WASHINGTON—House Democrats on Friday struggled to line up the 218 votes they need to pass a historic health care reform bill, possibly as soon as today, as Rep. Louise M. Slaughter made her final marks on the legislation during a long and acrimonious meeting of the House Rules Committee.

With House Majority Leader Steny Hoyer, D-Md., acknowledging that Democrats were still trying to secure enough votes to pass the bill, the Rules Committee, headed by Slaughter, D-Fairport, prepared to set the terms of a debate that is expected to consume much of today.

However, House action could be pushed off until Sunday or Monday as Democratic leaders seek compromises on provisions involving abortion and illegal immigration.

Anti-abortion Democrats are pushing for a way to prevent any of the health insurance plans sold through government-run exchanges from covering abortion. Meanwhile, Hispanics were seeking a guarantee that a later compromise with the Senate would continue to allow illegal immigrants to buy insurance with their own money through those exchanges.

“There are many people who are still trying to get a comfort level that this is the right thing to do,” Hoyer told reporters. “We’re very close.”

President Obama, who spent part of the day calling wavering House Democrats, planned to pay a visit to the House today before the expected vote.

Hoping to push the landmark $1.05 trillion legislation one step closer, Democrats on the Rules Committee were expected to jettison most of the nearly 200 amendments that lawmakers offered and focus debate on the Democratic plan and a far slimmer Republican alternative.

Slaughter said the bill is necessary not just because millions remain uninsured but because others often lose their coverage when they get sick.

“The stories that we get almost daily are almost unbelievable — that in America, that we would not be able to provide the health care to people to simply keep them alive,” she said.

But Republicans warned that the bill would be a historic mistake. “This bill will kill American jobs” by slapping hard-hit businesses with additional costs and mandates, said Rep. Dave Camp, R-Mich.

The bill aims to add 36 million people to the insurance rolls, in part by creating a “public option” government-run insurance plan to compete with private insurers.

In addition, the bill mandates that all Americans get health care coverage and imposes a financial penalty on those who don’t. Lower-income people would get government subsidies to buy insurance through the new insurance purchasing exchanges.

Despite Hoyer’s comments, House Speaker Nancy Pelosi, D-Calif., told reporters that she plans to hold the vote today.

Asked if she had the votes for final passage, Pelosi said: “We’ll see when we go to the floor.”

Meanwhile, the Rules Committee prepared for the floor debate. But its work — deciding which amendments go to a floor vote –was delayed as Republicans on the panel engaged in a filibuster-like debate that stretched the meeting into the evening.

On a day when the Labor Department announced that the unemployment rate had topped 10 percent last month, Rep. Pete Sessions, R-Texas, charged that the taxes in the bill could result in the loss of 4.7 million to 5.5 million jobs.

Democrats challenged Sessions on his numbers and noted that more medical professionals will be needed to care for the increasing number of people seeking medical care under the bill.

“This is a job creator, not a job loser,” said Rep. Charles Rangel, D-N. Y., chairman of the Ways and Means Committee.

Meanwhile, Rep. Virginia Foxx, R-N. C., said the creation of a government insurance program was much more than an intrusion into the free market. “It’s obvious that this 2,000-page bill is a government takeover of health care in this country,” she said.

The Democratic bill also bars insurers from denying people insurance on the basis of pre-existing conditions, a practice Sessions appeared to defend, saying: “We’re all different.”

Slaughter responded with a litany of pre-existing conditions that now can cost people their coverage. She noted that women can be denied coverage after getting pregnant and even after becoming victims of domestic violence.

Those practices would end under the bill, thanks in part to Slaughter who recently inserted a provision making it illegal for insurers to deny coverage to women who had been domestic violence victims. The provision would become effective early next year.

“Health care inequity for women will end upon the signing of this bill,” said Slaughter, who has been pushing for health care reform for more than two decades. “Women are set to gain the most from this health care bill.”