader Mitch McConnell said.

The changes in the reconciliation bill include expanding subsidies to make insurance more affordable and extending more state aid for the Medicaid program for the poor.

They also would eliminate a controversial Senate deal exempting Nebraska from paying for Medicaid expansion costs, close a "doughnut hole" in prescription drug coverage and modify a January deal on a tax on high-cost insurance plans.

The House and Senate approved separate healthcare reform bills last year, but efforts to merge them into a final product collapsed in January when Democrats lost their crucial 60th vote in a special Senate election in Massachusetts.

(Additional reporting by Caren Bohan, Thomas Ferraro; Editing by Eric Beech and Sandra Maler)