After what he called "a long and wrenching debate," President Obama called on Congress Wednesday to pass health care reform without further delay. The president spoke from the East Room of the White House, where he was flanked by doctors and nurses.
"Every idea has been put on the table," he said. "Every argument has been made. Everything there is to say about health care has been said and just about everyone has said it. 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."
Significantly, the president used his speech to give his support for a majority vote, signaling his preference for the controversial reconciliation process that will require 51, rather than 60 votes, to pass the measure through the Senate without Republican support. "Health care reform deserves the same kind of up-or-down vote that was cast on welfare reform, the Children's Health Insurance Program, COBRA health coverage for the unemployed, and both Bush tax cuts -- all of which had to pass Congress with nothing more than a simple majority."
The president framed his proposal, which is based on bills passed last year by the House and Senate, as a compromise between the two extremes of health reformers -- those who want a single payer, government-run health system, and those who want to loosen, rather than tighten, control over the insurance industry to inject free-market principles into people's health care.
"I don't believe we should give government bureaucrats or insurance company bureaucrats more control over health care in America. I believe it's time to give the American people more control over their own health insurance."
Three areas define his proposal, according to the president: First, it would protect Americans from insurance companies' worst practices, including denying coverage based on pre-existing conditions. Second, it would created a new marketplace where people without insurance through large groups can purchase affordable coverage. Finally, he said, it would lower costs for people who can't afford insurance through government subsidies.
The president characterized the $100 billion cost of expanding coverage to be a modest price in the $2 trillion heath care market and rejected Republicans' calls to scrap the current bill and start over.
"For us to start over now could simply lead to delay that could last for another decade or even more. The American people, and the U.S. economy, just can't wait that long."
Delay, he said, is not an option.
"The American people are waiting for us to act. They are waiting for us to lead," he said. "I don't know how this plays politically, but I know it's right."
On Tuesday, the president suggested modest additions, based on GOP input, to the health care bill, including expanded efforts to combat fraud and waste in Medicare, $50 million for medical malpractice demonstration programs, more leeway for health savings accounts, and the possibility of increasing Medicaid reimbursement rates for doctors.
But Republicans had no interest in further negotiations with Obama unless he agreed to start over on a new bill. Mitch McConnell, the top Republican in the Senate, rejected Obama's proposals as "inadequate," while House Minority John Boehner said, "You can't add a couple of Republican sprinkles on top of a 2,700 page bill and call it bipartisan."