President Obama's grassroots organization is targeting Sarah Palin by name, showing how large a public figure she has become and hinting perhaps that it sees her as a potential rival in 2012.

Organizing for America sent an email to supporters this morning seeking to raise $500,000 to counter Palin's criticisms of Obama's health care plan. The former Alaska governor and 2008 GOP vice presidential nominee has drawn huge audiences for her TV appearances on her media blitz accompanying the nationwide tour for her best-selling memoir.

Earlier this fall, she was the one who popularized the contention -- later debunked -- that the Democratic health care bills would create panels of bureaucrats who would decide end-of-life care.

"Right now, Sarah Palin is on a highly publicized, nationwide book tour, attacking President Obama and his plan for health reform at every turn," national director Mitch Stewart wrote.

"It's dangerous. Remember, this is the person who coined the term "Death Panels" -- and opened the flood gates for months of false attacks by special interests and partisan extremists. Whatever lie comes next will be widely covered by the media, then constantly echoed by right-wing attack groups and others who are trying to defeat reform."

The late Senator Edward M. Kennedy's legacy goes on and on in the health care debate.

The legislation that top Senate Democrat Harry Reid unveiled Wednesday night includes a bill that Kennedy had championed for years. Known as the CLASS (Community Living Assistance Services and Supports) Act, it would give the elderly at least $50 a day for long term care and allow them to stay at home if they want.

"The CLASS Act was immensely important to Senator Kennedy because, as he said, ‘It makes a simple pact with all Americans - if you work hard and contribute, society will take care of you when you fall on hard times.’ The Act gives the elderly and people with disabilities opportunities to continue living at home, function in their communities, and obtain the long-term care and support they need," Senator Paul G. Kirk Jr., who is carrying the health care baton for Kennedy as his temporary replacement, said in a statement today.

He and other supporters say it would save money in the long run by keeping people off Medicaid, but critics have questioned the cost.

A summary of the proposal, provided by Kirk's office, is below:

A leading abortion rights group said today that the Senate health care bill, while less objectionable than the House version, would still unfairly burden women.

The House bill bans a proposed public insurance option from covering abortion, and also prevents private insurers that accept federal subsidies from offering plans that cover abortion.

The bill unveiled by Senate majority leader Harry Reid is less restrictive, allowing insurers to use money from employers or consumers -- but not federal subsidies -- to cover abortions.

But NARAL Pro-Choice America said the legislation "includes a compromise that continues existing laws that unfairly single out abortion care, including a ban on federal funding."

“America’s pro-choice majority is speaking up loudly and clearly,” the group's president, Nancy Keenan, said in a statement. “Our goal is to ensure that women do not lose ground in the new health-care system and that attempts to expand existing restrictions on abortion are defeated.

"Some anti-choice politicians, such as Sen. Orrin Hatch (R-Utah), will follow Rep. Bart Stupak’s example and inject anti-abortion politics into health reform. However, we believe that senators understand that the Stupak amendment in the House bill goes far beyond the status quo and prohibits women from using their own money to buy the insurance coverage they want in the new system. Our activists will continue to remind senators that we’re expecting cooler heads to prevail at this stage of the process and that means the Stupak language is not an option.”

The health care debate is complicated enough to confuse even policy wonks.

So the House health committee has built a web application to help Americans figure out how the bill approved by the House earlier this month would affect them. The Senate is working on its own version, and if it passes legislation, a conference committee would try to reach a compromise that can pass both chambers and win President Obama's signature.

It's designed to answer questions including how someone would get coverage, who would be eligible for the new insurance "exchange," what would happen to a worker who gets coverage through their employer, and what would happen to Medicare.

The interactive graphic can be accessed here.

One of the most important interest groups in the health care debate -- Big Labor -- gave a qualified endorsement today to the bill finally unveiled by top Senate Democrat Harry Reid.

Union support is crucial to Democrats and President Obama to push through the bill, but AFL-CIO President Richard Trumka said the nation's largest labor federation is still not happy with a tax on the most generous insurance plans, though it would hit fewer workers than the Senate Finance version. Labor argues that many employees bargained for such benefits to make up for lower or nonexistent pay increases.

Trumka did praise another financing method -- raising payroll taxes on the upper income to help pay for Medicare.

"We commend Senate Majority Leader Harry Reid for bringing forward a health care bill that moves us closer to the historic goal of health care for America – high quality, affordable health care for all in our rich nation. The Senate leadership bill takes the strongest steps yet to bring down costs. But the bill is not perfect. It retains a version of the excise tax from the Senate Finance Committee bill. We continue to believe that a tax on working families’ benefits is the wrong way to finance health care and we will work hard to eliminate this provision as the bill heads to the floor," Trumka said in a statement.

"The bill’s inclusion of a public insurance plan option to hold private insurance companies accountable is a tremendous step. And the legislation should be praised for its other fair financing plans, including an increase in the Medicare tax on the wealthiest and an employer responsibility requirement, which we believe should be expanded to include more employers. The bill would expand access by covering 94 percent of Americans and reduce the deficit by $130 billion over 10 years. Today another hurdle is cleared and we are optimistic that good, affordable care for working families will soon be law."

By Lisa Wangsness, Globe Staff

WASHINGTON -- The health care overhaul bill that top Senate Democrat Harry Reid hopes to bring to the floor as soon as Saturday would cost $849 billion over 10 years and would reduce the ranks of the uninsured by 31 million Americans.

A senior leadership aide provided those figures as Reid unveiled his bill, which he has spent weeks working on, melding major elements of the versions passed by the Senate finance and health committees.

The preliminary price tag from the Congressional Budget Office would bring the bill in under the $900 billion that President Obama has set as a ceiling. According to the preliminary CBO analysis, the legislation would reduce the federal deficit by $127 billion over the first decade and by $650 billion over the second decade.

The bill would cover an estimated 94 percent of Americans. Reid bragged that the bill would save lives and protect Medicare, the government program for the elderly.

The bill would set up new insurance exchanges, where consumers could choose plans. It would include a public option that includes a provision for states to opt out of the system -- an exemption that is upsetting liberals who say that a strong government plan is needed to compete with private insurers to ensure affordable coverage.

Like the other bills, Reid's measure would require most Americans to buy insurance coverage with subsidies for those who can't afford it, and would require larger companies to provide coverage to their workers or face fees. It would ban insurance company practices such as denying coverage on the basis of pre-existing medical conditions.

The bill would be financed by cuts in projected Medicare payments and by higher payroll taxes on upper income taxpayers. Under current law, the Medicare payroll tax is 1.45 percent of income. Under Reid's legislation, it would rise by half a percentage point on individuals' income above $200,000 a year and couples' income above $250,000.

The bill also includes a version of the tax on the most generous "Cadillac" insurance plans. The Senate Finance Committee bill proposed to tax health insurance plans costing more than $8,000 annually for individuals and $21,000 for families. Unions and others had strongly opposed that idea.

The bill the House passed earlier this month would be financed in large measure by a 5.4 percent income tax surcharge on individuals making more than $500,000 a year and households making more than $1 million.

The bill also includes a far less restrictive provision on abortion coverage than the House bill, which would ban the public plan from covering abortion and also ban private plans that accept federal subsidies from doing so. Republicans say the provision is needed to ensure that tax money does not fund abortions, but liberals and abortion rights say it would treat women unfairly and have threatened to vote against the final legislation if it includes it.

Reid's bill calls for the exchange to cover plans with and without abortion coverage, giving consumers a choice.

Reid had been waiting for the CBO numbers before unveiling his bill, for which he is still seeking to round up 60 votes to start floor debate. This afternoon, he met privately with three wavering moderate Democrats, Senators Blanche Lincoln of Arkansas, Mary Landrieu of Louisiana, and Ben Nelson of Nebraska.

UPDATE: President Obama this evening issued a statement praising Reid's bill, calling it "another critical milestone in the health reform effort."

"I was particularly pleased to see that the Congressional Budget Office has estimated that the bill will reduce the deficit by $127 billion over the next ten years and as much as $650 billion in the decade following, saving hundreds of billions while extending coverage to 31 million more Americans," Obama said in a statement.

"From day one, our goal has been to enact legislation that offers stability and security to those who have insurance and affordable coverage to those who don’t, and that lowers costs for families, businesses and governments across the country. Majority Leader Reid, Chairmen Baucus and Dodd, and countless Senators have worked tirelessly to craft legislation that meets those principles," the president added.

"Just yesterday, a bipartisan group of more than 20 leading health economists released a letter urging passage of meaningful reform and praising four key provisions that are in the Senate legislation: a fee on insurance companies offering high-premium plans, the establishment of an independent Medicare commission, reforms to the health care delivery system, and overall deficit neutrality. The economists said that these provisions ‘will reduce long-term deficits, improve the quality of care, and put the nation on a firm fiscal footing.’ Those are precisely the goals we should be seeking to attain.

"The challenges facing our health care system aren’t new – but if we fail to act they’ll surely get even worse, meaning higher premiums, skyrocketing costs, and deeper instability for those with coverage. Today, thanks to the Senate’s hard work, we’re closer than ever to enacting solutions to these problems. I look forward to working with the Senate and House to get a finished bill to my desk as soon as possible.”

Senator Paul G. Kirk Jr. of Massachusetts, who replaced the late Edward M. Kennedy who had made universal health care his final cause, also praised Reid's bill.

“This is a bill that would make Ted Kennedy proud,” Kirk said in a statement. “We’re a giant step closer to his long-held dream that quality, affordable health care is available to Americans. I’m especially pleased that the bill includes Senator Kennedy’s CLASS Act, so that the elderly and people with disabilities can obtain the support and services they need to continue living at home and participate in their communities.

“I particularly commend Majority Leader Harry Reid, Senator Dodd and Senator Baucus for their extraordinary leadership on this historic legislation, and for doing so in a way that contains costs for families and reduces the deficit over the long run. I look forward to its passage by the Senate.”

President Obama's grassroots group late this afternoon announced the winner of its health care video contest -- a bunch of cute kids at a playground listing medical problems and saying that they deserve health care.

Organizing for America said it received more than 1,000 entries (some of which are mashed together at the beginning of the YouTube video with the winner) before narrowing them to 20 finalists and picking one.

"The winning video shows that our supporters' creativity and passion is more than a match for the slick ads and partisan spin doctors on the other side. In the next few days, we'll be using this video as the basis for a new television ad that will air across the country -- and you can help, by ensuring we have the resources to make the biggest impact," Obama's campaign manager David Plouffe says in an email to supporters soliciting contributions.

"With Congress wrapping up its last round of negotiations and closely gauging the public's mood in these crucial final weeks, now is the exact time to get this grassroots message out far and wide."

Americans remain divided about the health care overhaul and skeptical that it will make their lives better, according to new polling.

In the Washington Post/ABC News survey published today, 49 percent oppose and 48 percent support the proposed changes overall. But tellingly, 52 percent say they expect their own care to become more expensive, and 56 percent say the overall cost of health care in the country increasing. And among the majority of Americans who have insurance, 39 percent believe their coverage will worsen while only 13 percent said they expect it to improve.

On the contentious issue of abortion, 61 percent support banning coverage using public subsidies, but 56 percent say if private money were used to pay for abortions, even insurance for those receiving government aid should be allowed to include coverage.

Meanwhile, a poll conducted for the Associated Press found that Americans prefer taxing the high earners to taxing so-called Cadillac plans to pay for the overhaul bill.

Under the bill passed by the House, there would be a 5.4 percent income tax surcharge on individuals making more than $500,000 a year and couples earning more than $1 million. The poll found 57 percent support a surtax, even it hit individuals making more than $250,000 a year.

The bill passed by the Senate Finance Committee would tax insurance plans costing more than $8,000 annually for individuals and $21,000 for families. The survey found 56 percent opposed to that approach.

