Obama throws down gauntlet on health care

President Obama declared the health care debate over on Wednesday and urged congressional Democrats to take the politically risky step of pushing his newly written compromise reform bill through using a controversial tactic to circumvent a Republican filibuster.

Calling for an “up-or-down” vote, Mr. Obama offered to add a few Republican ideas to the $1 trillion bill, but made clear that the time for talk was over.

“Every idea has been put on the table; every argument has been made,” Mr. Obama said in a speech before an audience of health care professionals in the East Room of the White House. “So now is the time to make a decision about how to finally reform health care so that it works, not just for the insurance companies, but for America’s families and businesses.”

Republicans scoffed at Mr. Obama’s tough talk, vowing to fight the effort at every turn and to tap the American public’s distaste for the measure in the midterm elections.

“They’re making a vigorous effort to try to jam this down the throats of the American people, who don’t want it,” said Senate Minority Leader Mitch McConnell, Kentucky Republican.

“We think that’s a policy mistake, and we think resorting to these kinds of tactics, to thumb your nose at the American people, is something that ought to be resisted,” Mr. McConnell added.

At stake is the biggest policy initiative of the year-old Obama presidency, a rewrite of the nation’s health care system that would trim hundreds of billions of dollars from Medicare, expand Medicaid, mandate that every American join a plan and rewrite rules telling insurance companies how they can operate.

The House and Senate have passed their own versions of bills, but the debate has been stalled for nearly two months after Democrats lost their filibuster-proof majority in the Senate in January.

Now, Democrats are looking to turn to a complex budget procedure known as “reconciliation,” under which legislation can pass the Senate with 51 votes rather than 60.

Though congressional Republicans used the tactic when they were in power to pass tax cuts under the George W. Bush administration as well as welfare reform under President Clinton, they have vehemently opposed its use on health care, saying the American people have spoken out against the bill in a number of opinion polls as well as a spate of recent elections.

Mr. Obama did not use the term “reconciliation,” instead referring to the process as a way to secure a vote by a “simple majority.” Mr. Obama had previously been critical of using reconciliation and has said it should not be used on a major effort such as health care.

Even using the parliamentary tactic doesn’t ensure passage of Mr. Obama’s signature legislative effort.

House Speaker Nancy Pelosi, California Democrat, and Senate Majority Leader Harry Reid, Nevada Democrat, say they will be able to round up the votes, but it’s not clear how. In the House, where a bill passed by a narrow margin last year, several Democrats who voted for it have since said they’re reluctant to use reconciliation and that they object to portions of the Senate bill that Mr. Obama wants lawmakers to adopt.

In particular, a group of pro-life Democrats says the Senate text - upon which Mr. Obama’s proposal is based - is not strict enough to prevent federal dollars from going toward abortion.

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