Success vs. Survival on Health Care Bill Issue

In the homestretch of the health care debate, one obvious question being asked across the capital is whether Speaker Nancy Pelosi will find 216 votes to pass the bill. For a group of particularly jittery Democrats, the better question may be this: Who will be allowed to slip away?

Yes, the 11th-hour vote tallying is under way at a brisk pace in offices from Capitol Hill to the West Wing, with Ms. Pelosi and her lieutenants keeping hour-by-hour tabs on wavering Democrats.

But as the week inches along, with momentum steadily building to a Sunday vote, the party leaders are also beginning to decide which politically endangered lawmakers will be given absolution to vote no.

“Every vote around here is a heavy lift,” Ms. Pelosi told reporters Thursday.

House Democratic leaders added another key vote Friday morning, with Rep. John Boccieri (D-Ohio) switching from “no” to “yes” on the health care overhaul.

The move was not unexpected; House Majority Whip James Clyburn (D-S.C.) had predicted Boccieri would vote “yes” in a recent television interview.

Boccieri said that the story of Natoma Canfield, a cancer-stricken Ohio woman without health insurance highlighted by President Barack Obama, reminded him of his own family’s health issues.

“I remember standing at the foot of my mother’s bed when she told me she had breast cancer,” the freshman lawmaker said. “Thank God she had health insurance.”

Boccieri said that 39,000 residents of his district do not have health insurance and 9,800 have pre-existing conditions and will benefit from the bill.

“If in this job I can save one life … this job is worth it,” he said. “There are too many politicians worried about their future” and which party will control the House of Representatives, Boccieri said.

That point has been underscored repeatedly this week as on-the-fence lawmakers make their decisions. It has become such a vote-by-vote game that the White House began sending out alerts to reporters each time a Democrat agreed to support the legislation.

But each development, in fact, has a larger meaning.

And with every addition to the yes column, another Democrat potentially gets a pass. Representative Bart Gordon of Tennessee, who had been steadfastly opposed to the legislation, announced Thursday that he intended to support the bill. Mr. Gordon is retiring this year, so his vote to pass the measure does not necessarily mean that Democrats will get 217 votes, but rather it may let another Democrat off the hook.

By this point in the yearlong drama, nearly all lawmakers who remain undecided represent politically tough districts. So that fact alone is not enough for Ms. Pelosi to grant a pass.

But inside the speaker’s suite of offices on the West Front of the Capitol where Democrats are filing in for face-to-face discussions with party leaders, there is a pecking order for vulnerable lawmakers that helps determine the degree of arm-twisting and pressure imposed on them.

Who won by the smallest margin? Which districts have smaller black populations, a traditionally reliable vote? Who voted for the somewhat different version of the legislation in November and is going to be attacked by Republicans for that vote regardless of what they do this weekend? And who stands the best chance to persevere through a roiling political year and by November have at least a decent shot of winning?

Another sign that Democrats are reducing the pressure among Democrats was the latest campaign from Organizing for America, the arm of the Democratic National Committee, which by Thursday was urging activists to turn their attention to persuading centrist Republicans to support the legislation. Some party leaders said they were seeking to avoid agitating Democrats, some of whose votes they still need.

The intrigue surrounding the health care vote has captivated both sides of the Capitol and much of Washington, where the latest vote tally has—for a moment, at least—become nearly as popular as the N.C.A.A. championship basketball brackets.

“It’s pretty clear now that this is no longer an argument between Republicans and Democrats,” said Senator Mitch McConnell of Kentucky, the Republican leader. “It’s an argument between Democrats and their own constituents.”