UPDATE: A CNN/Opinion Research Corp. poll released this afternoon found 46 percent in favor and 49 percent opposed to the House-passed bill. Those opposed included 34 percent who said the bill was "too liberal" and 10 percent who said it wasn't liberal enough.

Of respondents, 30 percent said that the Senate should make relatively minor changes to the House bill before passing it, 22 percent said the Senate should make major changes, 28 percent said the Senate should start over with a new bill next year, and 18 percent said the Senate should stop working on any major changes to the health care system.

Americans are also divided on whether they believe a health care bill similar to the House version will be passed by Congress this year: 49 percent said it is very or somewhat likely, but 50 percent said it is very or somewhat unlikely.

A leading abortion rights group delivered petitions today to try to squash the funding ban when the Senate takes up its health care overhaul bill.

NARAL Pro-Choice America said it and its partners, including People for the American Way, collected 97,218 signatures in 72 hours calling on Senate Majority Leader Harry Reid to resist pressure from anti-abortion groups to include the controversial provision in the House-passed bill. It would ban a new public insurance option from covering abortion and would also bar private insurance plans that accept patients receiving federal subsidies from offering that coverage.

“America’s pro-choice majority is speaking up loudly and clearly,” NARAL President Nancy Keenan said in a statement. “As the fight for health reform moves forward, we are making sure Sen. Reid and his colleagues understand that adding the anti-choice Stupak-Pitts language to the Senate bill is not an option.”

While supporters of the abortion funding provision say it would just keep in place the current ban on federal funding of abortions -- except in the cases of rape, incest, and danger to the mother's life -- abortion rights groups say it would go well beyond that, effectively denying women the right to use their own money to buy insurance with abortion coverage.

UPDATE: Another abortion rights group is up with a new ad airing on cable in Washington, D.C., and on the Internet.

In the spot from the Center for Reproductive Rights, a female stand-up comic is shown telling a joke: "A woman walks into her doctor’s office and says: ‘Doc, I’m 11 weeks pregnant. My baby has anencephaly, which means parts of her skull and brain are literally missing. It’s fatal. Does my insurance cover an abortion?’ The doctor says: ‘No it does not.' "

The joke is met with dead silence, then the announcer says, "Don’t let Congress ban abortion coverage millions already have.”

There are two interesting developments today in the health care debate as top Senate Democrat Harry Reid tries to get his ducks in a row to start floor debate this week.

First, the Washington Post reports that the US Chamber of Commerce, a leading business group that is trying to build support against the Democratic bills, is soliciting money for a study that could be used to cast the legislation as a threat to the nation's economy. In an e-mail obtained by the Post, the Chamber's senior health policy manager proposes spending $50,000 to hire a "respected economist" to study the bill.

Also, a new poll released by the Associated Press found Americans split almost right down the middle about the health care bill and worried about the fine print.

According to the survey, 43 percent of respondents oppose the health care bill being debated by Congress, while 41 percent support it, and 15 percent remain neutral or undecided.

The poll, conducted by Stanford University with the nonprofit Robert Wood Johnson Foundation, found broad support for President Obama's goals, but concerns about the details to reach those goals. For example, while Americans support a ban on insurers denying coverage because of pre-existing medical problems, when told that such a prohibition would probably increase costs for many, 43 percent said they would still support the ban, but 31 percent said they would oppose it.

It has been a week since the House passed the sweeping health care bill, but Republicans remain on the warpath against it.

Representative Mark Kirk of Illinois, an Afghanistan war vet, rails against the legislation in the weekly GOP radio-Internet address today.

He says the bill -- approved with only one Republican "aye" -- would increase taxes, would worsen the record federal deficits, would put government in control of health care, and would threaten Medicare.

"In the teeth of the Great Recession, the Pelosi bill would impose ten new taxes on the American economy. The top combined tax rate for my state of Illinois would be four percentage points higher than France," he says. "The Democrat bill levies new taxes on health insurance, income and even pace makers. The bill also cuts health care for seniors – my parents and many of yours – with $500 billion in cuts for Medicare doctors, hospitals and advantage patients. The bill even cuts Medicare for skilled nursing, wheelchairs and hospices.

“In sum, the bill opens a new trillion-dollar entitlement just as our national debt tops $12 trillion. Ignoring the future needs of Social Security and Medicare, the bill creates a new massive spending program, supported by heavy taxes and cuts to senior health care," Kirk adds.

The House Democratic bill does not trim Medicare, itself. But more than 10 million seniors enrolled in an enhanced, private version known as Medicare Advantage -- including 175,000 in Massachusetts -- could see their plans shrink or be replaced with traditional coverage under the health care overhaul plans proposed by Democrats in Congress.

Kirk also outlines the Republican alternative, with a heavy weight on curbing medical malpractice lawsuits, allowing people to take their coverage across state lines, and encouraging states to experiment. That plan, however, would come nowhere close to extending coverage to the millions of Americans without health insurance.

His full address is below, and can be viewed here.

The GOP is doing its darndest to quickly move on from an embarrassing revelation -- that even as congressional Republicans insist that the health care overhaul does not cover abortions, the national party's own health plan covers elective procedures.

Late Thursday night, the Republican National Committee acknowledged that its health plan, as far back as 1991, included some coverage for elective abortion. Chairman Michael Steele instructed the RNC's director of administration to opt out of any coverage for elective abortion services in its health insurance policy, the party said.

"Money from our loyal donors should not be used for this purpose. I don't know why this policy existed in the past, but it will not exist under my administration. Consider this issue settled," Steele said in a statement.

The situation was first reported by Thursday by Politico, which cited two sales agents for Cigna who said that the RNC's policy covered elective abortion and that the RNC didn't opt out of abortion coverage when given the opportunity.

Abortion has emerged as a key issue in the health care debate after the bill approved by the House last weekend included a provision that would ban a new government-run public insurance plan from offering coverage and that would also bar private insurers that accept federal subsidies from doing so.

Supporters, including Republicans, say the provision preserves the Hyde Amendment, which prohibits the use of federal money for abortions, except in cases of rape, incest, or danger to the life of the mother. But opponents say the provision goes far beyond that and would result in many women either being denied coverage or having to pay more.

For the second time this week, Republicans are using the example of Senator John F. Kerry to pressure moderate Democrats on health care.

This time, it's a web video targeting Senator Ben Nelson of Nebraska for reportedly considering a vote to send the health care overhaul bill to the floor, but then voting against the bill. His vote could be crucial as Senate Majority Leader Harry Reid tries to reach the 60 votes to overcome a GOP filibuster and begin debate.

The Republican National Committee is calling it a "flip-flop" reminiscent of Kerry, who during his 2004 presidential campaign said of an Iraq war funding bill, “I actually did vote for the $87 billion, before I voted against it.” (He was inartfully saying he voted for an earlier version of an Iraq war appropriation because it would have repealed many of President George W. Bush's tax cuts, but opposing the spending because he would not have gone to war without more international support.)

A similar web video went after Senator Blanche Lincoln of Arkansas on the same grounds.

“Ben Nelson has taken part in the classic Potomac two-step of telling his constituents one thing in Nebraska and doing another thing back in Washington, D.C.," RNC Chairman Michael Steele said in a statement. "Politicians cannot have it both ways -- just ask John Kerry. Nebraskans can spot a phony politician when they see one and they know that any vote to move the Democrats’ health care bill forward is a vote for a government-run health care experiment.”

With President Obama abroad, first lady Michelle Obama will take up the health care mantle on Friday with a speech focused on the difficulties older women face getting insurance.

Her office announced today that she will be joined by Nancy-Ann DeParle, director of the White House Health Reform Office, and three women who will share their stories. "The event will highlight the important need for health insurance reform to help women access the care they need as they age, and to provide aging adults with affordable, reliable, quality health care," her office said.

The first lady jumped into the fray in a big way for the first time in mid-September, giving a speech on the importance of fixing health care for women.

“If we want to achieve true equality for women, if that is our goal . . . we have to reform the system. The status quo is unacceptable. It is holding women and families back, and we know it,’’ she said at an event sponsored by the six-month-old White House Council on Women and Girls.

A business-friendly group said this afternoon that on Thursday it will launch a $10 million nationwide TV ad blitz warning against doing too much, too fast on the health care overhaul.

The Employment Policies Institute joins the US Chamber of Commerce and others weighing in against the legislation that Democrats are trying to push through Congress and to President Obama's desk.

The ad -- to air before likely like-minded viewers on Fox News Channel as well as CNN and CNBC -- features June O’Neill, former director of the Congressional Budget Office, arguing that the bill would deepen the national debt and hurt job creation.

"Our country is facing an enormous debt crisis. Many of the plans to reform health care will make this crisis worse. As an economist and former director of the Congressional Budget Office, I’m deeply concerned about these health care reforms," she says in the ad.

"They will add hundreds of billions of dollars to the already $12 trillion national debt. We are paying $500 million a day in interest alone. This growing debt is unsustainable. It will have huge negative effects on jobs, taxes and our economy. Unfortunately, some politicians are using accounting gimmicks to hide the cost of these changes. And many seniors on Medicare will pay the price. Changes are necessary. But I fear these reforms are definitely not the answer."

By Susan Milligan, Globe Staff

WASHINGTON -- Former President Bill Clinton, who has painful personal experience with failure on health care reform, urged Senate Democrats this afternoon to get a bill passed.

"It's not important to be perfect. It's important to move. The worst is to do nothing,'' he said after a private luncheon.

The former president didn't specifically discuss his failed effort in 1993-94, senators in the lunch said afterwards. It was more of a pep talk, he said.

"He was upbeat. Positive with every chromosome in his body,'' said Senator Ron Wyden, an Oregon Democrat.

While the 39 Democrats who voted against the health care bill have received quite a bit of notoriety, the lone Republican who supported it is getting his share of attention.

Representative Anh Cao, a freshman from New Orleans, is a Vietnamese-American who represents a largely African-American district that had been the fiefdom of Democrat William Jefferson, was under indictment when Cao ousted him last November.

Cao said he decided vote aye after a call from President Obama on Saturday, a conversation during which he sought assurances of more federal aid for Hurricane Katrina recovery. A devout Catholic, Cao also wanted the language that was added further restricting abortion services from the bill.

"I felt last night's decision was the proper decision for my district even though it was not the popular decision for my party," Cao told CNN on Sunday. "A lot of my constituents are uninsured, a lot of them are poor. It was the right decision for the people of my district."

Cao also responded to Republican National Committee Chairman Michael Steele, who after last week's election threatened to "come after" lawmakers who didn't toe the party line.

"He has the right to come after those members who do not conform to party lines, but I would hope that he would work with us in order to adjust to the needs of the district and to hold a seat that the Republican party would need," Cao said.

Republicans are going aggressively after one of the key moderate Democrats who could decide the health care bill's fate in the Senate -- accusing Blanche Lincoln of Arkansas with an attempted "flip-flop" worthy of John F. Kerry.

A web video from the Republican National Committee slams Lincoln for a reported plan to vote for the bill to reach the Senate floor before voting against passage of the bill. Her vote could be crucial as Senate Majority Leader Harry Reid tries to round up 60 votes to overcome a GOP filibuster.

It repeatedly shows Kerry saying during one of his worst moments of his 2004 presidential campaign, “I actually did vote for the $87 billion, before I voted against it.”

He was explaining why he voted for an earlier version of an Iraq war appropriation because it would have repealed many of President George W. Bush's tax cuts, before opposing the spending because he would not have gone to war without more international support. But Republicans used the clip to portray him as wishy-washy.

"Democrat leaders want Senator Blanche Lincoln to use the same tactic,” the announcer says in the web video. "To pass President Obama’s government-run health care experiment with a vote to move a bill forward with tax increases, cuts to Medicare, and rising premiums. Then, once it comes up for a final vote, they will allow her to vote against it.”

