Daily Dose

By Paul Kane
The House has officially begun debate on President Obama's massive health-care proposal, with a final vote likely to come some time after 8 p.m. Several key moments have already occured, while a few more are in the offing, providing a glimpse of what the outcome will look like once all the votes are tallied. With not a single Republican expected to support the legislation, House Speaker Nancy Pelosi (D-Calif.) needs at least 218 of the 258 Democrats -- about 85 percent of the caucus -- to vote yes to reach victory.

Here's an insider's guide to the day's big moments:

* Opening Gavel: Democratic leaders had hoped the day's session to begin around 9 a.m. Saturday, about an hour earlier than most legislative sessions start, but they first took up a few non-controversial, unrelated pieces of legislation. According The Post's Sketch maven Dana Milbank, the formal health-care debate kicked off at 10:42 a.m. That was the preliminary debate on the bill, overseen by Reps. Louise Slaughter (D-N.Y.) and Pete Sessions (R-Texas), the chairman and a senior Republican on the Rules Committee.

* Rules of Debate: The first hour or so of debate on the nearly 2,000-page legislation focused on what is known as "the rule." Slaughter's committee establishes the rules governing the debate for every key piece of legislation -- how long each side gets, how many amendments can be offered, which amendments can be offered. In addition, the Rules Committee makes last-minute changes to the overall bill, and this time around Slaughter inserted language designed to be a compromise on abortion. A bloc of two dozen Democrats, many of them anti-abortion Catholics, held out support because they believed the original draft would open the door to federal funding of abortions. The "rule" vote is routinely party line, but 15 Democrats voted against the rule because they either did not support the abortion compromise or opposed the overall legislation. This vote occured shortly after 1 p.m., winning approval on a 242-192 vote. All Republicans voted no, and Pelosi -- as is often the custom with the House speaker on non-controversial matters -- did not vote. Do the math: This means all 435 members of the House are here.

Updated 1:29 a.m.
By Lori Montgomery
House Democratic leaders agreed Friday night to settle an impasse over abortion by letting the entire House vote on a proposed solution, a risky decision that could determine the fate of their trillion-dollar overhaul of the nation's health care system.

Under the agreement, anti-abortion Democrats will be permitted to offer an amendment on the House floor to the health-care overhaul bill. The amendment would prohibit a new government-run insurance plan created by the health-care bill from offering to cover abortion services, congressional sources said. It would also block people who received federal subsidies for the purchase of health insurance from buying policies that offered coverage for abortions.

The deal clears the way for the dozens of Democratic lawmakers who oppose abortion to lend their support to the health care package, the most dramatic expansion of health coverage in more than 40 years. It also satisfies the demands of the U.S. Conference of Catholic Bishops, which had threatened to oppose the House bill.

If the amendment from Rep. Bart Stupak (D-Mich.) passes, said Richard Doerflinger, associate director of the bishops conference, "we become enthusiastic advocates for moving forward with health care reform."

The amendment is expected to pass with the combined support of more than 40 anti-abortion Democrats and virtually every House Republican. That likelihood meant that leaders of the much larger group of Democrats who support abortion rights were not happy to learn of the deal.

"There will be no abortion, not just with public funds, but with private funds under the public option, and that's not acceptable," said Rep. Diana DeGette (D-Colo.).

House leaders met with that bloc of Democrats late Friday to try to quell their frustration., but the agreement makes clear that they believe abortion-rights Democrats will find it difficult to vote against the health-care bill even with such a restriction attached to it.

"This is a small facet of the bill that's very important to a lot of people," said House Majority Leader Steny Hoyer (D-Md.), adding that the greater goal is to pass legislation that makes health care "affordable and accessible to all Americans."

Updated 5:06 p.m. ET

The union representing thousands of Social Security Administration employees has reacted angrily to an official's recent assertion that H1N1 flu is not a serious communicable disease.

Celine Wilson, SSA's chief negotiator with the National Council of SSA Field Operations Locals AFGE, told labor leaders that H1N1 "is not a serious communicable disease," according to an account of the meeting described in a letter sent Wednesday from union President Witold Skwierczynski to SSA Administrator Michael J. Astrue.

