House Speaker Nancy Pelosi told her members Friday to brace themselves for a climactic health care vote as early as next week, warning them to clear their schedules for next weekend and promising to stay in session until the landmark vote, people present at the meeting said afterward.

President Barack Obama has postponed an overseas trip until March 21, and Pelosi said, "I am delighted the president will be here for the passage of the bill. It is going to be historic.”

Members and staff don't think Pelosi has the 216 votes she needs to pass reform at this point, but most believe she's close. A vote next week sets up the prospect that Congress could pass a sweeping health reform bill championed by Obama that has been in the works for more than a year — though the Senate would still have to take up a series of fixes through a procedural process called reconciliation.

House leaders reassured members that two of the most controversial side deals — the so-called Cornhusker Kickback and more Medicare Advantage money for Florida — would be stripped out of the reconciliation bill.

But it appeared that the “Louisiana Purchase” — $300 million in additional Medicaid money for the state — and a $100 million hospital grant program requested by Sen. Chris Dodd (D-Conn.) will remain in the legislation, sources said. 

In addition, it looks like House Democrats won't have to vote directly on a Senate bill they really don't like. The speaker hasn't made a final decision, but she told her rank and file during the meeting that the plan now is to craft the legislation in such a way that they would "deem" the Senate bill passed once the House approves the package of fixes.

That means they would vote on the rule and the so-called reconciliation package, which would make changes to the Senate bill and require only 51 votes to pass the upper chamber. In addition, the package of changes would include a student lending bill that was paired with health care through the reconciliation process, leaders said Friday.

All of this could change if the speaker faces major resistance from her members, but it would mean Democrats won't be forced to cast a vote specifically in favor of the Senate bill.

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