“But any vote to move the bill forward,” the announcer continues. “is a vote for Obama’s government-run health care experiment. They want Senator Lincoln to tell voters in Arkansas: ‘I voted for government-run health care for my party boss, before I voted against it to save my job.’ Americans don’t respect politicians who try to have it both ways. They want to know exactly where their leaders stand. Senator Lincoln, tell Harry Reid Arkansans know a flip-flopper when they see one.”

By Lisa Wangsness, Globe Staff

WASHINGTON -- The No. 2 Democrat in the House said this morning that Democratic leaders are "very close" to getting the 218 votes they need to pass their sweeping health care bill.

But House Majority Leader Steny Hoyer said they have put the rank-and-file on notice that the voting could spill over to Sunday afternoon and possibly Monday and Tuesday if necessary.

"My expectation is that time will not be needed, and we will get this done by Saturday night," Hoyer said in a conference call with the liberal health care consumers group Families USA. But a bit later he acknowledged that the leadership is still looking to solidify the support needed for passage.

"There are many people who are still looking to get a comfort level that this is the right thing to do," he said.

House leaders are trying to rush the bill -- one of the largest and most complex pieces of legislation considered in recent years -- through the lower chamber quickly. They fear that with every passing hour, more issues could arise and create obstacles to passage.

Hoyer said discussions are ongoing over two side issues, abortion and immigration. Conservative Democrats don't want public money to indirectly subsidize abortion, and they also don't want illegal immigrants to benefit from insurance subsidies.

If the House and Senate both pass legislation, Hoyer said -- rather ominously -- that he expects a "relatively lengthy and difficult conference" given the major differences between the House and Senate and the complexity of the bill.

UPDATE: White House spokesman Robert Gibbs told reporters that the administration regrets the likely delay in the vote, but President Obama still plans to go to Capitol Hill on Saturday and sees it as "an important step forward."

He also acknowledged the tense discussions over abortion and illegal immigrants. "Congress, obviously, is working through a process that will ultimately, we believe, before the end of the year get a bill to the president's desk," he said.

As House Democrats prepare to push through their health care overhaul this weekend, a new poll suggests that most Americans aren't satisfied with the sweeping measure and want Congress to keep working on it.

In the CNN/Opinion Research Corp. survey released this morning, 33 percent of respondents said they wanted Congress to pass the final legislation only after "major changes" are made, another 24 percent said Congress should start from scratch and seek passage next year, and 15 percent said Congress should stop work on an overhaul altogether.

Only 26 percent said they wanted Congress to proceed with only minor changes to the proposals.

The poll also found 55 percent in favor of the public option -- a government-run plan to compete with private insurers -- though that support was down from 61 percent two weeks ago. Support for President Obama's health care plan has also declined to 45 percent from 49 percent in mid-October.

And the poll found that health care is far behind the economy in importance to Americans -- and that gap has grown in the past two weeks. Now, 47 percent rank the economy as the most important issue facing the nation, compared to 17 percent for health care -- a 30-percentage-point difference compared to 21 percentage points two weeks ago.

The new survey was conducted Oct. 30 to Nov. 1 and has a margin of error of plus or minus 3 percentage points.

The political jockeying is ramping up as the House prepares to vote on its sweeping health care bill as soon as Saturday.

Not a single Republican is expected to vote for the Democratic bill, which would cost $1.2 trillion bill over 10 years, require employers to insure their employees, and prohibit insurance companies from dropping coverage for sick people.

Instead, House Republicans are promoting their own belated bill -- including in a marathon online town hall today -- that focuses far more on cutting costs than covering uninsured Americans.

(Democrats, meanwhile, issued a dismissive slap at the online town hall. "We're planning a twelve second town hall to explain every last detail of the GOP health care plan," Democratic National Committee spokesman Hari Sevugan said in a statement. "According to the non-partisan Congressional Budget Office, the Republican 'plan' would do no nothing to stop insurance companies from denying care to Americans with pre-existing conditions or other profit protecting practices, do less to reduce the deficit and leave more people without insurance than there are today. They might as well call it the Do Nothing Act of 2009.")

House GOP Leader John Boehner is bragging about an independent analysis by the Congressional Budget Office that says the Republican health care plan will lower premiums by as much as 10 percent and reduce the federal deficit by $68 billion over 10 years.

“When it comes to reforming health care, controlling skyrocketing costs is the American peoples’ top priority. Now CBO has confirmed that the Republican plan will lower health care costs for American families, and that’s good news for everyone struggling in today’s economy. The choice now could not be clearer: Speaker Pelosi’s plan raises costs. Our plan lowers them," Boehner said in a statement.

“Not only does the GOP plan lower health care costs, but it also increases access to quality care – including for those with pre-existing conditions – at a price our country can afford. The cost of the Speaker’s bill, now at $1.3 trillion and counting, is a debt that will be paid for by our kids and our grandkids. The American people deserve a better solution, and Republicans’ smart, fiscally-responsible plan gives them exactly what they want."

Boehner, however, does not mention that the CBO analysis found that the Republican plan would only decrease the number of uninsured Americans by about 3 million by 2019, leaving about 50 million without coverage. The Democratic bill, by contrast, would cover an estimated 96 percent of Americans.

UPDATE: Also, thousands of protestors, many of them "tea party" anti-tax activists, are holding a rally outside Congress in opposition to the Democratic bill and President Obama's plan. They say it would extend government control over health care and lead to higher taxes.

Speaking to the rally, Boehner called the Democratic health care bill "the greatest threat to freedom" he had seen in his 19 years in Congress.

He warned that it would lead to a government takeover with bureaucrats making health care decisions.

"I'm going to stand with you and all freedom-loving Americans," he said, holding up a copy of the Constitution and reading from the preamble about the "right to life, liberty, and the pursuit of happiness."

According to the Associated Press, protestors' signs included one that said "Waterboard Congress," along with echoes of the rallying cry at August town halls with lawmakers, "Vote no to government-run health care."

One protester carried a placard reading, "Bury Obamacare with Kennedy," a reference to Senator Edward M. Kennedy of Massachusetts, who died of brain cancer in August and who called universal health care the cause of his life.

A liberal-labor coalition is rebutting the GOP plan with a new TV ad that slams it as a bill to protect insurance company profits.

"This just in: Republicans in Congress have introduced the Health Insurance Industry Profits Protection Act," the announcer says in the ad from Americans United for Change.

"The Republican bill lets insurance companies continue denying care for preexisting conditions," the announcer continues in the faux newscast. "Republicans will still let insurers raise premiums four times faster than wages. And health care will remain unaffordable for most Americans."

"Well folks, it looks like when it comes to health care, the party of no is now, the party of no change."

The AARP, a powerful lobby for seniors, officially announced its endorsement today of the House Democratic bill, despite concerns about potential cuts for members enrolled in Medicare "plus" plans.

The group, however, focused on the provisions that it says will "curb insurance companies’ discrimination against older Americans and Medicare improvements that strengthen benefits while protecting the program for future generations."

“Our goals have always been to make health coverage more affordable for our younger members, those aged 50 to 64, and to protect Medicare for seniors,” Deborah Banda, AARP Massachusetts state director, said in a statement. “Having reviewed the Affordable Health Care for America Act, we believe it meets these goals by improving benefits for people in Medicare – including closing the Medicare prescription drug coverage gap, the dreaded “doughnut hole” – and making health insurance market reforms to help ensure affordable health coverage for every American.”

President Obama, in a surprise appearance during the regular press briefing, bragged this afternoon about the support for the Democratic health care bill by the AARP and the American Medical Association, saying the endorsements bring reform closer than ever.

"This is no small endorsement," he said of the AARP support, saying it should rebut criticism that the proposals would hurt seniors.

"We're thrilled they're standing with us," Obama, who plans to visit Capitol Hill on Friday in support of health reform, told reporters.

The AMA's backing is also important, he said, because "the doctors of America know what needs to be fixed with our health care system." (His full remarks are below.)

The AMA backed the Democratic bill, plus a companion bill that would shield doctors from cuts in Medicare reimbursements.

"The time to make health system reform a reality is now,” J. James Rohack, AMA president, said in a statement. "These two bills were introduced together, and they need to be passed together. Both are essential to achieving meaningful health system reform this year."

While the health bill is "not perfect," on balance it "is consistent with our principles of pluralism, freedom of choice, freedom of physician practice and universal access," he added. "It will significantly expand health insurance coverage to Americans to empower patient and physician decision making; institute meaningful insurance market reforms; make substantial investments in quality; institute prevention and wellness initiatives; provide incentives to states that adopt certificate of merit and/or early offer liability reforms, and reduce administrative burdens."

Earlier today, the AARP officially announced its endorsement despite concerns about potential cuts for members enrolled in Medicare "plus" plans.

The group, however, focused on the provisions that it says will "curb insurance companies’ discrimination against older Americans and Medicare improvements that strengthen benefits while protecting the program for future generations."

“Our goals have always been to make health coverage more affordable for our younger members, those aged 50 to 64, and to protect Medicare for seniors,” Deborah Banda, AARP Massachusetts state director, said in a statement. “Having reviewed the Affordable Health Care for America Act, we believe it meets these goals by improving benefits for people in Medicare – including closing the Medicare prescription drug coverage gap, the dreaded “doughnut hole” – and making health insurance market reforms to help ensure affordable health coverage for every American.”

By Lisa Wangsness, Globe Staff

WASHINGTON -- Governor Deval Patrick and House Speaker Robert A. DeLeo met with the state's congressional delegation at the Capitol this morning to discuss a variety of issues, including the national health care overhaul the House may begin voting on this weekend.

Patrick said the economic woes confronting Massachusetts were also a primary focus of the talks, which those who participated in them said also covered education, transportation and global warming.

"We are trying to project a reality to the public that is so in our working relationship -- we are working closely together, trying as best we can, with the tools we have, to bring some relief to people who are suffering and some hope to everybody," he said.

Patrick, who met with Health and Human Services Secretary Kathleen Sebelius Wednesday, said he was trying to make sure that the federal health care bills taking shape would not harm the state's health care system, which depends heavily on support from the federal government and provides far more generous subsidies for low-income people than the federal proposals on the table, and would provide the state the flexibility it needs to work on cost containment.

Representative Edward Markey, a Democrat from Malden and the dean of the delegation, said he is certain the House version of the legislation, which is scheduled to be voted on Saturday evening, would benefit Massachusetts.
"Our delegation is supporting the legislation because we know it does help Massachusetts," he said.

On his whirlwind two-day visit to Washington, Patrick is also meeting with other top administration officials, top Senate Democrat Harry Reid, and Massachusetts wounded at Walter Reed Army Medical Center. The governor is scheduled to have a brief audience this afternoon with his friend and ally, President Obama.

Senator Paul G. Kirk Jr. took to the Senate floor today to highlight a rather wonky provision in the health care overhaul legislation -- a national data collection organization to track spending on health programs and its effectiveness.

"We need measures to identify what is wrong with our current health care system, including what is driving the increasingly high cost of care," Kirk said, noting that the industry now totals a mind-boggling $2.33 trillion a year.

"Abundant research and reports have analyzed such questions. What is desperately needed, however, is a central, independent organization that can analyze all of the research performed by various organizations, and make that information readily available to Congress, the Executive Branch, and the American people. That’s an indispensable part of successful health reform. It will give decision-makers easier access to all the knowledge available and eliminate wasteful spending of the hard-earned dollars of American families," the Massachusetts Democrat said.

He noted that the lawmaker he replaced, the late Senator Edward M. Kennedy, proposed the Key National Indicator System to provide it. "It will be a non-partisan, independent agency with a public/private partnership. It will foster better relationships between members of the legislative, statistical and scientific communities, and will lead to greater transparency and accountability for spending on national health programs," Kirk said.

His full prepared remarks are below:

By Lisa Wangsness, Globe Staff

WASHINGTON -- Americans' opinion of the health care proposals now before Congress is eerily similar to public opinion of the Clinton health reform initiatives in 1994, according to an analysis published in the New England Journal of Medicine today -- and that may not bode well for Democrats.

