Democrats turned Friday from the drama of a health care summit to the nitty-gritty task of lining up votes to pass a bill without Republican support, as they sought to salvage the sweeping health care overhaul championed by President Barack Obama.
It doesn't promise to be easy, particularly in the House, where old intraparty quarrels over abortion, illegal immigration, costs and taxes are threatening to break out again.
"There was so much focus on the Senate and their search for 60 votes," said Rep. Gerry Connolly of Virginia, who is president of the Democratic freshman class in the House. "That has ignored the real dynamic in the House, where we had to sweat buckets of blood" to pass a bill last year. "It's going to be a serious challenge," he said.
But even as the effort got under way, there were signs that many rank-and-file Democrats are open to compromises to push the health care legislation across the finish line - perhaps as early as the end of March.
"I don't want to see any one issue derail health care reform," said Rhode Island Rep. James Langevin, an anti-abortion Democrat who pushed for tough restrictions on federal funding for abortion in the House bill last year.
Leading liberal lawmakers echoed the call for action. And several of the 39 Democrats who voted against the health care legislation in November - including Reps. Frank Kratovil Jr. of Maryland's 1st District, Allen Boyd of Florida, Jason Altmire of Pennsylvania and Brian Baird of Washington - left open the possibility that they might back the Senate health care bill if combined with a separate legislative package of changes along the lines that Obama proposed this week.
"What the president put forward, and certainly the Senate bill, … are obviously better than the House bill," Altmire said, singling out Obama's proposal to strip out a provision from the Senate bill that provides special assistance to Nebraska at the request of the state's Democratic senator, Ben Nelson.
Altmire, like many lawmakers, said he was looking forward to seeing more details from the president and senior Democrats on Capitol Hill.
Democratic leaders are focused on the House because, having lost their filibuster-proof majority in the Senate, they believe the only realistic chance of getting substantial health care legislation to the president depends on persuading House Democrats to approve the Senate bill as written.
The House and Senate would both vote on the package of changes sought by House Democrats, but they would do so using a process called budget reconciliation. Under Senate rules, this requires only a simple majority of 51 votes rather than the 60-vote supermajority needed to quash a filibuster.
Speaking to reporters Friday at the Capitol, House Speaker Nancy Pelosi of California said she did not think using reconciliation would be a tough sell, noting that what some describe as a "complicated procedure" is really just a "simple majority."
White House spokesman Robert Gibbs declined Friday to say whether Obama would back this approach but said the president would outline Wednesday his proposed strategy for moving forward.
Obama and his congressional allies have little margin for error.
In November, Pelosi pushed a health care bill through the House with just two votes to spare, prevailing 220-215 with the help of Republican Anh "Joseph" Cao of Louisiana, who has since indicated that he will not back the health care legislation again.
Now, the House Democratic caucus has three fewer members after the death of Pennsylvania Rep. John Murtha and the departures of Reps. Robert Wexler of Florida and Neil Abercrombie of Hawaii.
The political climate has also soured for Democrats, underscored by Republican Scott Brown's victory in last month's special election to fill the late Edward M. Kennedy's Massachusetts Senate seat.
Perhaps most challenging, the Democrats' new legislative strategy threatens to undo a series of delicate compromises that House Democratic leaders hammered out last fall to push through their health care bill.
No issue is more explosive than abortion. Michigan Rep. Bart Stupak, a Democrat, who authored a provision in the House bill last year to bar women who receive federal insurance subsidies from buying policies that cover the procedure, has already said he would not accept the Senate bill's restrictions.
The Senate bill would instead require women who receive subsidies to send their insurers a second check to cover the abortion part of their insurance policy. Backers of this approach say that would ensure that no public money goes to covering abortion services.
But Friday, the influential United States Conference of Catholic Bishops, which helped get the Stupak provision into the House bill last year, renewed its criticism of the Senate language.
Other House Democrats remain vehemently opposed to a provision in the Senate bill that would tax high-end "Cadillac" health plans, even though the president and others have proposed to scale back the tax.
Still others have expressed concern about using budget reconciliation to advance the health care bill.
"I think there would be a perception that we are jamming it through," said Rep. Baron Hill, an Indiana Democrat and member of the fiscally conservative House Blue Dog Coalition who backed the health care bill in November and now faces a potentially tough re-election fight.
But, like many centrist House Democrats, Hill said he hasn't "completely closed the door" on backing a reconciliation package.