WASHINGTON -- Surely, North Carolina House members considering a health care overhaul could hear "kill the bill" chants this week from thousands of protesters outside the U.S. Capitol.
If not, then the piles of letters or the constituents jammed inside their front offices might have offered clues about the political difficulty of this weekend's anticipated vote - especially for conservative-to-moderate Democrats.
Inside the small welcome area for Democratic Rep. Bob Etheridge of Lillington, a receptionist hurriedly handed comment cards to about 15 protesters crowding around her desk. "Y'all want some peanuts?" she offered, passing out snacks.
House Speaker Nancy Pelosi needs 218 votes to pass the Affordable Health Care for America Act, meaning only 40 Democrats can oppose it. A vote is expected as early as this evening after a House floor debate.
North Carolina's five Republican House members are solid "no" votes. Its four most liberal Democrats are solid "yes" votes.
"This bill, at its bottom line, will result in 36 million more Americans having health insurance," said U.S. Rep. Mel Watt of Charlotte, a Democrat. "I don't know how anybody can say that's a net negative."
Rep. David Price, a Chapel Hill Democrat, said the bill would "correct the failures of the American health care system without compromising its many strengths or adding to the budget deficit."
But in between stand Blue Dog conservatives Heath Shuler of Waynesville and Mike McIntyre of Lumberton, along with moderate Democrats Larry Kissell of Biscoe and Etheridge.
All represent rural, conservative-leaning districts.
Kissell announced this week that he will oppose the bill because it finds cost savings in $399 million in cuts to Medicare.
"From the day I announced my candidacy for this office, I promised to protect Medicare," Kissell said in his statement. "I gave my word I wouldn't cut it, and I intend to keep that promise."
Price said that while the bill does cut taxpayer subsidies to private Medicare plans, it strengthens the program overall by improving prescription drug coverage, lowering private Medicare co-payments and offering no-cost preventive care.
"Anybody that claims this bill hurts Medicare needs to look closely at the bill," Price said.
The others have not said publicly how they'll vote.
"I'm still weighing the stuff," Etheridge said in an interview Friday morning. "There are some issues I have concerns about."
Chief among them, he said, are worries about the bill's costs and its coverage for part-time workers.
Busloads of visitors
Etheridge was one of several Democrats targeted by three busloads of North Carolina visitors Thursday.
"We need people to go see Etheridge!" shouted Chris Farr, an organizer with the state chapter of Americans for Prosperity. She was standing on the U.S. Capitol steps under the afternoon sun, just after U.S. Sen. Richard Burr had welcomed the protesters and urged them to change Democratic minds.
"Anybody that doesn't listen is crazy," Burr said. "I don't think you're going away."
Chris Jones, 41, of Smithfield, shouldered his wooden sign ("Power to the People") and set off toward a House office building with six others in tow.
"I'm really concerned," said Jones, an insurance agent. "It's not about health care at all. It's really about control and expanding government. If government gets control of your health care, they have so much more control over your private lives."
Inside, Jones spent 15 minutes meticulously writing his thoughts on a comment card.
"I'm urging you to vote against the current bill," he wrote to Etheridge. Elsewhere, others were lobbying Etheridge and others to vote yes.
Pressing the undecided
Vice President Joe Biden, who attended a fundraiser last month for Kissell, was making calls Friday to reluctant Democratic members. This morning, President Barack Obama is scheduled to make a rare trip to the Capitol to meet with the Democratic caucus and try to get more support.
Obama's White House health care czar, Nancy-Ann DeParle, met with Shuler and Kissell in recent weeks.
Shuler talked about expanding a community care program in Asheville to other sites around the country, she recalled. And Kissell discussed his concerns about small businesses.
"I can tell you this: They've thought about it a great deal," DeParle said in an interview. "We want everyone's support, but Shuler and Kissell are people who have spent a lot of time on this who have not said they were definitely for it."
Shuler declined an interview request for this article. His spokesman, Doug Abrahms, said Shuler is worried about the bill's overall cost and has not made up his mind.
McIntyre reportedly is a "no" vote, according to whip counts circulating Capitol Hill. His office did not respond Friday to requests for comment, but he opposed the health bill put forward this past summer.
Across the aisle, not a single Republican is expected to support the House bill.
Republican Rep. Sue Myrick of Charlotte, who briefly attended Thursday's protest, said the health care debate reflects residents' fears about their jobs and the economy.
"One of the reasons you saw people up here yesterday is because they're frightened," Myrick said. "The economic situation in this country is very concerning to people."
A better health bill, she said, would focus more narrowly on tort reform, high-risk insurance pools, consumer choice and disease prevention.
"We could agree on a lot of these things, Democrats and Republicans," Myrick said. "But this has all been staked out. They're determined to try and get it done, although they don't have votes yet."