They all sound so confident, don’t they? Gibbs says that this time next week, health care reform will be passed. Pelosi says she has the votes now (I call bullsh*t on that - as does Pelosi’s own whip Rep. Clyburn). Axelrod, who must have been drunk yesterday morning, dared the GOP to run in the fall on repealing the bill. Um, yeah. And since the only people who are going to vote next midterm are people who are mad at the Democrats because of the economy and mad at them because of health care reform, Ax better find a nice deserted island to try and hide from the tsunami that is going to hit his party in the fall. If he thinks Americans are going to turn out in droves in November and thank Obama for this monstrosity, he is kidding himself.

But that’s the future and the immediate problem for the Democrats is to find a way to 216. The estimable Nate Silver explains:

It seems to me that there are sort of two equilbiria: either essentially all of the non-Stupak yes votes hold, in which case health care passes very narrowly (perhaps with exactly 216 votes) — or the floodgates open, there are a few key defections about half-way into the roll call, and anybody with a grievance deserts the bill, in which case all of the sudden it might struggle to get 200 votes. (Of course, Pelosi doesn’t have to hold a vote, and would probably want to avoid such an embarrassing outcome — but it’s not out of the question that she could push the measure to the floor not knowing the result, and that things could totally unravel during the roll call.)

Right now, I’d place slightly more weight on the former case: that Pelosi holds together somewhere between 216 and 218 votes. For essentially the first time during the health care battle, all of the key Democratic constituencies are lined up behind the bill: the Congressional leadership, the White House, the unions, the non-Naderite activists. And when one cuts through all the clutter, the vote-counting news has basically been pretty good for the Demorats: (i) the Stupak bloc is toward the smaller end of its prospective range; (ii) some non-retiring no votes, such as Jason Altmire and Scott Murphy, have been openly flirting with a yes; (iii) none of the non-Stupak yes votes have yet flipped.

A lot of members are playing this close to the vest, but I think Nate is correct. After all the leveraging, and maneuvering, and hand wringing by Blue Dogs, Pelosi is probably 5 or 6 votes short at this point. And the full court press for passage that will be initiated this week by Obama-Pelosi is going to be awesome to watch.

This whip count is based on publicly declared positions of members, which is useful to see how some Democrats are playing the game, but not particularly accurate as to what is happening on the Hill. Rich Baehr, my colleague at American Thinker and one of the sharpest political minds you’ll find, has been saying for months that Pelosi probably has 6-10 - maybe a handful more - of Democrats who voted “no” the first time around but who got “permission” to do so from the Speaker because she had the vote wrapped up. In essence, she granted them a stay of execution if - a big if - she could count on them for the final vote.

She is probably going to have to pull several of those Democrats out of her magic hat for passage. That’s because there may be at least six and as many as 10 Democrats who voted “yes” the first time around but have indicated they are going to vote “no” this time. A couple of those who have said they are leaning against voting despite supporting the bill in December are no doubt looking for a little leverage. Chicago Congressman Luis Gutierrez, for example, has made noises about voting “no” because the issues of illegals being able to purchase insurance is not addressed. But he will almost certainly be a yes vote when push comes to shove.

Dennis Kucinich is another vote that might switch from yes to no but again, I doubt if he will want to be remembered as the liberal who killed national health care. Expect a Road to Damascus conversion from Mr. Potato Head.

That leaves the “Stupak Six That Used to Be 12 But Nobody Believed That Anyway.” I’m afraid that the lobbying efforts to get those holdouts on board will not be pleasant. The combined ability of the Speaker of the House and the President of the United States to make life difficult for a Congressman is awesome. By mid-week, it is going to get awfully lonely for Bart’s boys unless they play ball.

With 25 confirmed “no” Democratic votes, that puts the Republicans at 203 - so close and yet so far. In essence, they need to get 13 of the remaining 37 fence sitters. This sounds doable until you realize that there’s not a thing the GOP can offer these Democrats while Obama-Pelosi can promise the moon or threaten them with hell. There will be some resisters but it is very difficult to see where the Republicans are going to get the votes. It will take uncommon courage to look the president or the Speaker in the eye and turn them down when they are appealing to party, to history, to the viability of Obama’s presidency.

No doubt Rahmbo will be on the phone reminding the holdouts of the president’s ability to not only make them, but break them too. For example, the discretionary authority a president has to release funds earmarked for specific congressional districts will mean the difference between getting funds for that road building project, or old folks recreational center approved before or after the election. That’s real power that a member can’t ignore.

The blandishment of a presidential visit can be effective also. Meanwhile, Pelosi can promise a better committee assignment next January, or banish the member to the post office committee. Co-sponsors for a member’s bill can suddenly dry up. And PAC money from other members may not be forthcoming.

The point is simple; vote against reform and there will be unpleasant consequences. How many of those 37 waverers have the courage to resist the onslaught? In the end, it will be easier to go along and worry about getting re-elected later. Besides, they can always believe the codswallop that by the fall, the American people will absolutely love Obamacare and thank their representative for being such a swell fellow and voting for it.

Can it be stopped? The courage to resist may indeed be found given the stakes. And one should not give up trying to influence the vote (I’ve written three emails to my own Congresswoman, Debbie Halverson, who is a possible no). And perhaps Nate’s scenario of a floor revolt may come to pass, although I don’t think Pelosi will have any kind of a meaningful vote until she’s reasonably sure she has 216.

Situation grave, but not hopeless.