In theory, Americans think the health care system needs to be fixed and they like many of the ideas Democrats are promoting. But they don't like the specific proposals taking shape because they do not think they will benefit them personally.

The report, an in-depth look at more than 30 polls conducted this fall and during the same period in 1994, when the Clinton health reform effort was gasping its last breaths, was co-authored by Robert J. Blendon, a Harvard professor and a leading specialist on health care and public opinion whom congressional leaders of both parties have consulted.

Critics are likely to point out that it is impossible to compare the two periods -- in the fall of 1994, Clinton had been president for a year longer than President Obama has now. Obama has had much more cooperation from Congress than Clinton has had, thanks partly to a difference in strategy. Obama allowed Congress to handle the details of the lawmaking process, while Clinton created resentment among lawmakers by employing a secretive process within the executive branch.

At this time in 1993, the parallel point in the Clinton presidency, Clinton had not yet even introduced bills; this time, five congressional committees have passed legislation, and all of the bills approach the problem of how to insure nearly 50 million Americans without coverage in basically the same way.

But Blendon's analysis hones in on a key point that Democrats are likely to pay increasing attention to, particularly after this week's elections put them on notice that voters remain deeply concerned about the economy and restless with their political leadership.

After months of bashing the Democratic bills, House Republicans have come up with their own health care proposal.

The near-final draft focuses more on cutting costs than on covering the uninsured. And it comes in at 230 pages, compared to the 1,990-page behemoth that Democrats plan to bring to the House floor for a vote this week.

UPDATE: Late this afternoon, Republicans announced that party Chairman Michael Steele, House Republican Conference Chairman Mike Pence and other House members will hold a 12-hour online town hall marathon -- from 1 p.m. EST Thursday to 1 a.m. EST Friday.

"This online health care forum named 'Pelosi Plan Exposed' will ... expose the 12 truths of Nancy Pelosi’s health care bill. House Republicans will also promote and discuss the GOP health care legislation introduced in the House this week," the announcement said.

Republicans plan to offer their bill as an alternative on the floor. It does not require employers to offer coverage and does not require individuals to obtain, and does not ban insurers from denying coverage to people with pre-existing conditions. It most certainly does not include any kind of "public option" government plan to compete with private insurers.

Rather, the GOP plan incorporates some tried -- and Democrats would argue tired -- prescriptions: more health savings accounts, limits on pain and suffering awards in medical malpractice cases, and more leeway to sell health insurance to be sold across state lines.

"Americans want a step-by-step, common-sense approach to health care reform, not Speaker Nancy Pelosi’s costly, 1,990-page government takeover of our nation’s health care system. Republicans’ alternative solution focuses on lowering health care premiums for families and small businesses, increasing access to affordable, high-quality care, and promoting healthier lifestyles – without adding to the crushing debt Washington has placed on our children and grandchildren," House Republicans said in releasing their plan.

House Republicans this morning released the full text of their plan, available here. (Their summary of the plan is below.)

White House spokesman Robert Gibbs quickly noted how long it took Republicans to roll out their health care alternative and that it does not include "banning insurance companies from discrimination against sick people."

But Gibbs went on to say during his daily briefing that the Obama will continue to try to work with Republicans.

Congressional Democrats were even more dismissive of the GOP plan.

The No. 2 House Democrat, Steny Hoyer of Maryland, told the Associated Press that the Republican alternative "does little to provide security and stability to all Americans, doesn't provide insurance availability for all Americans, does little to expand access to coverage."

"Ours is vastly superior and we think the American public will think that," Hoyer added.

The Democratic National Committee called the GOP bill the "Health Insurance Company Protection Act.”

“It’s appalling that John Boehner and Republicans in Congress would rather maintain the status quo and allow insurance companies to continue engaging in unfair practices that boost their profits at the expense of consumers than pass the health insurance reform American families and businesses so desperately need," Representative Debbie Wasserman Schultz of Florida, a DNC co-chairwoman, said in a statement.

"We have said for some time that Republicans are more interested in protecting the health insurance industry than in helping consumers - and the plan Republicans are putting forward is all the proof anyone would need to know we've been telling the truth. The Republican plan amounts to a ‘Health Insurance Company Protection Act’ and shows once and for all that Republicans don’t want real reform and will fight to protect the status quo every step of the way. At a time when health insurance costs are skyrocketing and families fear losing their coverage if someone gets sick, the last thing we need is to give insurance companies another break. Passing the Republicans’ bill would be worse than passing no reform at all," she added.

“It’s time for Republicans to get the message: Americans want real reform. Instead of handing out favors to big insurance companies, Republicans should work with President Obama and Democrats in Congress to pass the health insurance reform our country needs.”

"This is it?" asked Americans United for Change, a liberal-labor coalition supporting the Democratic bills. "Only 139 days after promising a better proposal for health insurance reform, the Republican House Leadership are today proudly waving in the air a thin outline of a bill that ought to be named the ‘Perpetuate the Status Quo to Protect Insurance Industry Profits Act of 2009.’

"Congressional Republicans say their bill will show they mean business -- except that business is the health insurance industry, and their bill is all about protecting its massive profits. And demonstrating just how serious congressional Republicans are about reform, they’ve decided to omit reforms the American people support the most -- namely the GOP bill does nothing to end the unscrupulous insurance industry practices of denying coverage to Americans who are sick or have ‘pre-existing’ conditions," the group added.

It's gut check time, a liberal-labor coalition is telling wavering members of Congress.

The latest TV spot on health care from Americans United for Change tries to remind lawmakers that some of the biggest advances did not come until after lots of controversy -- and that it's time to buck up as the House prepares to vote this week on the health care overhaul.

"A great American once said that you can’t have the rain without the thunder and lightning," the announcer says over an animation of a big storm. "Social Security, child labor laws, Medicare, even the creation of the national parks. They were all born in controversy."

As the skies clear in the image, the announcer continues: "But after the storm they all became essential parts of the American landscape. Ask your members of Congress to take a vote they will be proud of for generations to come. Ask them to vote yes to make health care a right for every American."

Republicans have criticized the Democratic health care overhaul in a lot of ways: as a government takeover, as a huge tax increase, as a job killer, as rationing by death panels.

But worse than terrorism?

That's a new one -- and it came out of the mouth today of a Republican congresswoman from North Carolina.

"I believe that the greatest fear that we all should have ... to our freedom comes from this room, this very room, and what may happen later this week in terms of a tax increase bill masquerading as a health care bill," Representative Virginia Foxx said on the House floor. "I believe we have more to fear from the potential of that bill passing than we do from any terrorist right now in any country."

The Democratic National Committee quickly pounced: "It is outrageous that anyone would compare the action of terrorists to efforts to help American families get secure, stable and affordable health insurance," said DNC spokesman Brad Woodhouse.

In a speech today, Senator Paul G. Kirk Jr. seconded former Senator Edward W. Brooke, who even as he received Congress's highest civilian honor Wednesday admonished lawmakers for partisan warfare.

"I am proud that Massachusetts sent Ed Brooke to Washington, and we saw yesterday what our state long ago saw in him: his strength, his wisdom, his decency, and his deep commitment to meeting the needs of the American people," Kirk said. "Ed Brooke was elected as a Republican, but the people of Massachusetts didn’t see him as a party man. They saw him as a great American, and a model politician. They supported him because they understood that difficult times require statesmen who can work across party lines."

And that bipartisan spirit should start with the health care overhaul, Kirk told his colleagues.

"We are poised to enact the most significant domestic legislation since the civil rights era. I know that each and every senator has deeply held beliefs about how we can best reform our health care system -- and that those deeply held beliefs will sometimes collide. We should and we will have a vigorous debate in this chamber," said the former Democratic Party chairman.

"But that debate should reflect a level of the civility and the cooperation that is equal to the magnitude of what is at stake for American families. It should reflect the spirit of teamwork and collaboration that we always saw in statesmen like Ed Brooke -- and Ted Kennedy. Our times, and our nation, demand nothing less."

His full prepared remarks are below:

House Speaker Nancy Pelosi this morning unveiled the health care overhaul bill that is to go the floor next week for a vote.

At a pep rally-style event in front of the Capitol, she said that Congress is "about to deliver on the promise" of making affordable health care available to all with a bill that would extend coverage to 36 million more Americans and ban insurers from denying coverage on the basis of pre-existing conditions.

On a major point of contention, the bill includes a "public option" that would let the government sell insurance in competition with private insurers.

The bill, pegged to cost $894 billion over 10 years, would require nearly all Americans by 2013 to obtain coverage, either through their employer, a government program, or new purchasing exchanges. The plan also calls for a significant expansion of Medicaid, the federal-state health program for the poor. And it would impose a requirement on employers to offer insurance to their workers or face penalties.

The bill has been posted online and is available here.

If the House passes a bill, it would have to be melded with the version that comes out of the Senate, where top Democrat Harry Reid is still trying to round up the votes to bring his version -- which includes a public option from which states could opt out -- to the floor.

Republicans and other critics quickly attacked the House Democrats' bill as a recipe for government control of health care and for higher costs. Americans for Tax Reform released a list of what it said was more than a dozen new or increased taxes or fees in the bill.

"Over the last several months, the American people have spoken, and it's pretty clear that our Democrat colleagues have not listened. Through the month of August and September, the American people let members of Congress from both sides of the aisle know that they wanted no part of a government-run health care plan," Representative John Boehner of Ohio, the top House Republican, told reporters on Capitol Hill.

"But nothing really has changed over these last couple of months, and yet the Democrats come forward with a bill that really is a government takeover of our health care system. It's not just the so-called government option. It's the over 50 new mandates, bureaucracies, tax hikes, commissions, all of this is going to require tens of thousands of new federal employees, which is clearly designed for a government takeover of our health care system," Boehner added.

"So no listening and 1,990 pages. Now, tell me how -- how we're going to fix our health care system with 1,990 pages of bureaucracy. This is what the American people have been saying over the last few months: Enough is enough."

UPDATE: The AFL-CIO came out this afternoon in praise of the House Democrats' bill, which it much prefers to the one being worked on in the Senate, which would tax high-cost "Cadillac" health plans to help pay for covering more people. Labor says that would hurt working people, who gave up pay raises for those more generous health benefits.

"Today’s release of a progressive health care reform bill by House Speaker Nancy Pelosi puts America’s working families one big step closer to getting quality and affordable health care, and it’s a model for fair financing. The leadership in the House has crafted a fiscally responsible bill that will provide coverage to 96 percent of Americans and successfully works to lower costs, increase choice, expand coverage and stop insurance company abuses. It will reduce our deficit by $30 billion over the next 10 years," AFL-CIO president Richard Trumka said in a statement.

"The inclusion of a public plan option ensures that we reduce skyrocketing health care costs by holding insurance companies accountable and forcing them to compete. The public option also ensures that all Americans can get coverage no matter what," he added. "The bill does not attempt to finance reform on the backs of the working middle class. In addition, the employer responsibility provision ensures a fair share of financing from employers and prevents employers from increasing costs for everyone by dumping people into subsidized programs. We look forward to working with the leadership in both the House and the Senate to continue to strengthen these provisions as we move forward to pass real health care reform. We strongly believe that these fair financing elements should be included in the final legislation in order to ensure that we are not asking those who struggle to pay for health care to pay even more."

President Obama issued a statement congratulating House Democrats on their bill, calling it "another critical milestone in the effort to reform our health care system."

"This legislation is the product of unprecedented cooperation and countless hours of hard work by Speaker Pelosi, Chairmen Waxman, Rangel, and Miller, Congressman Dingell, and scores of House members who share my conviction that we can’t wait another year for health insurance reform. They have forged a strong consensus that represents a historic step forward," he said in his statement.

