Obama Makes Final Health Care Push, Calls for Up or Down Vote in Congress The president laid out his final push for health care reform legislation.

March 3, 2010 -- President Obama today launched his final push to get health care legislation passed, indicating a willingness to work with Republicans on some issues but telling Democrats to use Capitol Hill's controversial "reconciliation" rules to get a bill to his desk if necessary.

While not specifically referencing the controversial "reconciliation" rules, which would allow Democrats to pass the legislation with 51 votes instead of the 60 votes needed to stop a filibuster and proceed to a vote, Obama said Congress owes the American people an up-or-down vote and noted that the procedure had been employed for other key issues.

"[Health care reform] deserves the same kind of up-or-down vote that was cast on welfare reform, the Children's Health Insurance Program, COBRA health coverage for the unemployed, and both Bush tax cuts – all of which had to pass Congress with nothing more than a simple majority," the president said, citing five bills that were passed in the Senate using reconciliation rules

Republicans have been grousing for weeks about the use of reconciliation, saying it shortcuts the process and should not be used for a bill of such importance.

Obama once again dismissed calls from Republicans to scrap the current legislation and start over, arguing that too much time has already been spent on this issue and the differences between the two parties will not be resolved with another year of negotiations and debate.

"For us to start over now could simply lead to delay that could last for another decade or even more," he said. "The American people, and the U.S. economy, just can't wait that long."

After a year of debate and at times acrimonious negotiations, the clock is once again ticking on health care reform legislation. The president said that since the first meetings on the issue last March, the debate has run its course.

"Every idea has been put on the table. Every argument has been made," he said. "Everything there is to say about health care has been said and just about everyone has said it."

Lawmakers on Capitol Hill have been waiting for direction from the president on how health care reform will proceed.

Today Obama urged them "to finish their work and schedule a vote in the next few weeks."

"From now until then, I will do everything in my power to make the case for reform," he said. "And I urge every American who wants this reform to make their voice heard as well – every family, every business owner, every patient, every doctor, every nurse."

The White House's outline for the path to getting a bill passed includes having the House of Representatives pass the health care reform legislation passed by the Senate on Christmas Eve, as well as a second bill containing "fixes" to that legislation.

Republicans to Obama: Thanks, But No Thanks

While the endorsement of the reconciliation rules may sound like partisanship to Republicans, Obama noted that what he was proposing brings together "the best ideas from both parties," according to excerpts.

"This is where we've ended up," he said. "It's an approach that has been debated and changed and I believe improved over the last year."

The president indicated a willingness to work with Republicans to incorporate some of the ideas they brought to the table at last week's bipartisan health care summit.

On Tuesday Obama sent a letter to congressional leadership from both parties that said he would be open to including $50 million for state grants for demonstration projects to explore alternatives to medical malpractice cases, and a crackdown on Medicaid and Medicare fraud as proposed by Sen. Tom Coburn, R-Okla.

Obama also heralded the removal of extraneous provisions in the bill such as the so-called Cornhusker Kickback, a deal to secure the support of Sen. Ben Nelson, D-Neb., in which the federal government would pay for Nebraska's Medicaid expansion; and "Gator-aid," the provision to shield Florida seniors from cuts to the Medicare Advantage program, secured by Sen. Bill Nelson, D-Fla.

But he said there are many Republicans who "just have a fundamental disagreement" over how much oversight the government should have over insurance companies. Obama was blunt in telling those lawmakers what they could do.

"If they truly believe that less regulation would lead to higher quality, more affordable health insurance, then they should vote against the proposal I've put forward," he said.

The Republicans responded to the president yesterday with their own letter that essentially said, "Thanks but no thanks."

Senate Minority Leader Mitch McConnell, R-Ky., wrote to the president to say that the Republicans were "surprised and disappointed with your latest proposal to simply paper a few of these commonsense proposals over an unsalvageable bill."

"The American people are asking us for step-by-step reforms that target cost and expand access, not a couple of commonsense ideas layered over a rewrite of one-sixth of the economy, a massive expansion of the federal government's role in their daily lives, and higher taxes and cuts to Medicare to pay for it," he wrote.

The president will be joined in the East Room by health care professionals from around the country and Secretary of Health and Human Services Kathleen Sebelius.

Obama said today that it is not just the fate of health care reform that's at stake right now, but the ability of politicians in Washington to solve problems.

"The American people want to know if it's still possible for Washington to look out for their interests and their future," Obama said.

"They are waiting for us to act. They are waiting for us to lead. And as long as I hold this office, I intend to provide that leadership."

Obama's poll numbers have suffered as the health care debate has dragged on since early last year. "I don't know how this plays politically, but I know it's right," he said.

But at the same time he expressed consternation that health care has been consistently framed in the context of elections.

"I know there's a fascination, bordering on obsession, in the media and in this town about what passing health insurance reform would mean for the next election and the one after that," the president said. "Well, I'll leave others to sift through the politics. Because that's not what this is about. That's not why we're here. "

Obama to Make the Case for 'Reconciliation' for Bill

The president sought to paint a picture of what he will say will happen without a health care reform bill – skyrocketing premiums, everyone at the mercy of the insurance industry, as recently seen with the 39 percent premium increases proposed by Anthem Blue Cross in California.

He said the "fixed" bill will include the proposal for a new "Health Insurance Rate Authority" to set guidelines for reasonable rate increases. If proposed premium increases are not justifiable per those Health Insurance Rate Authority guidelines, the Health and Human Services Secretary or state regulators could block them. "Those practices would end," he said.

The White House said on Tuesday that the health care debate moves into its "final act" after the president's remarks and that he will "continue the role he's played throughout this process."

"He will obviously be very involved in whatever happens next," White House spokesman Robert Gibbs said. "We wouldn't be where we are without the president's involvement and we'll leave process to after the president's announcement."