At issue is any potential contact between SSA employees and customers at the 1,300 SSA service locations nationwide. The agency already provide tissues, hand sanitizers and face masks for employees who want them.

Union leaders asked for a meeting with officials in late October requesting that the agency add H1N1 to a list of serious communicable diseases covered by agency protocols regarding an employee's contact with sick customers. Employees are supposed to stop any interview with a customer who shows symptoms and refer them to a manager, Skwierczynski said. The current contract includes diseases such as tuberculosis, but not H1N1.

Wilson would not comment on the letter when reached by telephone, and did not confirm or deny making the statement. An SSA spokesman, Mark Hinkle, also did not confirm or deny Wilson's statement, but instead said Skwierczynski "continues to fabricate reports for media attention on this important public health issue."

"Social Security had worked long and hard on H1N1 policies before the union ever asked to discuss it," Hinkle said. "Our policies meet or exceed everything Health and Human Services is recommending, and we believe they are in the best interest of the public and our employees.”

Asked for further clarification, Hinkle said, "We recognize that H1N1 is a contagious disease that can be serious, and we are taking all recommended action."

Wilson's alleged statement is at odds with the opinion of the Centers for Disease Control and Prevention, which describes H1N1 as a communicable disease that "is spreading from person-to-person worldwide." President Obama declared H1N1 a national emergency last month and demand for the H1N1 vaccine has forced federal officials to admit that it may not be widely available until December or January.

By Scott Wilson
President Obama said Thursday he is "extraordinarily pleased and grateful" for the AARP and American Medical Association endorsements of the health care reform legislation moving through the House of Representatives.

"We are closer to passing this reform than ever before," Obama said. "And now that the doctors and medical professionals of America are standing with us; now that the organizations charged with looking out for the interests of seniors are standing with us, we are even closer."

Obama made his remarks during a surprise appearance in the White House briefing room, and his decision to do so appeared designed to generate momentum for the bill heading into a decisive weekend.

Obama is scheduled to travel to the Hill Friday to speak with House Democrats about the importance of passing the legislation. A House vote is scheduled for Saturday, the first of several key Congressional floor votes that will determine whether he secures his signature domestic policy initiative by his end-of-the-year deadline.

White House Press Secretary Robert Gibbs said Thursday that the goal of Obama's Hill visit is "trying to get the bill out of the House."

Obama declined to endorse the House version during his appearance in the briefing room, but Gibbs did not rule out his doing so Friday in meetings on the Hill.

"I think it's important for members to hear the importance of continuing to move this process along, continuing to make progress on reforms that are real and tangible for the American people," Gibbs said.

Updated 12:51 p.m.
By Philip Rucker
As thousands of activists converged on the lawn of the Capitol for a midday rally against Democrats' health-care reform legislation, Capitol Police arrested nine protesters Thursday morning in the Hart Senate Office Building.

The protesters were arrested about 10 a.m. on the seventh floor of the Hart Building and were charged with unlawful entry, a Capitol Police spokeswoman said.

"They were inside an office and didn't leave," Sgt. Kimberly Schneider said.

A noon rally was scheduled for the steps of the Capitol in protest of the health-reform bill that House Democrats plan to take up for a floor vote Saturday.

Rep. Michele Bachmann (R-Minn.) is leading the "Hands Off Our Health Care!" rally and has said she plans to lead protesters through congressional office buildings for a series of "House calls" orchestrated to intimidate members against voting for health-care reform.

By Lori Montgomery
The AARP, the nation's largest and most influential association of older Americans, endorsed the House health-care bill Thursday morning and vowed to lobby House members in advance of Saturday's historic vote.

AARP vice president Nancy A. LeaMond said the House package, which would spend more than $1 trillion over the next decade to expand insurance coverage to millions of Americans who lack it, meets the group's chief goals for reform, including strengthening Medicare, the federal health program for people over 65.

"We can say with confidence that it meets our priorities for protecting Medicare, providing more affordable health insurance for 50- to 64-year-olds and reforming our health care system," LeaMond said in a briefing for reporters.