"The House legislation includes critical reforms to the insurance industry, so that Americans will no longer have to worry that they will be denied coverage, or that their coverage will be dropped or watered down when they need it most. I’m also pleased that the bill includes a public option offered in an exchange. As I’ve said throughout this process, a public option that competes with private insurers is the best way to ensure choice and competition that are so badly needed in today’s market. And the House bill clearly meets two of the fundamental criteria I have set out: it is fully paid for and will reduce the deficit in the long term.

"While we know there will may more steps and much spirited debate before a bill reaches my desk, I congratulate the House on their work so far, and I’m confident that members will continue to work together to deliver meaningful reform for America’s families and businesses.”

Meanwhile, Obama is pressing his case for health care reform, speaking this morning to invited small business owners and members of the US Chamber of Commerce and National Federation of Independent Business.

"If we’re serious about strengthening small businesses; if we’re serious about creating a climate where our entrepreneurs can succeed; if we’re serious about giving you the chance to prosper and grow, then we need to pass health insurance reform in the United States of America," he plans to say, according to remarks released in advance by the White House.

"Few have a bigger stake in what happens than all of you. Few have a bigger stake than the men and women who own a small business, work at a small business, or rely on someone who does. Few have a bigger stake in what happens because few are struggling more under the status quo."

His full remarks are below:

A day after giving his first floor speech -- on the need for bipartisanship on the health care overhaul -- Senator Paul G. Kirk Jr. returns to the chamber this morning to talk about how the version passed by the Senate health committee would help the elderly and disabled.

Kirk is one of nine freshman Democrats scheduled to give back-to-back speeches, his office said. Each will touch on a different issue or program that "exemplify how health care reform will work and how it is working already."

Kirk's topic is the Community Living Assistance Services and Supports Act, also championed by his mentor and the man he is temporarily replacing, the late Senator Edward M. Kennedy.

"Here’s how the CLASS Act will help the middle class," Kirk said. "Under the act, a worker in Massachusetts or any other state can choose to pay into a voluntary insurance program through affordable payroll deductions. After five years of those deductions, they would be eligible for a daily cash benefit of $50 if they became disabled. That money can make a huge difference in allowing a disabled person to live with independence and with dignity. For example, it can pay for having a ramp installed in their home or pay for needed transportation or purchase a commuter to work from home and remain self-sufficient."

His full remarks are below:

Public support for a public option in health care appears to be growing, according to a new poll.

The NBC/Wall Street Journal survey found that 48 percent support a government-run plan to compete with private insurers and 42 percent oppose it -- the strongest support ever in the survey. Last month, opinion was basically divided with 46 percent in favor and 48 percent against.

The new poll, conducted Thursday through Sunday, has a margin of error of plus or minus 4.4 percentage points.

The top Senate Democrat, Harry Reid of Nevada, revived the possibility of a public option being in the final bill by announcing Monday that he would include one in the version he plans to bring to the full Senate -- albeit with a big exception in that states would be able to opt out.

But at the same time, Reid's move might have cost him a vote of a Senate moderate.

The Associated Press is reporting that Senator Joe Lieberman, a Connecticut independent who caucuses with Democrats, is saying that while he's "strongly inclined" to vote to bring Reid's health care plan to the Senate floor for debate, he would ultimately vote no because it includes a public option.

Lieberman told the AP that he's worried a public option would be costly to taxpayers and drive up insurance premiums.

UPDATE: But Lieberman told Politico that he would join a Republican filibuster if the bill includes a public option.

"We're trying to do too much at once," Lieberman told Politico. “To put this government-created insurance company on top of everything else is just asking for trouble for the taxpayers, for the premium payers and for the national debt. I don’t think we need it now." 

And Senator Olympia Snowe of Maine, the only Republican to support any of the health bills so far, is saying she would vote with fellow Republicans to block the Democratic bill if changes are not made to the version that Reid outlined, the AP reports.

Counting Lieberman, Democrats control 60 votes -- just enough to overcome a possible GOP filibuster -- so Snowe's vote could be crucial.

Senator Paul G. Kirk Jr. delivered his first major floor speech today, and he chose a subject close to the heart of the legendary lawmaker he replaced.

And Kirk sounded a theme woven through the late Edward M. Kennedy's 47 years in the Senate -- reaching across the aisle in search of bipartisan compromise on the most important issues facing the nation.

“Of all the issues on which he led the Senate and our nation, the one Ted Kennedy called the cause of his life was the battle for affordable, quality health care," Kirk told his colleagues. "At this moment, we are closer to realizing the long held dream that all Americans have access to quality, affordable health care than at any time in our nation’s history."

But, he added, "At this moment, when America’s families are imperiled by economic hardship and uncertainty, it provides them no comfort to see the United States Senate so politically polarized over an issue that should be bringing us together on their behalf."

When he was sworn in last month, Kirk became the 60th vote in the Senate allied with Democrats, theoretically giving his party enough votes to overcome Republican procedural hurdles and to get a health care bill through the chamber.

Today, Kirk stressed, "This debate should not be about one party reaching 60 votes; it should be about 100 Senators reaching out to each other to reform a health care system so that it better reflects the true values and character of our nation.”

Kirk, a former Kennedy aide and Democratic Party chairman, noted that the late senator gave his first major health care speech 40 years ago, and that Capitol Hill has been littered with unsuccessful efforts at reform since as the estimates of uninsured Americans has ballooned from 25 million to 46 million.

"As this debate continues, I hope we will pause for a moment – to hear Ted Kennedy’s voice in the quiet of our hearts. You and I know, he will urge us to seize this moment – to come together in this common cause, and to make sure, at long last, that all Americans will have access to the quality, affordable health care they have long deserved and so urgently need," said Kirk, standing at the desk where Kennedy's booming voice advocated for civil rights and help for the poor as well as universal health care.

But Kirk, who is serving until a special election on Jan. 19 decides who will serve out Kennedy's term, said he will advocate for a proposal that is causing much of the partisan divide -- a public option.

Republicans say that a government-run plan to compete with private insurers will drive insurance companies out of business and give government too big a role in the health care system.

But Kirk agreed with top Senate Democrat Harry Reid, who announced Monday that a public option would be in the bill that comes to the floor. A public option will "stimulate competition and reduce costs in the health care marketplace," Kirk said.

Kirk also defended the landmark health insurance law in Massachusetts, saying that it is "regrettable" that "special interests who have a financial stake in our failing health care system" have attacked the reform bill and "the success of our reform in Massachusetts."

"Well, let me set the record straight," he is telling the Senate. "First, because of our bipartisan reforms, less than 3% of the Massachusetts population is without health insurance -- lower than any other state. Second, the state’s most respected independent fiscal watchdog concluded that Massachusetts implemented reform in a fiscally responsible and financially sustainable way. Third, unlike every other state, employer-based health insurance is increasing in Massachusetts. Finally, according to a recent statewide poll by the Harvard School of Public Health, 79% of the public -- and practitioners in every sector of the Massachusetts health care system -- including physicians -- strongly support our bipartisan reform."

Fellow Massachusetts Senator John F. Kerry and top Senate Democrats, including Dick Durbin of Illinois and Reid, were in the chamber for the speech. Senator Jay Rockefeller of West Virginia came up to Kirk afterwards and congratulated him.

Kirk's full prepared remarks are below:

After weeks of uncertainty, the top Senate Democrat announced this afternoon that he wants to include a government-run option as part of the health care overhaul, though it's not clear he has the votes to get it through the Senate.

Senate Majority Leader Harry Reid said at a news conference that he favors the contentious public option, which is included in the versions passed by the Senate health committee and three House panels but not the one from the Senate Finance Committee, according to several media organizations.

"While the public option is not a silver bullet, I believe it's an important way to ensure competition and to level the playing field for patients with the insurance industry," Reid said.

Reid threw his support behind a version that would allow states to opt out of offering government-run coverage to compete with private insurers. Under his proposal, states would have until 2014 to do so.

"Under this concept, states will be able to determine whether the public option works well for them and will have the ability to opt out, if they so choose," Reid said. "I believe that a public option can achieve the goal of bringing meaningful reform to our broken system. It will protect consumers, keep insurers honest and ensure competition."

But the opt-out will not please liberal Democrats, who say the public option should be available nationwide and is essential to keeping the insurance industry honest.

President Obama has said he prefers a public option, but is not demanding it as part of a bill he could sign.

Reid said the bill that goes to the Senate floor will also include a provision for nonprofit co-ops as another option for affordable coverage.

He said he is sending his proposal -- which combines elements of the Senate Finance and Senate health bills -- to the Congressional Budget Office for an analysis of how much it would cost. He and Obama are aiming for a plan that comes in at $900 billion over 10 years or less.

White House press secretary Robert Gibbs issued a statement on Obama's behalf congratulating Reid, Senate Finance Chairman Max Baucus, and Senate Christopher Dodd, who shepherded the health committee bill.

“Thanks to their efforts, we’re closer than we’ve ever been to solving this decades-old problem," Gibbs said. "And while much work remains, the President is pleased that at the progress that Congress has made. He’s also pleased that the Senate has decided to include a public option for health coverage, in this case with an allowance for states to opt out. As he said to Congress and the nation in September, he supports the public option because it has the potential to play an essential role in holding insurance companies accountable through choice and competition.”

Senator John F. Kerry of Massachusetts, a Finance Committee member, also applauded Reid for including a public option.

“This is big news, and it’s very good news. Majority Leader Reid is taking the gutsy and appropriate road in fighting for the right policy, something the American people want and an issue on which every Senator should be held accountable," Kerry said in a statement.

"That’s why I voted for it in the Finance Committee and why I’ve advocated for it since day one. Leader Reid has laid out a plan that is reasonable and fair and will help achieve quality, affordable healthcare for all Americans. Ted Kennedy once told me there were many ways to arrive at health care reform, and he always knew that the first step was in finding every possible avenue to fight for the best policy. That’s the tradition the Majority Leader is carrying on today.”

The No. 2 Republican in the House says there's still daylight for a bipartisan deal on health care.

But what Representative Eric Cantor of Virginia says the GOP would support falls far short of what Democrats and the White House want -- making even more clear how deep and wide the partisan divide is on health care.

"Given the heated rhetoric and sharp partisan divides that have characterized this year's debate, it's easy to forget that there are several key reforms in health care that Democrats and Republicans can agree on," Cantor says in an opinion piece published online on CNN.

He says both parties agree on providing more affordable health coverage, especially for Americans who change jobs; barring insurers from denying coverage for pre-existing conditions; and going some distance on medical malpractice reform.
"Congress can accomplish the dual goals of improving the quality of care in America and trimming the ranks of the uninsured if we focus on what Democrats and Republicans can agree on, rather than on our differences. It's not too late for the majority to change course," he writes.

But Cantor says Democrats' proposals for a public option -- a government plan to compete with private insurers -- is a "poison pill" that would guarantee Republican opposition. And he accuses Democrats of a bill that "dishonestly resorts to a host of budget gimmicks to give the veneer of deficit neutrality over the next decade."

Liberals are trying to intensify their pressure on President Obama for a full-fledged public option as part of the health care overhaul.

The Progressive Change Campaign Committee has a petition, website, and a new TV ad urging Obama to insist on a government-run plan to compete with private insurers -- and to stop kowtowing to Senator Olympia Snowe of Maine, the only Republican to support the health reform bill so far. She has made clear the most she would support is a public option "trigger" that would go into effect only if private insurers don't provide coverage and cut costs.

The petition, YesWeStillCan.org website, and ad all seek to remind Obama of his campaign pledges that attracted a huge grassroots groundswell that put him in the White House.

In the TV spot, an activist notes that Maine went heavily for Obama last November and that polls show a majority of Maine residents support a public option. "We worked hard for it," the activist says. "We worked hard for you."

The petition echoes, "Every day, insurance companies deny care and let people die. Getting one Republican senator's vote is not worth delaying reform -- too many real lives are at stake. We need you to fight and state clearly that anything less than a strong public option is not change we can believe in."

