When President Obama vowed last week to rebuild the nation's slumping economy on the strength of "five pillars," there was little doubt on which column construction would begin first - health care reform.
As Congress returns to Washington on Monday after its two-week spring break, efforts on a plan to overhaul the nation's health care system will move into high gear as Democratic leaders rush to meet the president's priority.
Plenty of other high-profile issues still will demand the attention of Capitol Hill lawmakers in the coming months, including the 2010 federal budget, the country's economic woes, the banking crisis and a war in Afghanistan that shows no signs of letting up.
But with several big-ticket legislative items already hammered out this year, such as the $787 billion economic stimulus package and a $410 billion omnibus spending bill, lawmakers pushing for health care reform say the next two months will be critical for sending a measure to Mr. Obama's desk this year.
Senate Finance Committee Chairman Max Baucus, Montana Democrat, who is expected to take the lead on writing a health care reform package, has said he wants to have a bill ready by the end of June.
The committee's top Republican, Charles E. Grassley of Iowa, said last week that "if we don't get it done this year ... it ain't going to be done for four years."
"That's why Senator Baucus and I are on an aggressive schedule," said Mr. Grassley during a health care forum in his home state last week. "I think we have momentum right now."
Beginning this week, the committee will host a series of three roundtable meetings between senators and health care industry experts in preparation for piecing together a health care reform package.
The first meeting, set for Tuesday, will focus on the delivery of health care services. Roundtables scheduled for May will focus on increasing access to health care coverage and how best to pay for overhauling the nation's health care system.
The president repeatedly has stressed that health care reform is among his most important priorities this year, saying during a speech on Tuesday at Washington's Georgetown University that it is one of "five pillars" on which he hopes to support a stronger economic foundation for the nation.
"We cannot rebuild this economy on the same pile of sand - we must build our house upon a rock," said Mr. Obama, who included more regulations for Wall Street, education reforms, increased spending on renewable energy and technology, and lowering the national debt as his four other principle priorities, or pillars.
The president said the key to lowering the country's deficit and debt "is to get a handle on out-of-control health care costs - not to stand idly by as the economy goes into free fall."
A bitter partisan battle almost certainly will accompany any attempt to change the nation's health care system.
Democrats likely will insist on the inclusion of a government-run insurance plan for middle-class Americans that would compete with the private sector - a provision that worries Republicans. A massive government-insurance plan modeled after Medicare and Medicaid may drive many private insurers out of business, Republicans say, resulting in fewer health care options for Americans.
"I think we believe, along what Democrats believe, that all Americans should have access to high-quality, affordable health insurance," House Minority Leader John A. Boehner, Ohio Republican, said Sunday on ABC's "This Week" program. But "we're not for a plan that puts the government in charge of our health care, decides what doctors ought to be paid or what treatments ought to be prescribed."
Another difficult decision Democratic leaders face is whether to bypass regular legislative rules to allow health care reform to pass the Senate by a simple majority using a fast-track procedure called "reconciliation."
The procedure would eliminate the filibuster and allow legislation to pass with only a simple majority, not the three-fifths supermajority needed to end a filibuster. Democrats have 58 seats - a comfortable margin, but two seats short of the 60-seat supermajority.
House Democratic leaders for weeks have insisted that keeping the fast-track option open is essential to avoid Republican obstructions on health care legislation.
Republicans have likened the use of reconciliation to an "act of war."
But Democrats say such talk is hypocritical, pointing out that Republicans frequently used reconciliation when they had control of Congress.