Nov. 5 (Bloomberg) -- Democratic leader Steny Hoyer predicted the House will narrowly pass a sweeping overhaul of U.S. health-care policy as the party sought to resolve concerns about abortion and medical care for illegal immigrants.

As the vote draws closer, thousands of protesters gathered near the Capitol and several were arrested after entering House Speaker Nancy Pelosi’s office.

“It’s going to be close,” Hoyer told reporters. “This is a huge undertaking; there are legitimate concerns.”

House Democrats, undeterred by Senate delays on companion legislation or Republicans’ electoral triumphs in two governors’ races this week, plan a vote Saturday on the biggest revamp of U.S. health policy in four decades.

The $1.05 trillion legislation would cover 36 million uninsured people and create a government program to compete with private insurers. President Barack Obama is planning to go to Capitol Hill tomorrow to meet with House Democrats, as they try to secure the votes.

Thousands of placard-waving protesters rallied outside the Capitol, where Republican lawmakers and anti-abortion activists spoke against the legislation.

Tony Perkins, president of the Family Research Council, called it “another bailout of the abortion industry.” He termed the Democrats’ proposed overhaul “radical social policy dressed up in a hospital gown.”

Arrests

House Republican Leader John Boehner referred to the legislation as “Pelosi-care,” calling it “the greatest threat to freedom that I have seen in 19 years” in Congress.

Capitol police arrested four protesters who were charged with unlawful entry into Pelosi’s office in the Cannon building across the street from the U.S. Capitol. Six more people were charged with unlawful conduct in the hallway outside the speaker’s office, and two women were charged with disorderly conduct outside her office, police said.

Earlier in the day, police arrested nine people in a Senate office building. They were charged with unlawful entry.

The legislation got a boost when AARP, which represents 40 million seniors, and the American Medical Association each endorsed the measure.

Obama said he’s “extraordinarily pleased and grateful” to the organizations, adding that support from two of the groups with significant stakes in the debate means passage of the legislation is more likely.

Not ‘Perfect Bill’

“AARP knows this bill will make health care more affordable and coverage more secure,” he said in an unannounced appearance at the start of the daily White House briefing. Doctors “have seen what’s broken” in the medical care system and realize it must be fixed, he said.

AARP said in a statement it plans to educate its members about the legislation through advertising, phone calls and e- mails. AMA President James Rohack said while it’s “not the perfect bill,” it “goes a long way toward expanding access to high-quality affordable health coverage for all Americans.”

The legislation would require all Americans to get insurance, set up new online purchasing exchanges, and provide subsidies to help people buy insurance. It represents the biggest changes to U.S. health care since the 1965 creation of the Medicare system for the elderly.

Need 218 Votes

With Republicans unified in opposition, Democrats need 218 votes to pass the bill. “We are probably right at about 218 right now,” Hoyer said.

Some lawmakers want assurance that the legislation sufficiently restricts government financing of abortions or subsidies for undocumented workers, he said.

“We certainly have well over 218 people who say they want to vote for the bill” if they have those assurances, Hoyer said.

Pelosi said Senate delays wouldn’t necessarily force Congress to hold off on the enactment of the legislation until next year.

“I think we can do all this before Christmas,” she said.

Senate Democratic Leader Harry Reid suggested on Nov. 3 that the goal of passing a bill this year may slip.

Can’t Lose Any

Pelosi, of California, rejected claims that Democrats may have lost momentum on Election Day, when Republicans won governorships in New Jersey and Virginia.

“From my perspective, we won,” she said, pointing to Democratic wins in two House races to fill vacancies in California and New York.

Hoyer said, “we’ve got to resolve both the abortion and immigration” issues “so we don’t lose votes of people who would otherwise be for health care.”

Democrats opposed to abortion, along with many Republicans, are concerned that lower-income Americans in the proposed health-insurance exchanges could use federal subsidies to pay for abortions.

Democratic leaders are trying to line up support for a compromise proposed by an abortion opponent, Representative Brad Ellsworth of Indiana, which would clarify the restrictions, Hoyer said.

The U.S. Conference of Catholic Bishops said it opposes the Ellsworth plan. In a memo to congressional aides yesterday, Richard Doerflinger, an official with the group, said the proposal “addresses none of the substantial criticisms” by the bishops or “other pro-life advocates.”

Illegal Aliens

Ellsworth had said last night that several anti-abortion lawmakers were waiting to hear from the bishops before deciding whether to support his compromise.

On the issue of illegal aliens, the legislation bars the undocumented immigrants from getting subsidies to purchase private insurance that would go to low-and middle-income people. Illegal immigrants would also be prevented from buying insurance from the government-run insurance plan.

Some lawmakers want to go beyond that, preventing the undocumented people from purchasing private coverage on the online exchange the government will set up for people who don’t have employer-provided benefits.

Changing the legislation to keep the immigrants from buying private insurance with their own money on the exchange “certainly is one of the alternatives being discussed,” Hoyer said.

Private Brokers

They could continue to purchase such insurance from private brokers “to try to get around the assertion that if you participate in the exchange you are really getting a subsidy,” Hoyer said.

In the Senate, Reid faces a tougher road to passage because of the chamber’s procedures and opposition to his plan.

Reid needs all 60 votes controlled by the Democratic caucus to even begin debate, and it isn’t certain he has them. He would then need 60 votes again to cut off debate and take a vote, amid controversies over whether to set up a government-run insurance program, the so-called public option, and new taxes to pay for the expanded insurance coverage for Americans.

Reid is waiting for Congressional Budget Office estimates on his proposals and trying to count votes. The nonpartisan agency probably won’t finish its analysis this week, Senate Finance Committee Chairman Max Baucus told reporters.

To contact the reporter on this story: James Rowley in Washington at jarowley@bloomberg.net

Last Updated: November 5, 2009 18:52 EST