House Democrats Friday night pushed ambitious health care legislation through a key committee, clearing the way for a final vote this fall. The House Energy and Commerce Committee voted largely along party lines, 31 to 28, on a compromise between liberal and conservative Democrats. In a last-minute series of changes, the committee agreed to cap increases in the cost of insurance sold under the bill and also to give the federal government authority to negotiate directly with drug companies for lower prices under Medicare. 'We have agreed we need to pull together,' said Rep. Henry A. Waxman, D- Calif., the committee chairman. Five Democrats on the panel voted against the bill. Before the vote, committee members acknowledged the momentous nature of their action. 'We have a historic opportunity to transform our healthcare system,' said Rep. Mike Ross, D-Ark. Now Democrats are preparing to fan out around the country during their August recess and help President Barack Obama convince the nation that the plan would not only extend health care to the 47 million who now lack insurance but also provide help to millions more already covered. Democratic leaders have given palm cards to every House member summarizing the details of the $1 trillion bill -- including new subsidies for the poor, tax credits for small businesses that provide insurance for their workers, and expanded prescription drug coverage for the elderly. 'The president of the United States will be out front as the drum major,' said House Speaker Nancy Pelosi, D-Calif. 'We will be the drumbeat across America.' White House Press Secretary Robert Gibbs called the House committee action 'a big positive step forward (that) gets us even closer to comprehensive health care reform.' A key part of the Democratic political strategy for the summer, worked out in coordination with the White House, will be to demonize insurance companies for opposing a bill that has been backed by a wide array of health and consumer groups. Pelosi predicted the industry would conduct a 'shock and awe' campaign in the coming weeks to block the legislation. Said Gibbs, 'I think many people that believe we need comprehensive health care reform think that insurance companies have not lived up to all of their responsibilities and that they can do better.' Major provisions of the bill include an expansion of Medicaid, the federal-state health care program, to cover more low-income people. Middle-class workers would receive new subsidies to pay health insurance. A government-sponsored insurance plan would be available as an alternative to private plans. Critics worry that the government option will undercut private plans by offering cut-rate premiums, putting the health system on a path to being dominated by the government. Congress is moving more slowly on the legislation than Obama wanted. In the Senate, a key committee has not reached agreement on its version of the bill. House Democratic leaders had hoped the legislation would come to a full chamber vote before the August recess. But Friday's vote by the House energy committee gave much-needed momentum to the bill. Parts of the legislation had been approved by other committees, including a surtax on wealthy people to help pay for the program and a requirement that most employers provide coverage for their workers. The bill stalled in the energy committee over provisions to provide a public insurance program to compete with private companies. That panel was also deeply split between conservatives who worried about the cost and liberals who wanted to provide more help for low-income Americans. To break that deadlock, Waxman agreed to conservative demands to limit the cost of the bill to $1 trillion over 10 years, to allow more small businesses to be exempt from the employer mandate and to reduce the number of low-income people who would qualify for subsidies. (Optional add end) But those changes provoked a backlash among liberals. To win them back, Waxman crafted a compromise that would restore low-income subsidies among other provisions. During the August recess, House Democratic leaders will tackle the politically risky task of blending the three committee bills into one. Unable to count on many votes from Republicans, leaders will have to produce a bill that commands broad Democratic support, balancing the concerns of conservatives who think the bill costs too much and liberals who think it does not go as far enough. 