WASHINGTON — Making an impassioned demand for swift action on health care, President Barack Obama on Wednesday urged Congress to vote "up or down" on sweeping health care legislation in the next few weeks.
"I believe the United States Congress owes the American people a final vote on health care reform," Obama said Wednesday from the East Room of the White House.
"We have debated this issue thoroughly, not just for a year, but for decades. Reform has already passed the House with a majority. It has already passed the Senate with a supermajority of 60 votes. … Now is the time to make a decision."
Obama did not use the term "budget reconciliation," a process by which Congress bypasses Senate filibuster threats.
But he made it clear that he would back the procedure to advance health care, citing its use by past Republican Congresses to overhaul welfare in the mid-'90s and to pass two large tax cuts in the first years of the last Bush administration.
Health care "deserves the same kind of up-or-down vote," Obama said.
Republican senators vowed to find other procedural tactics to stall the health bill, and warned that Democrats were making a big political mistake.
"History is clear: Big legislation always requires big majorities. And this latest scheme to lure Democrats into switching their votes in the House (of Representatives) by agreeing to use reconciliation in the Senate will be met with outrage," said Senate Minority Leader Mitch McConnell, R-Ky.
After the speech, the White House indicated that the president would take to the road next week to campaign for the legislation with stops in Philadelphia and St. Louis.
On Capitol Hill, party leaders were making the final push to line up the necessary votes behind a two-part strategy that will rely on budget reconciliation to circumvent Republican opposition.
Under that strategy, House Democrats would approve and send to the president the health bill passed by the Senate last year. Both the House and Senate would then approve a second bill containing changes to the terms of the Senate bill, using budget reconciliation.
Under Senate rules, bills voted on under that process can pass with a simple 51-vote majority, rather than the 60-vote supermajority needed to prevent filibusters.
It doesn't promise to be easy.
Senior Democrats on Capitol Hill will not finish writing the reconciliation package until next week at the earliest, according to senior congressional aides. House Speaker Nancy Pelosi also needs to identify the 217 votes that will be necessary to move the unpopular Senate bill and the reconciliation package through the House chamber at a time when scores of rank-and-file lawmakers are growing increasingly uneasy.
Obama is advocating the biggest changes to the nation's medical system in 45 years, but said he isn't worrying about how the issue will affect his party in the November congressional elections. "I do not know how this plays politically, but I know it's right," Obama said. "So I ask Congress to finish its work."
At stake is a plan that would give insurers millions of new customers. Insurers would be required to accept all clients, even those with preexisting medical conditions; and drugmakers would help elderly patients afford medicines.
The legislation would require Americans to get insurance, with new purchasing exchanges and subsidies to help people afford the coverage. The White House said Obama's proposal would cover 31 million uninsured Americans.
Obama said the plan would reduce the federal budget deficit by about $1 trillion over the next two decades, citing the nonpartisan Congressional Budget Office. The plan's price tag of about $100 billion a year mostly comes from the $2 trillion spent annually on health care in the United States, he said.
In the Senate, Democrats face yet another challenge from Republicans if they try to bring the reconciliation package to the floor.
The Senate's budget rules will limit debate on the measure to 20 hours, but there is no limit on the number of amendments that Republicans will be able to offer, raising the spectacle of what has come to be known as a "vote-a-rama" that could drag on for days.
At the White House on Wednesday, Obama made one more nod to his GOP opponents, highlighting Republican ideas that Democrats have incorporated into their health legislation.
And he repeated an offer he made Tuesday to incorporate additional Republican proposals, including initiatives to root out Medicare fraud, reduce medical malpractice lawsuits and encourage greater use of individual health savings accounts.
He rejected GOP calls to start anew. "The insurance companies aren't starting over. They are continuing to raise premiums and deny coverage as we speak," he said "For us to start over now could simply lead to delay that could last for another decade or even more."
This report contains information from the Associated Press, Bloomberg News and McClatchy Newspapers.