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Washington - -Democratic leaders scrambled Friday to secure enough votes to push major health care legislation through the House this weekend, but opposition from a growing number of Democrats, including Rep. Frank Kratovil of Maryland, raised new questions about the measure's prospects.

Kratovil, a freshman Democrat from the Eastern Shore, ended months of uncertainty by announcing that he would vote against the House plan, which would extend health insurance to an estimated 36 million Americans who lack coverage. The Marylander, among the most vulnerable House members in the country in next year's election, has long been skeptical of his party's proposal but had left open the possibility of supporting it.

House Majority Leader Steny H. Hoyer, a Maryland Democrat, said the leadership did not yet have the votes to pass the overhaul plan. No House Republicans are expected to support the Democratic measure, which means that Democrats cannot afford to lose more than 40 of their 258 members on the final vote.

Hoyer told reporters Friday morning that he still expected the vote to take place tonight, as planned. However, he and House Speaker Nancy Pelosi of California indicated that the vote could be delayed until next week.

President Barack Obama is expected to pay a visit to Capitol Hill today to rally his party's representatives on the measure, which he strongly supports. But it was possible that House leaders might make an 11th-hour decision to postpone a vote to spare him - and themselves - embarrassment if they are not assured of the votes needed to prevail.

In an interview, Kratovil said he could not overcome his strong doubts about the overall cost of the plan and its likely impact on the federal deficit. He said he could support a different version of the legislation, though not the current Republican alternative.

Kratovil said the $1 trillion House Democratic plan does not adequately control costs, especially in the Medicare program, and as a result "is going to increase the deficit substantially" over the long term.

Kratovil, who represents the Eastern Shore and parts of Baltimore, Harford and Anne Arundel counties, is close to Hoyer of Southern Maryland. He said he talked to Hoyer after notifying the leadership through regular vote-counting channels about his decision.

"As far as I know, he took it OK," Kratovil said.

Hoyer, who has said that House members should vote the views of their constituents on health care, said in a statement that Kratovil "has worked as hard as anyone to engage his constituents" on the issue and "knows well where they stand."

Kratovil said it remains to be seen what effect the health care vote will have on his re-election prospects, which are generally rated no better than a tossup by most independent analysts. From a political standpoint, he said, "there are such strong views on both sides that I'm not sure it makes a whole lot of difference which way you go."

The former Queen Anne's County prosecutor is a member of the House Blue Dog coalition, a group of 52 fiscally conservative Democrats who have been critical of the cost of their party's health care proposal. Kratovil had been under pressure from conservatives in his district and from political ads paid for by opponents of the Democratic health care plan, to cast his vote against it.

A leading opponent of the Democratic plan, the U.S. Chamber of Commerce, praised Kratovil's decision. "We look forward to continuing to work with Congressman Frank Kratovil as this difficult but important process continues to move forward," said a statement from the Chamber, which has spent more than $50 million on federal lobbying this year, much of it against Democratic health proposals.

Kratovil said his fellow Blue Dogs are split on the latest House measure, which addressed the concerns of some rural representatives who had felt that their districts had been shortchanged under the Medicare reimbursement formula.

Fifteen to 20 "yes" votes will be needed from the Blue Dogs to approve the Democratic overhaul legislation, based on statements by other House Democrats who have indicated that they will be voting against the plan.

In recent days, several House Democrats who represent Republican-leaning districts have come out against the measure. Kratovil, whose district backed Republican Sen. John McCain by a wide margin in the 2008 presidential election, fits that profile.

By announcing their opposition before Saturday's planned floor debate, those Democrats spare themselves from coming under heavy pressure from House leaders to support the measure out of party loyalty.

Republicans are waging an aggressive campaign to warn Democrats from conservative-leaning districts that a vote in favor of the House health care plan, strongly supported by Obama and by groups such as AARP and the American Medical Association, could produce a voter backlash next year that would end their careers in Congress.

If health care overhaul bills make it through both houses of Congress, a new, merged version would have to be crafted and submitted to both chambers for another vote. The final legislation could be closer to the Senate plan, which is more palatable to some moderates.

The Associated Press contributed to this article.

How they're expected to vote

Here are the expected votes on health care overhaul by Marylanders in Congress:

Sen. Barbara A. Mikulski (D): For

Sen. Benjamin L. Cardin (D): For

Rep. Roscoe G. Bartlett (R): Against

Rep. Elijah E. Cummings (D): For

Rep. Donna Edwards (D): For

Rep. Steny H. Hoyer (D): For

Rep. Frank M. Kratovil Jr. (D): Against

Rep. C.A. Ruppersberger (D): For

Rep. John Sarbanes (D): For

By Paul West

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