The potentially historic House session today to decide the fate of the health care overhaul isn't just one vote, but three.

The first will be on a "rule" to establish debate guidelines. The next will consider a package of changes to a Senate-passed bill, including deletion of special Medicaid benefits for Nebraska.

Then, finally, will come an up or down vote on the bill already approved by the Senate, which has been the focus of intense national debate for months. President Barack Obama will sign that bill, and the Senate will vote on the changes measure approved by the House.

House Democrats need 216 votes each time, and the legislation's fate lies in the hands of about 20 Democrats who remained uncommitted late yesterday.

Party leaders appear confident that most will break in favor of the bills.