Even as President Obama delivered a prime-time sales pitch for his embattled health care reform plan Wednesday, basic facts about coverage, cost and who foots the bills remain in dispute and many of the president's favorite talking points are challenged not only by Republicans but also by independent fact-checkers.
For example, Mr. Obama promises that people who are happy with their current health insurance can keep it. That's a claim contradicted by Factcheck.org, a nonpartisan consumer advocacy group at the University of Pennsylvania's Annenberg Public Policy Center.
The group found that while the government would not require people to change their health insurance, proposals by Senate Democrats would result in some people losing health care benefits from employers, either because it would become too expensive or because workers would be able to get a better deal elsewhere.
Such inconsistencies between the rhetoric and the reality cloud much of the health care debate as Mr. Obama retools some of his claims to fend off criticism and adjusts positions he staked out on the campaign trail.
One of the more startling shifts since the campaign was the dropping of Mr. Obama's oft-stated promise to provide universal health care coverage. The House bill leaves about 17 million off the insurance rolls, and one of the Senate bills leaves out about 34 million.
The administration says it is a matter of how you define "universal" and that some people were always expected to slip through the cracks.
Mr. Obama also changed his tune on requiring individuals to buy insurance or pay a fine. He opposed that idea on the campaign trail but has warmed to the idea as it became an element of the package being drafted by Congress.
Then there is the money.
Striving to calm concerns in his own party about the plan's budget-busting $1 trillion price tag, Mr. Obama pledges that the overhaul will be "deficit neutral" and funded, in part, with savings from "bending the curve" of skyrocketing health care costs.
But the Congressional Budget Office, Congress' nonpartisan accountant, last week said the bills taking shape on Capitol Hill would not lower costs and would drive up government spending at an unsustainable pace.
House Speaker Nancy Pelosi, California Democrat, insisted the bills are a work in progress and there are more savings to come. She also claimed the CBO analysis did not accurately account for savings from preventive and wellness measures that will spawn a population that is healthier and less expensive to treat.
Mr. Obama reportedly summoned CBO Director Douglas Elmendorf to a closed-door meeting Monday at the White House - an unusual move for a president that drew sharp criticism from Republicans.
"This reeks of the type of Chicago-style politics that Americans were warned about," said Rep. Tom Price of Georgia, chairman of the conservative Republican Study Committee. "The CBO was created to be independent and nonpartisan. To spoil that with political dealings in the West Wing only adds to American cynicism about the presidents misguided health care plan."
White House officials said there was nothing underhanded about meeting.
"The president invited Mr. Elmendorf to the White House to discuss strategies for bringing down health care costs," White House spokesman Reid Cherlin said. "He's committed to getting costs under control, and he'll continue to seek opinions from experts on the best ways to do so."
Factcheck.org has challenged other assertions by Mr. Obama:
• The president claimed that the cost of treating uninsured people raises the cost of health care for the rest of Americans by $1,000 per family. The Web site pointed to research by the Kaiser Family Foundation that showed the $1,000 figure is "clearly an exaggeration."
According to the foundation, the amount of costs that care providers can shift to the privately insured is only about $8 billion, which Factcheck.org calculated comes to about $200 per family per year.
Mr. Obama tweaked the claim in a speech to the American Medical Association in June, saying higher premiums, higher taxes and higher health care costs attributable to the uninsured result in families paying $1,000 more a year. The Web site said the change in language largely supported the $1,000 figure.
• Mr. Obama claims that nearly 46 million people in the U.S. are uninsured, but that includes about 6 million illegal immigrants and about 14 million with high enough incomes - more than $75,000 year - that they likely could afford insurance, according to Factcheck.org.
The Web site notes, however, that just because you can afford insurance doesn't mean you can get it. About 28 percent of applications for insurance are rejected for medical or nonmedical reasons, and about 11 percent who get insurance pay more than they requested, according to a study by American Health Insurance Plans.