Democratic leaders promised swift action on a healthcare overhaul today after a high-stakes speech by US president Barack Obama that earned good public reviews but appeared to change few minds in Congress.
Democrats hoped Mr Obama's prime-time address to a joint session of Congress would dispel public skepticism and generate new momentum for his drive to reshape the $2.5 trillion healthcare industry.
"We'll pass healthcare insurance reform that will work for the American people," House of Representatives Speaker Nancy Pelosi told a news conference. "I'm confident the president will sign a bill this year."
Mr Obama, speaking to a group of nurses this morning, renewed his call for urgency in the healthcare debate.
"Now is the time to act and I will not permit reform to be postponed or imperiled by the usual ideological diversions," Mr Obama said. "We have talked this issue to death, year after year, decade after decade, and the time for talk is winding down, the time for bickering has passed."
A CNN/Opinion Research poll showed 67 per cent of respondents supported Obama's healthcare reforms after the speech, compared with 53 per cent beforehand.
One in seven who watched the address to Congress changed their minds on the president's plan. The poll had an error margin of 5 percentage points, and more Democrats than Republicans were surveyed.
In a sometimes emotional speech, Mr Obama told Congress his government was "closer to the goal of reform than we have ever been" and spelled out proposals he said would improve stability for those with insurance and expand the options for those without, including a controversial government-run "public option".
He issued a sharp rebuke to critics of his healthcare drive, accusing them of substituting scare tactics for honest debate.
"I will not waste time with those who have made the calculation that it's better politics to kill this plan than improve it," he told a joint session of Congress and a national television audience. "If you misrepresent what's in the plan, we will call you out."
Democrats gave Mr Obama frequent standing ovations and Republicans at times murmured unhappily and held aloft copies of a Republican-sponsored healthcare bill. One Republican shouted "you lie" when Mr Obama said his plan would not pay for healthcare for illegal immigrants. Some laughed openly when Mr Obama said there remain some significant details to be ironed out.
"I think he recentered the debate," Vice President Joe Biden said of Obama's speech in an interview on ABC's
Good Morning Americatoday. But he acknowledged, "I don't know whether he got the Republicans or not."
Republican reaction was far cooler. Senator John McCain was concerned about the high cost of the Obama plan.
"The math doesn't add up and the record doesn't add up," Mr McCain, who ran against Mr Obama for the presidency last year, said on NBC's "Today" show. "There is very little if anything in this package that calls for real spending reduction and $1 trillion is basically what it's going to cost."
Shares of US health insurers climbed in early trading on Wall Street as analysts said Mr Obama's speech contained no surprises and indicated a government-run insurance option opposed by the industry was less likely to be included in the plan.
Shares of UnitedHealth Group and WellPoint Inc, the two largest health insurers, each edged up less than 1 per cent in morning trading. Other insurers rose more sharply, with Aetna up more than 1 per cent and Cigna Corp rising more than 3 per cent.
Senate Finance Committee negotiators were set to resume talks today in a final bid to forge a bipartisan agreement on a bill, although committee chairman Max Baucus said yesterday he was ready to go forward without Republican support.
Activists opposed to the proposals plan a mass march on Washington on Saturday as the next step in their campaign.
Groups that reject Obama's reform and seek limited government and lower taxes said that nothing they heard in the speech to a joint Congress session would deter them.
Instead, it provided fresh fuel for their opposition to the government plans for the $2.5 trillion sector, in part on the grounds that it would raise the country's budget deficit.
That opposition took the form of often rowdy town hall meetings over the summer and Saturday's march provides a new opportunity for the campaign to seize the agenda, they said.
"Every group (going to the march) has its own agenda but we have a common agenda to get the country back," said Jack Staver, who leads a Tea Party Patriots group in northern Georgia and plans to attend the march.
At least 20,000 people are expected for the march, said Pete Sepp of the National Taxpayers Union, a conservative group.
The event will gather groups including FreedomWorks, the National Taxpayers Union, the Tea Party Patriots and Smart Girl Politics, all of which rely on the Internet and social networking sites to communicate with members.
The groups said they have seen a spike in membership and activism since a political fight over a big economic stimulus package passed by Congress in February, and again more recently over healthcare.
"We are educating and motivating citizens to get involved in this debate through petitions, faxes, phone calls, personal visits," said Ron De Jong of the conservative Grassfire.org group. "Obama's speech has only galvanized our opposition."
The Census Bureau released new data estimating the number of people living in the United States without health insurance climbed to 46.3 million in 2008 from 45.7 million a year earlier, a modest rise that was unlikely to alter the argument over basic changes in the US insurance system.
Mr Obama adjusted his goals for coverage during his speech to Congress, saying his aim was to win health insurance for 30 million who are now uninsured, rather than 46 million. A White House official said the new figure does not include illegal immigrants and a smaller group who would refuse insurance even when available.
Mr Obama hoped his speech would reclaim control of a debate that has been bogged down in Congress amid a flood of criticism and disputes even as his own public approval figures dropped.
He said the overhaul would cut costs, improve care and regulate insurers to help protect consumers while expanding coverage. He repeated his pledge that the proposal, which would cost $900 billion over 10 years, would not increase the budget deficit.
Mr Obama spelled out the concepts he wanted in any final bill passed by Congress, including affordable coverage for all Americans and creation of an insurance exchange where individuals and small businesses could shop for policies.
He reiterated his support for a government-run insurance plan - the so-called "public option" - that has drawn strong opposition from critics who say it would harm insurance companies and amount to a government takeover of the industry. But he said the lack of a public option in any final bill would not be a deal-breaker.
"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.
Three committees in the House of Representatives and one other Senate panel have completed work on a healthcare bill, leaving the Senate Finance Committee as the final hurdle before each chamber takes up the issue.
In a bid to win Republican support, Mr Obama proposed a series of state demonstration projects on medical malpractice reform, a long-sought goal of Republicans. He also endorsed a proposal from McCain for an insurance pool for high-risk consumers.
He said millions of uninsured Americans were living one illness away from bankruptcy and others could not get insurance because of pre-existing conditions. He promised tax credits for individuals who cannot afford coverage.
Reuters