President Barack Obama urged Congress Wednesday to enact his signature health care legislation swiftly. He said it now contains the best ideas from both political parties. "This is where we've ended up. It's an approach that has been debated and changed and I believe improved over the last year," Obama said in excerpts released in advance of an early afternoon appearance at the White House.
The president was also expected to endorse a plan by Democrats to try and enact the legislation by majority vote — using a Senate procedure that would deny Republicans the right to filibuster.
His appeal came several days after the president convened a bipartisan summit with lawmakers of both parties, then released a revised plan that he said incorporated several GOP suggestions.
Even so, Republicans are solidly opposed to the legislation, demanding instead that Obama and Congress start over again.
At its core, Obama's proposal would extend health care to tens of millions of uninsured Americans, while cracking down on insurance company practices such as denying coverage on the basis of a pre-existing medical condition.
Obama and congressional Democrats are working to mount a party-line rescue mission for the health care legislation that appeared on the cusp of passage late last year, only to be derailed when Republicans won a Massachusetts Senate seat that gave them the ability to stop it.
There is still no certainty about the outcome — or even that Democrats will agree to the series of changes that Obama said represented Republican contributions.
Whatever the final outcome, the issue is certain to reverberate in this fall's congressional elections, a fact that both Obama and Senate Republican leader Mitch McConnell referred to.
"I don't know how this plays politically, but I know it's right. And so I ask Congress to finish its work, and I look forward to signing this reform into law," the president said in the excerpts.
McConnell said that a decision by Democrats to invoke rules that bar a filibuster would be "met with outrage" by voters, and he said Obama was pushing a sweeping bill that the public doesn't want.
"They've had enough of this yearlong effort to get a win for the Democratic Party at any price to the American people," McConnell said on the Senate floor.
Even if Obama's maneuvering draws no Republican support, the White House and Democratic congressional leaders hope it will give comfort to moderate to conservative members of their own rank and file whose votes will be essential to passage.
"I like the idea that the president is working with Republicans and trying to find common ground," said Sen. Mark Pryor, a centrist Democrat from Arkansas. "I think that's a good place to be for him; I think that's what the American people want to see."
The Democrats' strategy includes several steps. The House would be required to pass the legislation the Senate passed late last year, and then both houses would be called on to enact a companion bill making changes in the first one.
Democrats talked confidently of the outcome.
If Republicans "want to run a campaign of bring back the day of kicking people off because of pre-existing conditions, I relish it," the Democratic chairman, Tim Kaine, said on the NBC-TV's "Today" show.
Obama has already made the basics of his plan clear. He would extend health coverage to about 30 million uninsured Americans, leash the insurance industry by banning practices like denying coverage for the ill, expand drug benefits for the elderly and give lower-income people subsidies to help them afford coverage. It would be paid for by raising taxes on upper-income Americans and culling savings from Medicare.
In a letter to congressional leaders Tuesday, Obama went further. He said he was exploring GOP proposals for cracking down on fraudulent medical charges, revamping ways to resolve malpractice disputes, boosting doctors' Medicaid reimbursements and offering tax incentives to curb patients' visits to doctors.
The ideas included an experiment that would establish special courts in which judges with medical expertise would decide malpractice allegations. The idea has been criticized by the Center for Justice & Democracy, a consumer group that prefers the current system of awarding damages. It said health courts would be "anti-patient."
To round up votes, Democratic leaders have been citing polls showing that many voters dislike the overall idea of a health overhaul but favor specific proposals. One presentation by the Democratic firm Lake Research Partners suggests that lawmakers emphasize benefits that would take effect this year, like preventing insurers from denying coverage to those already sick and beginning to improve seniors' pharmaceutical coverage.
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