LeaMond praised House leaders for including a plan to close the coverage gap in Medicare prescription drug coverage known as the donut hole. Key Democrats said the endorsement, one of several expected today, could prove critical to pushing their vote count over the top.

"This gives the bill a very important boost,' said Rep. Chris Van Hollen (D-Md.), a member of the House leadership. "Some of our members are very nervous about how this bill has been received by seniors. For AARP to endorse it provides important validation."

By Lori Montgomery
The long-awaited Republican entry in the health care debate received its assessment late Wednesday from congressional budget analysts, who concluded that the proposal would barely dent the ranks of the uninsured.

The measure would cover only 3 million additional people at a cost of $60 billion through 2019, according to an analysis by the nonpartisan Congressional Budget Office. It would leave more than 52 million Americans uninsured a decade from now.

"The share of legal nonelderly residents with insurance coverage in 2019 would be about 83 percent, roughly in line with the current share," CBO director Douglas Elmendorf wrote in a letter to House Minority Leader John A. Boehner (R-Ohio).

The costs of coverage would be more than offset by other provisions, reducing projected budget deficits by $68 billion by 2019.

Boehner plans to offer the proposal as an alternative to the Democratic package when the House debates health reform as soon as this weekend. The measure, unveiled last week after mounting taunts from Democrats, seeks to expand coverage primarily by lowering the cost of insurance through regulatory reforms, state grants, federal funding for state-based high-risk pools and an expansion of tax-exempt health savings accounts.

By way of comparison, the bill crafted by House Democratic leaders would spend $1.055 trillion to expand coverage to 36 million additional Americans, leaving 96 percent of nonelderly legal adults with coverage by 2019, according to the CBO. The Democratic bill would also do slightly more to reduce future deficits, by $104 billion over the next decade.

By Lori Montgomery
House leaders released the final version of their nearly 2,000-page health package late Tuesday, clearing the way for a vote by the full chamber as soon as this weekend.

But Majority Leader Steny Hoyer (Md.) declined to say when debate would begin on the measure, issuing a statement that said Democratic leaders were still talking with their members.

"With the completion of the Manager's Amendment to the Affordable Health Care for America Act, we are now in the final stage of moving this critical bill through the House," Hoyer said. "We pledged we would make this amendment available for 72 hours before a vote. Now that the Amendment is posted, the clock has started."

"We are continuing to discuss this legislation with our Members, and I will bring it to the Floor once we have consensus and in keeping with our 72 hour pledge."

The final version of the bill can be accessed on the Rules Committee Web site.

The Associated Press
The White House says detainees at Guantanamo Bay are not receiving vaccinations against the swine flu vaccine.

Robert Gibbs on Tuesday said concern that terrorism suspects at the U.S. naval base in Cuba were receiving vaccines was misplaced. Gibbs says no vaccines are at the naval base and none are on the way. A spokesman for the U.S. jail facility a day earlier said guards and then inmates were scheduled for inoculations. Critics were fast to object, saying U.S. civilians were waiting for vaccines while suspected terrorists were being given injections.

Army Maj. James Crabtree on Monday had said that doses should start arriving this month and medical personnel requested the doses. He said detainees will be vaccinated "entirely on a voluntary basis."

by Shailagh Murray
Although the House appears on track to begin a floor debate on health care this week, the Senate showdown looks to be several weeks off.

Senate Democratic leadership aides said they don't expect the Congressional Budget Office to deliver an official cost analysis of the Senate health-care reform legislation until next week at the earliest -- just in time for lawmakers to leave town for a three-day Veterans Day break scheduled for Nov. 11-13.

That leaves just about a week before members of Congress scatter again for Thanksgiving. Senate Majority Leader Harry M. Reid (D-Nev.) could launch the health-care debate during that period, but the window is almost certainly too narrow to finish the job. Given the numerous amendments and procedural challenges that are expected, Senate deliberations could take two weeks or longer, said Reid spokesman Jim Manley.

But Democratic lawmakers said the Christmas deadline for sending legislation to President Obama remains realistic. "We're moving well, we really are," said Senate Finance Committee Chairman Max Baucus (D-Mont.)