And Adam Green, co-founder of the Progressive Change Campaign Committee, criticizes Obama for not putting more pressure on top Senate Democrat Harry Reid for a public option and for telling his grassroots Organizing for America group last week that they should be happy with the bill that doesn't include the government plan. "Understand that the bill that you least like in Congress right now. The one you least like, of the five that are out there, would provide 29 million Americans health care," the president lectured.

Green retorts: "Yay insurance for 29 million people -- by mandating they buy insurance from rip-off artists with no choice of a public option!"

"Here's what the White House needs to understand: Expressing a preference for the public option is not the same as fighting for the public option. Telling Harry Reid 'good luck with that' is not the same as the president saying, 'I am there helping Reid fight for those final votes,' " Green said in a statement.

"Americans clearly favor a strong bill over a bipartisan bill and are clamoring for President Obama to make good on the mandate for sweeping change that was given to him in the 2008 election. President Obama will be judged by many of his biggest 2008 supporters on whether he fights for a strong public option at this critical moment."

A senior White House economic adviser is trying today to make the economic case for a health care overhaul.

Republicans and other critics are warning that the president's proposals to remake such a significant portion of the US economy could hurt growth, balloon the federal deficit, and pinch recession-weary families.

But Christina Romer, chairwoman of White House Council of Economic Advisers, plans to tell the liberal Center for American Progress this afternoon that the only way to get the deficit under control is to trim health care costs, particularly in the government Medicare and Medicaid programs.

"Given the central role of rising health care expenditures, any solution to our long-run budget problem will simply have to include slowing the growth rate of health care costs,” Romer will say, according to advance excerpts released by the White House.

"Some have argued that it is irresponsible to reform our health care system at a time when the budget deficit is so large and our long-run fiscal problems are so severe. I firmly believe the opposite: it is fiscally irresponsible not to do health care reform.

State and local governments and private businesses alike would benefit from the health overhaul, she asserts. "Slowing the growth rate of health care costs will enable firms to once again give raises in the form of take-home pay rather than more expensive health insurance,” Romer plans to say.

“[F]iscally prudent health care reform that expands coverage to tens of millions of Americans and transforms our health care system to one that is higher quality and lower cost is possible.”

A liberal-labor coalition pushing the health care overhaul is going for a little humor in its attack on the insurance industry.

Americans United for Change today unveiled a satirical web video featuring the story of a four-month-old, 17-pound toddler in Colorado who was denied coverage because he was deemed obese -- a pre-existing condition -- by Rocky Mountain Health Plans, a member of America’s Health Insurance Plans the health insurance industry lobby

“Too fat?!?! You cannot be serious!” a character called "Patriot Baby" says in the video, reminiscent of the E*Trade TV commercials with an adult voice coming out of an infant. “He’s a baby! What’s he supposed to do -- go on 'The Biggest Loser'?”

The public option -- one of the most contentious proposals in the health care fight -- might end up in the Senate health overhaul bill after all.

Several media organizations, including the New York Times and the Associated Press, are reporting this evening that there's no done deal, but there is movement toward including a provision for the federal government to sell insurance in direct competition with private insurers with individual states permitted to drop out of the system.

The Times says that the top Senate Democrat, Harry Reid, is leaning toward including the government-run health insurance plan in the bill he will soon take to the Senate floor. While Republicans and some moderate Democrats oppose the public option, those in favor of it are pushing Reid to force a vote to strip it out of the bill. "The idea is that it's better to show some fight," a senior Democratic aide told the Times.

Senator Olympia Snowe of Maine, the only Republican to support the health care bill in the Senate Finance Committee, has made clear she would only support a public plan if it is triggered by private insurers not cutting costs and extending coverage enough.

House Democrats have the public option in the bill they are finalizing, without a provision for states to opt out.

Polls have also shown public support for a public plan to keep private insurers honest, but Republicans and other critics say it would lead to a government takeover of health care.

Democrats picked a big, highly visible target for the latest in their series of "call 'em out" missives -- GOP chief Michael Steele.

The Democratic National Committee today announced a multimedia effort aiming at the Republican Party chairman for "continuing to spread lies about health insurance reform."

It is using a website and a web video and urging supporters to use Facebook and Twitter to go after Steele, whom the DNC says is spreading misinformation by claiming, among other assertions, that the health care overhaul being pushed by President Obama and congressional Democrats would "dump" millions of Americans out of their insurance and would cut Medicare.

The political pendulum has swung slightly away from President Obama on health care, though a majority of Americans still want an overhaul, and still want a public insurance option, a new poll says.

According to the CNN/Opinion Research Corp. survey released this afternoon, 49 percent favor and 49 percent oppose the health overhaul. That's down from 51 percent support last month, though better than the 48 percent in late August after protestors at town halls railed against the president's plan.

The rest of the poll had better news for Obama.

A majority -- 53 percent -- said it would be better for the country to pass a bill along the lines proposed by the president instead of leaving the current health system in place.

The poll also found that 61 percent support a public option -- a government-run plan to compete with private insurers -- up from 55 percent in August. And 40 percent said they would support the overhaul bill only if it included the public option.

And respondents trust Obama far more than Republicans -- mocked by Democrats as the "party of no" -- on health care; 50 percent said they trust Obama more to deal with major health care changes, while 34 percent picked congressional Republicans.

The poll, conducted Friday through Sunday, has an overall margin of error of plus or minus 3 percentage points.

Pro-Obama groups said this morning they ended up at 315,023 calls to Congress on Tuesday pushing the health care overhaul, tripling the original goal of 100,000.

The massive effort was put together by Organizing for America, the president's grassroots group from the campaign. (Click here for updates.)

"As you know, we set a big goal: 100,000 calls to Congress placed or committed to in a single day by OFA supporters and allied organizations. By 2:30 p.m., you had crushed it. So, we gulped and said let's go for 200,000, not knowing what would happen. But the calls just kept pouring in -- keeping phones ringing off the hook in congressional offices in D.C. and your representatives' district offices around the country," the group's national director, Mitch Stewart, told supporters this morning.

"Then, OFA supporters gathered in over 1,000 living rooms and community centers from Macon, Georgia to Missoula, Montana. You called hundreds of thousands of key voters in your community and got them to agree to call Congress and speak out for reform, too. President Obama joined in at a call party in New York -- and he had some amazing words of support for the folks like you who make this movement possible."

Obama, himself, addressed thousands of supporters who are making calls via live webcast Tuesday night from the Hammerstein Ballroom in New York City, where 2,500 people will be making similar calls in support of reform.

"You know why this is so important," he told them. "You know premiums have doubled over the past decade."

The Republican National Committee announced today that it is getting donations from a record number of small donors.

The RNC said that it raised $8.74 million in the month of September and had $18.9 million cash on hand at month's end with no debt. It averaged 2,400 new donors a day during the month, an off-year record and an increase of about 2,000 new donors per day since February, the RNC said.

The average donor contribution in September was $36, with a year to date average donation of about $41.

The RNC also unveiled its latest web video, slamming top Senate Democrat Harry Reid for negotiating the details of the health care overhaul in private.

The video has Reid promising transparency, saying, "No longer can we allow special interests and lawmakers to conspire behind closed doors." It also shows Obama making similar pledges.

But now, the video points out, Reid is working closely and privately with the White House to meld the version the Senate Finance Committee approved last week, and a more liberal version that the Senate health committee passed earlier.

They're talking in secret because they don't want the public to realize the health care bill would raise costs and mean a far greater government role, the announcer says.

"It may be Halloween, but the Democrats' intentions cannot be disguised," the announcer concludes.

The chief spokeswoman for the nation's private insurance companies is defending a report that many saw as the industry trying to kill the health care overhaul.

America's Health Insurance Plans issued the report just before the Senate Finance Committee voted last week, asserting that the bill would dramatically raise premiums. The report has been widely pilloried for not accounting for cost-saving measures in the bill. (To reach the entire bill, click here.)

In an opinion article in today's Washington Post, Karen Ignagni, president and CEO of AHIP, writes, "Let me be clear and direct: Health plans continue to strongly support reform. In fact, last year we proposed new insurance market rules and consumer protections to achieve universal coverage, remove restrictions on preexisting conditions and end the practice of basing premiums on health status or gender. We firmly believe that all the cost concerns the report raised can be resolved."

She adds, "The report's central finding has long been noncontroversial in health policy and economic circles: namely, that implementing reforms of the insurance market without a strong requirement that everyone participate will cause adverse selection and significantly increase costs for individuals and small businesses. This finding echoes the message President Obama delivered in his address to Congress last month."

But liberal groups supporting the health bills are continuing their assault on the insurance industry.

Americans United for Change released its latest ad today featuring an insurance horror story -- this one about a woman who purportedly was told she would have to be sterilized to keep coverage.

"The new spot is our latest salvo against the shameful practices of the health insurance industry, which finally dropped the ‘we want reform, too’ façade last week with AHIP’s release of that amazingly disingenuous “report” asserting of all things that reform would mean 'higher premiums' – laughable stuff coming from the folks that raised premiums three to four times faster than wages the last ten years," Americans United for Change said.

A new poll finds support rebounding for a public option and some discomfort with President Obama among his liberal allies.

The Washington Post/ABC News survey released this afternoon found that 57 percent of Americans favor a public insurance option, while 40 percent are opposed. But opinion continues to be split -- 45 percent for, 48 percent against -- for the overall health overhaul bills being debated in Congress.

Obama's aides repeated over the weekend that while the president prefers a bill that includes the public option -- a government-run plan to offer affordable coverage and to compete with private insurers -- he isn't wedded to it.

While 7 in 10 Democrats back the plan being put together, Obama's strong approval ratings on health care from fellow Democrats have dropped 15 percentage points since mid-September.

More broadly, while 57 percent approve of the way Obama is handling his job as president, "strong approval" among liberal Democrats is down 16 percentage points over the past month.

Liberals are ramping up the pressure on top Senate Democrat Harry Reid, one of the key players in the negotiations over the health care overhaul.

Trying to craft a plan that can draw at least 60 votes in the Senate, Reid, the White House, and other moderate and conservative Democrats are waffling on whether a "public option" -- a government-run plan to offer affordable coverage and compete with private insurers -- should be in the final bill. Worried liberals say that health reform without it would be less than half a loaf.

Today, the Progressive Change Campaign Committee unveiled a TV ad in Nevada, where Reid face re-election next year, and sent an email to 225,000 activists nationwide seeking to raise at least $100,000 online to air the spot 200 times.

It features Nevada nurse Lee Slaughter, who says she has spent 20 years providing critical care -- and seeing patients cut off because of insurance. "Now, it's happening to me," she says, saying that she broke both her hips and that her insurer isn't providing all the care she needs. broke both hips insurers

Slaughter says she's a swing voter for supported Reid and President Obama, and says that in 2010, she will vote on only one issue.

"I'm watching to see if Harry Reid is strong and effective enough as a leader to pass a public health insurance option into law," she says.

A health care bill within sight, President Obama aggressively takes on his critics who he says are trying to stop the overhaul by misleading and scaring Americans with dire warnings of higher premiums and other damage.

In his weekly radio-Internet address, Obama targets insurance companies, one-time allies who have gone on the attack, blasting a bill approved by the Senate Finance Committee this week.

"In fact, the insurance industry is rolling out the big guns and breaking open their massive war chest -- to marshal their forces for one last fight to save the status quo," Obama says. "They’re filling the airwaves with deceptive and dishonest ads. They’re flooding Capitol Hill with lobbyists and campaign contributions. And they’re funding studies designed to mislead the American people."

"It’s smoke and mirrors. It’s bogus. And it’s all too familiar," the president adds. "Every time we get close to passing reform, the insurance companies produce these phony studies as a prescription and say, “Take one of these, and call us in a decade.” Well, not this time. The fact is, the insurance industry is making this last-ditch effort to stop reform even as costs continue to rise and our health care dollars continue to be poured into their profits, bonuses, and administrative costs that do nothing to make us healthy – that often actually go toward figuring out how to avoid covering people. And they’re earning these profits and bonuses while enjoying a privileged exception from our anti-trust laws, a matter that Congress is rightfully reviewing."

