Health care reform is finally lurching out of neutral in the House. After weeks of Democratic Caucus meetings and leadership huddles that produced no discernible progress on the stickiest remaining issues, leaders said they will present rank-and-file members with options Wednesday for how to proceed on outstanding issues and will begin moving toward a final bill. “We’re going to give options and see what the feelings are,— House Majority Leader Steny Hoyer (D-Md.) said Tuesday night. House Democrats still need to make decisions on the shape of a public insurance option likely to be included in the bill, how tightly to limit access to abortions, the refiguring of Medicare reimbursement rates and the final mix of cost cuts and tax increases to pay for the package. On one of those issues — how to pay for the bill — Speaker Nancy Pelosi (D-Calif.) indicated the measure was all but certain to include a tax on the wealthy, as opposed to the tax on expensive insurance plans approved by the Senate Finance Committee. “We’re pretty much committed to the surtax,— she said. Leaders will be ready to make the tough calls on the other issues after the Wednesday meeting, House Democratic Caucus Chairman John Larson (Conn.) said. Leaders hedged on the timing of sending a final version of the legislation to the Congressional Budget Office to tally the total cost but indicated that it could happen as soon as this week.