Obama Calls for 'Up or Down' Vote on Health Care

WASHINGTON (March 3) -- President Barack Obama made a final plea to enact sweeping health care legislation into law today, urging an "up or down" vote on a plan that he said incorporated "the best ideas from Democrats and Republicans" over the course of a "long and wrenching debate" that has stretched more than a year.

The president's proposal, delivered in nationally televised remarks at the White House, boiled down to a simple message to a Congress controlled by increasingly anxious Democrats: At long last, just get it done.

"No matter which approach you favor, I believe the United States Congress owes the American people a final vote on health care reform," Obama said in a 20-minute speech.

"Every argument has been made. Everything there is to say about health care has been said, and just about everyone has said it," Obama said. "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."

He called on Congress to "finish its work" on a final health care bill, versions of which passed both the House and Senate late last year. His proposal, he said, is an approach that "has been debated and changed and I believe improved over the last year."

Obama's speech came six days after he convened a seven-hour bipartisan summit with congressional leaders that featured substantive debate about the issues but failed to bridge the chasm between the two parties. It was largely an attempt by Obama to persuade skeptical centrist Democrats to provide the support needed to put the bill over the top.

The president acknowledged that Republican leaders want the administration to "start over" and scrap the current legislation. He rejected that approach. "But given these honest and substantial differences between the parties about the need to regulate the insurance industry and the need to help millions of middle-class families get insurance, I do not see how another year of negotiations would help," he said.

The president also dismissed the idea of taking a piecemeal, step-by-step approach to reform by passing only those insurance market reforms that have broad bipartisan support, like a ban on insurers denying coverage to people with pre-existing conditions. Breaking the bill apart, Obama said, would be untenable. "The fact is, health reform only works if you take care of all of these problems at once," he said.

He stressed that his proposal included many Republican ideas, some of which he detailed in a letter to congressional leaders that was released Tuesday.

Obama avoided talk about the process of enacting the legislation, and he made no direct mention of the "reconciliation" procedure that Democrats will likely need to use to pass changes to the bill with 51 votes instead of a filibuster-proof 60. Republicans have seized on that technique to argue that Democrats intend to "jam through" health care reform over the objections of the American public. The president said only that health care deserved the "same kind of up-or-down vote" that was cast on popular measures like welfare reform, the Bush tax cuts and the children's health insurance program.

The president's proposal is broadly similar to the one he outlined before last week's summit, including a mandate for individuals to buy insurance, subsidies for low-income Americans and increased regulation of the insurance industry. It jettisons unpopular deals like the so-called "Cornhusker Kickback" for Nebraska and an Medicare exemption for Florida.

Shortly after Obama spoke, the White House announced that he would travel to Pennsylvania and Missouri next week to campaign for his reform plan. He set no specific deadline for passage -- most deadlines that were set last year were missed -- but he urged both houses of Congress to vote "in the next few weeks."

He concluded his speech by couching the push for health care as a test of a political system in Washington that has increasingly been seen as dysfunctional. "At stake right now is not just our ability to solve this problem, but our ability to solve any problem," he said, sounding defiant and even angry at times near the end of his remarks. "The American people want to know if it's still possible for Washington to look out for their interests and their future. They are waiting for us to act. They are waiting for us to lead.

" I don't know how this plays politically," Obama added, "but I know it's right."