Asserting that Americans voted for change when they made him their president, Obama urges Congress "to stand against the power plays and political ploys – and to stand up on behalf the American people who sent us to Washington to do their business."

The full address is below and can be viewed here.

Hillary Rodham Clinton -- former first lady, presidential contender, and now secretary of state -- knows painfully first-hand how difficult a lift health care is.

So she counsels patience as Congress and the White House tries to come up with a bill that can pass -- and that can work.

"I'm very encouraged by the action that's going on in the Senate. But I think I, probably better than anyone, know how difficult this is," she said in an interview aired on CNN today.

"But we've made a lot of progress in the last nine months. And I'm very optimistic we're going to get a health care plan that will really improve the lives of the American people," added Clinton, who led a White House health care task force in 1993-94 that submitted a detailed bill to Congress that was derided as "Hillarycare" and went nowhere.

In the interview, Clinton also preached patience on Obama's decision whether to dispatch more US troops to Afghanistan, saying that "it's to the president's credit that he has had the patience and the persistence to really force the process without responding prematurely."

The president, she said, needs to closely scrutinize the broad view of what the US mission in Afghanistan should be and how best to accomplish it, citing a recent strategic review.

"It was quite remarkable that the report came in with two big ideas that had not, in my view, been fully either explored or certainly implemented in the prior eight years," she said. "One was you've got to look at Afghanistan and Pakistan together. Now, that may sound self-evident. But that wasn't what was being done previously. And you have to have a much greater integration of the civilian and the military efforts."

The full transcript of Clinton's interview with CNN's Jill Dougherty, as provided by the network, is below:

The Democratic National Committee said today it is going after the insurance industry in the latest of its “Call ‘Em Out” series targeting those who it says is trying to mislead the public on the health care overhaul.

Democrats are criticizing an industry-funded study that said insurance premiums would rise under the bill approved Tuesday by the Senate Finance Committee and assailing an insurance industry ad campaign warning seniors of cuts in Medicare.

"After fighting health reform with lies, deceit, and multi-million dollar ad campaigns, the health insurance lobby -- America's Health Insurance Plans (AHIP) -- just released a report on the 'effects of health reform.' Surprise! It's full of flawed claims that reform would increase costs," the DNC told supporters in a email accompanying a video.

"We're not going to take it sitting down. So this week, we're calling out the health insurance lobby. The lobby has invested millions trying to convince Congress to oppose reform. So this week, we're not simply debunking lies: The best way to Call 'em Out is to cut through the spin and tell our representatives to say 'no' to deceitful lobbyists and 'yes' to reform. "

President Obama is activating his grassroots army again, trying to get 100,000 of them to call Congress on a single day to push for health care.

Organizing for America's national director, Mitch Stewart, announced today that Obama will join thousands of "Time to Deliver" events on Oct. 20 via a live webcast

"These call parties couldn't come at a more important time -- the final Senate committee just passed their version of the plan, so the debate is about to move to the full Congress for the first time. And the insurance industry lobby is throwing everything they've got at us to distort the issues and derail progress. Our voices must be heard," Stewart said in an email to supporters.

Organizing for America, housed within the Democratic National Committee, is the post-election iteration of Obama's vaunted campaign organization.

The nonpartisan, normally genteel League of Women Voters is taking the unusual step of airing a TV ad taking a tough issue position -- urging Americans to support the Democratic-supported health care overhaul.

The League said it is airing the 30-second spot in the home states of key senators, including Maine, where Olympia Snowe was the only Republican on the Finance Committee to support the bill on Tuesday and where fellow Republican Susan Collins suggested she might go along.

“Health care reform is a critically important issue for Americans – an issue that requires action from all of us,” League President Mary G. Wilson said in a statement. “After watching opponents of health care reform repeatedly attempt to scare people with lies and disorderly conduct, the League decided that we must speak up.”

“This is an unusual step for us. But as a nonpartisan membership organization that believes in reasoned and civil debate we felt compelled to take a stand against the lies and the distortions,” Wilson added.

“Health care is too important to let the nay-sayers and the special interests stand in the way of real reform. We have an obligation to get the facts straight.”

Two major players in the health care debate -- Big Insurance and Big Labor -- are both registering their objections to the bill passed by the Senate Finance Committee.

But they're coming at it from far different vantage points.

America's Health Insurance Plans, which represents the big insurers, is airing a TV ad that criticizes the bill's provision that would trim Medicare Advantage, the premium coverage that seniors get through private insurers.

"Most people agree we need to reform health care but is it right to ask 10 million seniors on Medicare Advantage for more than their fair share," the announcer says.

The Democratic bills would cut Medicare Advantage by more than $120 billion over 10 years, meaning that 10 million seniors -- including 175,000 in Massachusetts -- could have their health plans shrink or be replaced with traditional coverage.

On the other hand, a dozen of the largest labor unions are taking out full-page ads in Washington and national newspapers complaining that the Finance bill does not include a public option -- a government-run plan to compete with private plans -- and does call for penalties on people who do not obtain coverage.

The ad, entitled "Our Bottom Line for Health Care Reform," says that "Unless the bill that goes to the floor of the U.S. Senate makes substantial progress to address the concerns of working men and women, we will oppose it."

The White House and Democrats were thrilled that Senator Olympia Snowe of Maine broke ranks with Republicans to give a bipartisan patina to the Senate Finance Committee's approval of a health care overhaul.

But Republicans predictably are not as impressed.

“One Republican vote out of 40 in the Senate does not bipartisan make,” GOP chairman Michael Steele said today on Fox News Channel.

“You’ve got a long way to go Mr. President before you get to bipartisanship in terms of really putting together a bill that makes sense,” he added.

Meanwhile, the Associated Press reports that there could be a second Republican vote for the health care bill -- Snowe's fellow Mainer, Susan Collins.

Collins said that the bill approved on a 14-9 vote Tuesday by the Finance Committee needs substantial improvements. "My hope is we that can fix the flaws in the bill and come together with a truly bipartisan bill that could garner widespread support," Collins said in the AP interview. "I think this bill is far superior to the ones passed by the Senate [health]) committee and the three House committees, but it needs substantial additional work."

Steele said the health package would have to be far different to draw more Republican support. “If it doesn’t have triggers for a government plan, if it doesn’t have little hidden mechanisms and features that Congress is famous for doing that ultimately gets us on a road to government controlled health care, I think you will see a lot of Republican support,” he said on Fox.

Back from a failed bid to bring back the 2016 Summer Olympics to Chicago, President Obama returns today to the issue he initially said would keep him too busy to go to Copenhagen to make the sales pitch in person.

In his weekly radio-Internet address, Obama asserts that his health care overhaul would help America's small businesses, which he says a crucial job engine but are being "overwhelmed by rising health care costs."

Obama, who also plans a health care event on Monday, bringing doctors from across the country to the White House, says health costs are stopping budding entrepreneurs from going out on their own because they're afraid to lose their health coverage and preventing firms from growing and hiring more workers.

The health care legislation before Congress will allow small businesses to buy health insurance through a new exchange where they can compare policies and will offer tax credits to help them pay for it, the president says

"These small businesses are the mom and pop stores and restaurants, beauty shops and construction companies that support families and sustain communities. They’re the small startups with big ideas, hoping to be the next Google, or Apple, or HP. Altogether, they create roughly half of all new jobs." he says.

"So we know that reforming our health insurance system will be a critical step in rebuilding our economy so that our entrepreneurs can pursue the American Dream again, and our small businesses can grow and expand and create new jobs again."

The full address is below and can be viewed here.

A liberal-labor coalition is trying to keep up its support for a "public option" in the health care overhaul -- and going after House Republican leader John Boehner in the bargain.

Americans United for Change unveiled a new TV ad airing on cable TV in Boehner's district in Ohio that attacks what they call his "laughable claim" that “I’m still trying to find the first American to talk to who is in favor of the public option” as part of health insurance reform.

It says that Boehner is out of touch with his constituents, noting a recent Quinnipiac University poll showing that 57 percent of Ohio voters support the idea of a government-run option as part of the health care overhaul.

“Maybe Congressman Boehner should spend a little less time schmoozing with lobbyists on golf courses in Florida and a lot more time talking to his constituents back home about the kind of health insurance reform they are demanding," Tom McMahon, acting executive director of Americans United for Change, said in a statement.

President Obama hailed the Senate Finance Committee's endorsement early this morning of a health care overhaul that follows most of his principles -- a major step in his push for reform.

“Thanks to the unyielding commitment of Senator Baucus and members of the Senate Finance Committee, we have reached another milestone in our effort to pass health insurance reform," the president said in a statement. "Over the past two weeks, the Committee has engaged in long hours of thoughtful deliberation and vigorous debate. They have considered hundreds of amendments, and incorporated many of the best ideas from both parties. And they have shown a spirit of civility, a seriousness of purpose, and a willingness to compromise that embodies our democratic process at its very best.

“The Finance Committee’s work is the culmination of tireless efforts over the better part of this year by the five committees and many members of Congress involved in health reform -- holding numerous hearings and bi-partisan meetings; reaching out to stakeholders across the spectrum; and striving to find common ground. As a result of this work, we are now closer than ever before to finally passing reform that will offer security to those who have coverage and affordable insurance to those who don’t. We have a long way to go, but I am confident that as we move forward, we will continue to engage with each other as productively as the members of the Finance Committee, and will get reform passed this year,” Obama added.

The Finance Committee put off a final vote until next week so congressional budget officials can certify the $900 billion bill does not add to federal deficits. Then, Senate Democrats and the White House will have to try to meld the bill with one passed earlier by the Senate health committee.

President Obama, who vows to support science in contrast to his predecessor, is touring one of the nation's epicenters for research today to announce that $5 billion in grants have been awarded for cutting-edge work.

Obama is at the National Institutes of Health in Bethesda, Md., and is announcing that the institute has already handed out more than 12,000 grants from the $10 billion it received from the economic stimulus package he championed.

He said the grants are expected to create tens of thousands of jobs over the next two years and are part of a total of $100 billion in the stimulus package that is broadly going to science and technology.

“We know that this kind of investment will also lead to new jobs: tens of thousands of jobs conducting research, manufacturing and supplying medical equipment, and building and modernizing laboratories and research facilities,” Obama said in a statement. “I’ve long said, the goal of the Recovery Act was not to create make-work jobs, but jobs making a difference for our future. There is no better example than the jobs we will produce or preserve through the grants we are announcing this morning.”

The grants include $1 billion for research, using the technology produced by the Human Genome Project, to study genetic changes linked to cancer, heart, lung, and blood disease and autism -- in hopes of finding new treatments and cures. Of the money, $175 million will go to collect more than 20,000 tissue samples from more than 20 cancers, and determine in detail all of the genetic changes in thousands of these tumor samples.

“This historic investment demonstrates this administration’s commitment to pushing the boundaries of science and turning those discoveries into benefits for the American people. NIH researchers and grantees are already conducting some of the world’s most groundbreaking biomedical research," added Health and Human Services Secretary Kathleen Sebelius, who is accompanying Obama on the tour. “These awards will accelerate our progress towards the new medicines, treatments, and cures that will help Americans live longer, healthier lives."

UPDATE: Senators John Kerry and Paul Kirk today announced that Massachusetts will receive a total of $434,036,356 in Recovery Act funding for cutting edge medical research. The funding comes in the form of 1,148 separate grants for 84 schools and organizations across the state.

The funding will be used to support the full spectrum of medical research – from clinical studies to basic research.

