Seizing control of the rowdy health care debate, President Obama implored feuding lawmakers Wednesday night to pass a plan that would require all Americans to buy insurance and all companies to help cover the costs, but he stopped short of mandating a government-run option that befuddled Congress and angered many Americans during a summer of political tumult.
Using the rare and grand forum of a prime-time address to a joint session of Congress, Mr. Obama said he personally supports creating a pool of affordable insurance plans in the marketplace that included a narrow public option for the uninsured. But he said he considered the public option "a means" to achieving the goal of universal health care and that he was open to other solutions.
He warned liberal Democrats not to be obstinate on the public option and extended his hand to Republicans. He praised Sen. John McCain, Arizona Republican, for contributing an idea to the debate -- while insisting he won't let Republicans spread false political attacks to stop the plan.
"The time for bickering is over. The time for games has passed," Mr. Obama said. "Now is the season for action. Now is when we must bring the best ideas of both parties together and show the American people that we can still do what we were sent here to do."
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Not everyone was ready to leave behind the rancor behind. Rep. Joe Wilson, South Carolina Republican, shouted, "You lie," as the president said he didn't intend to cover illegal immigrants.
After a summer of contentious town-hall meetings where Americans protested his efforts to create a government-run health insurance plan, and with polls showing two-thirds of voters are still confused by his plans, Mr. Obama's address was the biggest gambit of his young presidency. He promised to avoid creating a new health care bureaucracy that would interfere with care.
"I will make sure that no government bureaucrat or insurance company bureaucrat gets between you and the care that you need," he said, directly addressing a fear expressed by many Americans during nationwide town-hall meetings in August. He said he wasn't interested in putting private insurance out of business but simply to hold them accountable.
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He noted he was personally injecting himself into a debate that he said has gone on for nearly a century, and said he's not the first president to tackle this cause, "but I am determined to be the last." And, seeking to counter what he said are misrepresentations, he chastised top Republican politicians for claiming his bill would create "death panels" with the power to decide is someone should receive life-extending care.
"Such a charge would be laughable if it weren't so cynical and irresponsible. It is a lie, plain and simple," Mr. Obama said, also decrying claims that Democrats' proposals would expand taxpayer funding of abortions or would provide insurance benefits for illegal immigrants.
Republicans said Mr. Obama missed an opportunity by not completely disavowing the public option.
"Most Americans wanted to hear the president tell Speaker [Nancy] Pelosi, Majority Leader [Harry] Reid and the rest of Congress that it's time to start over on a common-sense, bipartisan plan focused on lowering the cost of health care while improving quality," Rep. Charles Boustany Jr., Louisiana Republican, said in the official Republican response. "That's what I heard over the past several months in talking to thousands of my constituents."
Mr. Boustany, a doctor with more than 20 years' experience, said Mr. Obamas plan would add dozens of new bureaucracies, balloon the debt and lead to cuts in Medicare.
In a silent protest, Republicans held up copies of Republican bills during the speech to show they are trying to offer alternatives.
With strong majorities in both the House and Senate, Democrats should be able to pass whatever bill they like. Instead, Democratic leaders have found themselves battling both the liberal and conservative wings of their party.
House Republicans released a list of 44 conservative-leaning House Democrats who have made statements that indicate their opposition to the bill that's advancing through the chamber, and an additional 57 liberal Democrats who have said they cannot support a bill if it doesn't include a public option.
Rep. Raul M. Grijalva, Arizona Democrat and a leader of the House's liberal caucus, said the president didn't do enough Wednesday to push for a public option.
"President Obama was elected to bring change and progress. I fear that if my party and the president do not appreciate the mandate the American people have given us, the people will lose confidence in the idea that they can vote for change and get what they voted for," he said.
Conservative-leaning Democrats were likewise lukewarm to Mr. Obama's remarks.
"I believe that we can make necessary reforms without creating a purely public, new government entitlement program," said Sen. Blanche Lincoln, Arkansas Democrat.
Mr. Obama offered liberals little encouragement in his remarks, telling them that rather than holding firm on a public plan, they should realize the goal is to push down the costs of insurance.
"The public option is only a means to that end -- and we should remain open to other ideas that accomplish our ultimate goal," he said.
Instead, Mr. Obama's list of must-haves covered basics to which many in both parties would agree: Consumer protections such as requiring coverage of pre-existing conditions, and allowing portability of health insurance when workers switch jobs.
Somewhat more controversially, Mr. Obama said he wants to mandate that most businesses provide health insurance coverage, and require that all individuals be covered by a policy, just as automobile owners are required to have car insurance.
In yet another overture to Republicans, who want a tort reform bill to try to control malpractice costs, Mr. Obama proposed allowing states to go forward with demonstration projects to test what can work in reducing the kind of "defensive medicine" that adds to insurance costs.
The president used memories of Sen. Edward M. Kennedy to push Congress to act, and pointed to three Republicans -- Mr. McCain, Sen. Orrin G. Hatch of Utah and Sen. Charles E. Grassley of Iowa -- who he said worked with Mr. Kennedy to try to expand health coverage.
Vice President Joseph R. Biden Jr., sitting with Mrs. Pelosi behind the president, teared up at the mention of Mr. Kennedy, a longtime fighter for expanded health coverage, who died last month.
The joint session offered Mr. Obama a chance to reset the discussion using a set-piece major speech -- a format the president mastered during the 2008 campaign.
The White House said Mr. Obama had considered an address from the Oval Office but decided this speech was too long for that forum, and required a joint session of Congress.
Addresses to joint sessions to Congress are rare. His two predecessors gave just one each. President George W. Bush spoke just after the Sept. 11, 2001, terrorist attacks, and President Clinton gave his own health care speech to Congress in 1993.
As is traditional for these speeches, Mr. Obama was repeatedly interrupted by applause from the members. And a surprising number of his lines drew approval from both sides of the aisle.
In a sign the speech was being tweaked until the end, Republicans said the White House broke from tradition and instead of providing members who attend with a ceremonial bound copy of Mr. Obama's remarks, only distributed talking points.
A White House official said Mr. Obama was still editing the speech as he flew back from a memorial service for newsman Walter Cronkite in New York on Wednesday afternoon.
Mr. Obama appears to have learned lessons both from Mr. Clinton and from his own 8-month-old administration.
Mr. Clinton tried to push a health care bill, drafted in secret, onto Congress in 1993 and 1994, but lawmakers balked at the complexity and at having been left out of the process.
By contrast, Mr. Obama had left this Congress to craft bills -- and ended up with bickering between and within both political parties. With the fights threatening his entire push, Mr. Obama on Wednesday decided to take direct control of the debate.
But the divisions remain.
Three House committees and one Senate committee have approved health care bills along party lines.
One key Senate panel -- the Finance Committee -- has yet to act. Chairman Max Baucus, Montana Democrat, has been trying to craft a bipartisan deal, but said Wednesday he will move forward with a bill over the next two weeks whether he has Republican support or not.
After the president's speech, Mr. Baucus said his plan is "basically the same" as the president's proposal, except for the public option and coverage for catastrophic care.
Mr. Baucus said he supports the catastrophic plan, which Mr. McCain proposed during last year's presidential campaign, but favors cooperatives rather than a public option because the latter can't pass the Senate.
He said insurance cooperatives would provide the competition that some are seeking from the public option.
Stephen Dinan can be reached at firstname.lastname@example.org.
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