Washington (CNN) - Can the House of Representatives pass a health care bill without actually voting on it?
That question - bizarre to most casual political observers - took center stage Tuesday as top House Democrats struggled to find enough support to push President Barack Obama's top legislative priority over the finish line.
The House of Representatives is expected to vote later this week on the roughly $875 billion bill passed by the Senate in December. House Speaker Nancy Pelosi, D-California, needs a bare majority of 216 votes from her 253-member caucus to pass the measure. No Republicans are expected to back it.
Pelosi's problem: A lot of House Democrats don't like the Senate bill. Among other things, some House members have expressed concern that the Senate bill does not include an adequate level of subsidies to help middle- and lower-income families purchase coverage. They also object to the Senate's proposed tax on high-end insurance plans.
Pelosi's solution: Have the House pass the Senate bill, but then immediately follow up with another vote in both chambers of Congress on a package of changes designed in part to make the overall legislation more acceptable to House Democrats.
Now, however, Pelosi may also try to help unhappy House Democrats by allowing them to avoid a direct up or down vote on the Senate bill. The speaker may call for a vote on a rule that would simply "deem" the Senate bill to be passed. The House would then proceed to a separate vote on the more popular changes to the Senate bill.
House GOP leaders will try to block the procedure, a House GOP aide told CNN Tuesday morning. They will try to force a vote on a resolution requiring the Senate health care bill to be brought to an actual up or down vote, the aide said.
Senate Minority Mitch McConnell, R-Kentucky, called the maneuver Pelosi's "scheme and deem" plan Tuesday morning. He said the maneuver was "jaw-dropping in its audacity."
The "process has been tainted," he said on the Senate floor. This "will go down as one of the most extraordinary legislative sleights of hand in history. ... Make no mistake: this will be a career-defining and a Congress-defining vote."
He said the "entire effort has been a travesty."
"To resort to these kinds of tactics to deal with this [bill] is just plain wrong," Rep. David Dreier, R-California, said Monday.
"While the process of lawmaking should be ugly, I have never seen it as ugly as it seems to be coming before us this week. ... I think that [James] Madison would be spinning in his grave at the fact that there is absolutely no accountability to what is taking place here."
Vince Morris, spokesman for House Rules Committee chair Rep. Louise Slaughter, D-New York, said leaders haven't decided how the vote will be structured, but told CNN that folding the vote on the Senate bill into a rule vote is being considered.
"We're looking at a couple of different ways to get the bill to the floor and any path we take will obviously require a majority House vote," he said. "And it's worth pointing out that whatever we do will be built upon the precedents of the house and familiar to Republicans from when they held the majority."
–CNN's Deirdre Walsh, Alan Silverleib and Paul Steinhauser contributed to this report
This report was updated at 11:00 with new information.