With or Without Republicans, Democrats Move Forward With Health Care Overhaul

WASHINGTON, March 1, 2010— -- Political strategists doubt whether there is enough support among Democrats to pass President Obama's health care legislation, even though House Speaker Nancy Pelosi, D-Calif., expressed confidence Sunday she would eventually have enough House votes to do so.

"The math is pretty daunting," Democratic strategist James Carville told "Good Morning America's" George Stephanopoulos today. "I don't think it's impossible, but it's going to be difficult. This is going to be a real, real fight."

Republicans want the bill to pass because of its unpopularity, but at the same time, they can't be complacent on health care overhaul, said Matthew Dowd, ABC News contributor and former adviser to President George W. Bush.

Polls show that even though a majority of Americans dislike the Democrats' bill, they do want health care overhaul.

"Republicans [would] like this bill to pass, because they know how unpopular it is," Dowd said on "GMA." "Right now, it's all upside for the Republicans whether the bill passes or fails."

Pelosi acknowledged that gathering enough votes would pose a challenge. To pass the health care bill, the House and Senate bills would need to be meshed together into one piece of legislation that can pass both chambers.

But since there are significant differences between the House bill and Senate bills, Democrats are discussing the possibility of first passing the Senate bill in the House, then passing a separate bill with House Democrats' revisions through reconciliation, a legislative process that would require only 51 votes in the Senate.

The speaker of the House has a lot of persuading to do, because the bill's unpopularity has caused members who voted for it last year to reconsider.

Proponents of the bill argue that Democrats need to step up and push the bill through because if it doesn't pass, it will only hurt them.

"If the bill loses ... it will, I think, by and large be a lot of the president's Waterloo, and I think a lot of Democrats understand that," Carville told George Stephanopoulos on "GMA."

"I think the Democrats need to realize that there's some political value in taking this on," he said. "They can do better coming down the stretch. ... We're in overtime in this hockey game."

Dowd said the administration wanted to, and needed to, finish up the health care bill and move on to other important issues. Health care legislation last year took up a majority of the Senate's time. and. as a result, key bills were put on the back burner, including climate legislation and jobs creation.

"I think the benefits of this bill -- if you look at the actual specifics of the bill -- aren't going to take place for many years. ... And I think the problem for the administration is, even if they pass this bill, they don't want to spend months trying to sell an unpopular bill," Dowd said. "They know there's another issue -- jobs -- that everybody cares about."

Final Push on Health Care Overhaul

Obama's and Democratic leaders' health care push is likely to accelerate this week and could possibly go well into April.

"Time's up, yes," Pelosi said. "So we really have to go forth. What's the point of talking about it any longer?"

Democratic lawmakers facing a tough fight in the upcoming mid-term elections are uncertain of their future political prospects and, hence, wary of throwing their support behind the bill.

"The problem is the moderate Democrats who voted for this bill a few months back, but now the political environment has changed dramatically," Dowd said. "I don't know if she [Pelosi] can keep those."

Obama and Pelosi need to pick up those votes and persuade some of their skeptical party members, including moderate, so-called Blue Dog Democrats, some of whom want more restrictive abortion language in the bill and are wary of the bill's price tag. The president and Pelosi will also try to woo retiring Democrats and lawmakers who are almost certain to lose this November anyway.

In November, 220 House members voted for the health care bill, but the one Republican who voted for it has since retracted his support. One congressman died and two others have resigned.

That Senate version of the bill will need a majority of 217 votes to pass the House. The Democrats are staring with 216. If the president can get 217 votes, the bill will go to the Senate where the only path to victory is to use a controversial voting rule that requires 51 votes.

All the while, the president and Democrats will face Republican and insurance industry attacks, and the winds of public opinion blowing against the bill.

Republicans continue to call for Democrats to start over. But with vast ideological differences, it appears that the Democrats have decided to forge ahead or face the political and economic costs of inaction.

"I have to tell you, as a Democrat, that frightens me," Carville said. "When you're a governing party, and you have a majority like we do, and you have a president, sometimes you got to step up and do something. I suspect this is one of those times."

"It's crunch time out there," he added. "If this doesn't get done, it will hurt the Democratic Party. There's no doubt about that."