“These significant investments in medical research across Massachusetts will save lives, create jobs and ensure that our state remains a world leader in medical technology,” said Senator John Kerry. “12,000 grants were awarded nationwide and more than 1,000 right here in our state. I'm grateful that President Obama has once again recognized the cutting edge work being done by our medical institutions.”

Senator Paul G. Kirk said, “These grants are well-deserved and will enable our world class universities, hospitals and research centers across the Commonwealth to continue their groundbreaking work in medical research. Massachusetts is and will continue to be a leader in this field, and I commend the Obama Administration for committing these essential funds.”

Obama's full remarks are below:

President Obama has had doctors and nurses by his side as he pitches his health care plans.

Now, his political group wants to put the medical professionals in new TV ads to rebuild public support for an overhaul of the health care system.

"The cavalry is here -- and they're in white coats and scrubs: More than a half a million doctors and millions of nurses are joining forces to help pass real health reform. Americans listen to their nurses and doctors when it comes to health reform -- and for good reason. If we can help them amplify their voices, it'll be a huge boost to our campaign for change," Mitch Stewart, national director of Organizing for America, told supporters in a fund-raising solicitation today.

Stewart said the group is trying to come up with $300,000 by Thursday for the ad, which would note that the reform effort has the backing of the American Medical Association and a dozen other physicians groups representing 500,000 doctors, plus the American Nurses Association and other organizations representing millions of nurses.

A liberal-labor group supporting President Obama and the Democrats on health care has a new web ad that uses a more humorous, tongue-in-cheek approach to make the case that Republicans don't have a plan to offer.

The video from Americans United for Change puts together clips of various Republican lawmakers to argue that the GOP plan for those without insurance is to go to emergency rooms and seek charity care; for those seeking better benefits to get a federal government job; and for those trying to cut costs by dropping maternity care.

"This has been Republican Party health care solutions," the video ends.

Democrats are keeping up their assault on Republicans for what they say is scaring seniors by warning of cuts in benefits that would come from the health care overhaul.

The new TV ad today from the Democratic National Committee cites news reports that question the truthfulness of the Republican critiques and the AARP conclusion that Republicans are using "scare tactics." The spot is clearly aimed at the elderly set, down to the key points appearing on a billboard and on a piece of paper inserted into an ancient Royal typewriter.

The ad asserts that instead of cuts, seniors will benefit from lower prescription drug costs and premium payments.

While Republican accusations that the Democratic bills could lead to rationing of care have been largely debunked, independent analysts say that the GOP does have a point when it comes to a portion of the Medicare program. Under the Democratic proposals, more than 10 million seniors enrolled in an enhanced, private version of Medicare known as Medicare Advantage could have their coverage shrink or be replaced with traditional plans.

As the Senate Finance Committee today voted against including in the health care overhaul a government-run public option to compete with private insurers, the back-and-forth continues over an existing government program.

After Senate Finance Chairman Max Baucus complained about a mailer sent by Humana, one of the nation's largest insurers, warning seniors that they could lose important Medicare benefits under the Democratic health care bills, Health and Human Services ordered Humana and other private companies that contract with Medicare to stop sending customers information about the overhaul's potential effects on their benefits.

While Democrats deny that the bills would cut Medicare benefits, the Congressional Budget Office and independent analysts said some seniors could lose some enhanced benefits under the Medicare Advantage program .

Republican leaders responded late last week by warning HHS Secretary Kathleen Sebelius that they will block confirmations of any agency appointees until she lifts what they call the "gag order" on insurers.

Today, the liberal-labor coalition Americans United for Change unveiled a new TV spot going after Humana and the Republicans.

The Halloween-themed ad accuses the insurance industry and its GOP allies of resorting to fear tactics.

"This year Halloween comes early for health insurance giant Humana," the announcer says. "Humana is sending letters to its senior citizen policy holders intended to frighten them into opposing health insurance reform. The letters say health insurance reform threatens their Medicare benefits. AARP says: that’s just not true."

"But we shouldn’t be surprised," the announcer says as images of Republican leaders in various costumes flit across the screen. "Whether it’s the insurance companies or their Republican allies, the case against health insurance reform always gets down to one word."

"Boo!" it says on screen.

Baucus did not include a public option in his draft plan, largely because he does not believe that a bill that includes it would pass the Senate. Liberal groups launched a new TV ad this week in his home state trying to pressure him to change his mind.

But Senator Jay Rockefeller, a West Virginia Democrat, is proposing a public plan modeled on Medicare, the government program for the elderly.

President Obama has said he prefers a public option, but is not firmly wedded to it, as long as there is competition for private insurers.

The latest health care poll is also the most recent to suggest that the battering the Democratic bills took during the protests and shouting that met August congressional town halls has dissipated as the focus returned to Capitol Hill.

According to the sixth tracking poll by the Kaiser Family Foundation, 57 percent of Americans believe that tackling health care reform is more important than ever, up from 53 percent in August. The proportion of Americans who believe their families would be better off after an overhaul is up six percentage points to 42 percent and the proportion who think that the country would be better off is up eight points to 53 percent.

Also according to the survey, most Americans support the principles at the core of the bills supported by President Obama and congressional Democrats, including a requirement that individuals obtain coverage (68 percent), a mandate that most employers offer coverage (67 percent), and an expansion of Medicaid and the Children’s Health Insurance Program (82 percent).

Majorities also back "having health insurance companies pay a fee based on how much business they have” and “having health insurance companies pay a tax for offering very expensive policies,” according to Kaiser.

The Kaiser poll, which has a margin of error of plus or minus 3 percentage points, was conducted Sept. 11-18 -- just after Obama gave a nationally televised address to Congress to lay out what he wanted in a health care bill. He has kept up the drumbeat for reform since with rallies and repeated TV appearances.

Other polls have also shown rebounding support for reform after the drumbeat of criticism led by conservative activists and Republicans in August drove down the numbers.

Liberal groups are trying to intensify the pressure on Senate Finance Chairman Max Baucus on the eve of his panel's vote whether to include a "public option" -- a government-run plan to compete with private insurers -- in its bill.

Seeking support from moderate Democrats and Republicans, Baucus did not include it in his draft. The finance committee is expected to vote Tuesday.

The Progressive Change Campaign Committee and Democracy for America are airing an ad in Baucus's home state of Montana and in Washington, D.C., featuring a Billings man as a real-life example of the need for a public option.

Bing Perrine says he had to have heart surgery, but didn't have insurance. While friends and strangers held bake sales and other fund-raisers, he still owes $100,000, he says in the ad.

Perrine goes on to assert that Baucus has received nearly $4 million in campaign contributions from health care interests.

"Senator Baucus, when you take millions of dollars from health and insurance interests that oppose reform, and oppose giving families like mine the choice of a public option, I have to ask: 'Whose side are you on?' the Montana farmer asks.

A new GOP web ad aims straight for the sensitive spot in the health care overhaul from President Obama and Democrats -- that the proposals would mean higher taxes.

The ad claims that the bills would mean taxes on tests, scans and X-rays; on medical supplies; and on charities and small businesses. “Hundreds of billions in new taxes, all of it passed right back to the consumer,” the announcer says over images of a laughing Obama, House Speaker Nancy Pelosi, and top Senate Democrat Harry Reid, juxtaposed with worried consumers.

The GOP ad then notes that the bill calls for a penalty for those who don't obtain health insurance, though it doesn't mention that there would be subsidies to help them: “And if you think you can’t afford it, you can’t afford not to, because they’ve even proposed a tax for not having health insurance.”

Obama has insisted that the penalty does not amount to a tax increase, but many independent observers disagree and the ad shows the dictionary definition.

"Obama health care taxes,” the announcer concludes. “Wrong for health care. ”

“For months, President Obama has tried to convince the American people that his government-run health care experiment will be all gain and no pain, but they aren’t buying it," Republican National Committee chairman Michael Steele said in a statement. "The fact is, his plan contains huge new taxes that will harm the economy and cost more jobs. Democrats are paying for their dangerous experiment with higher taxes on small business owners, charitable giving, and even middle-class families who can least afford it. I encourage President Obama to abandon these health care taxes and set a course for a truly bipartisan bill that embraces reforms Americans actually want and need.”

Democrats, however, argue that the Senate Finance bill does not include any mandate on employers and that both businesses and individuals would end up eventually benefiting from lower health care costs.

"Apparently undeterred by the facts, the RNC is again relying on scare-tactics to ‘kill’ health insurance reform in a new web video released today," the Democratic National Committee said in its response. "The RNC’s latest attempt to mislead voters accuses the President of being 'in denial' over 'new taxes' that the RNC claims would result from reform. The only person guilty of that charge, however, is the Republican Party’s own Chairman who just this morning on Fox News denied that this country’s 'health care system' was 'going broke.' ”

For its part, the Democratic National Committee today sent out an email bashing House Republican leader John Boehner -- the second missive in its "Call 'em out" campaign targeting Republicans for repeating "falsehoods" about the Democratic proposals.

"As the Republican leader in the U.S. House of Representatives, John Boehner could use his important position to forge honest consensus around reforms that most Americans overwhelmingly support. Sadly, Boehner is choosing to be a leading peddler of health reform lies instead," says the email to supporters, urging them to criticize Boehner on social networking sites such as Facebook and Twitter and to write letters to the editor.

"When Boehner repeated his claim that reform would result in a government takeover of health care, it was clear he's been too busy trying to score political points to read the overwhelming evidence -- including a post from the non-partisan FactCheck.org -- debunking this claim," the email continues. "And cruelly scaring seniors with lies about benefit cuts, even though his own party voted to gut Medicare? On his side of the aisle, that's become standard operating procedure. Then of course there's Boehner's blatant lie that reform will provide taxpayer-funded abortions, a claim rejected even by groups that oppose abortion. His lies have been thoroughly debunked, but John Boehner just won't stop -- so we're calling him out."

Boehner responded to the Democrats' attack: "There's a reason why the majority of Americans oppose the Democrats' government takeover of health care, $500 billion in Medicare cuts, tax hikes, and mountains of new debt on our kids and grandkids. It's because they are in their bill. Try as they might, Democrats have a major credibility problem. Americans don't trust them with their health care, and they shouldn't."

Senate Republicans ratcheted up their assault today on the Health and Human Services Department for cracking down on an insurance company for a mailer the agency said was scaring seniors.

The GOP leaders warned HHS Secretary Kathleen Sebelius that they will block confirmations of any agency appointees until she lifts what they call a "gag order" on insurers that is "without apparent justification or basis in law."

"America’s seniors and the health plans that serve them deserve to have their free speech rights respected," they wrote. "Their rights should not be subject to the whims of any administration, and the health plans that serve them should not be threatened with punishment if they speak out on a matter of public concern simply because the administration disagrees with their position."

(The full letter is below.)

According to the office of Senate GOP leader Mitch McConnell, there are at least 10 vacant posts covered by the hold: Surgeon General, Assistant Secretary for Resources, Assistant Secretary for Planning, Assistant Secretary for Public Affairs, Assistant Secretary for Legislation, Commissioner of the Administration for Children, Commissioner of the Administration for Native Americans, Administrator for the Centers for Medicare and Medicaid Services, Administrator for Substance Abuse, and General Counsel.

"They have ten vacancies of people they are trying to get appointed to the administration," McConnell said on Fox Business Network this afternoon. "None of those people will get through the Senate easily until they lift the gag order."

He also accused Democrats of skirting the truth on Medicare. "I think the Democratic majority is undeterred by the facts. The facts are that they are trying to cut Medicare. They are certainly cutting Medicare Advantage...It's astonishing."

Senate Finance Chairman Max Baucus had complained about the mailer sent by Humana Inc., warning seniors that they could lose important benefits under the Democratic health care bills. HHS launched an investigation and ordered Humana and other private companies that contract with Medicare to stop sending customers information about the overhaul's potential effects on their benefits.

While Democrats deny that the bills would cut Medicare benefits, the Congressional Budget Office and independent analysts said some seniors could lose some enhanced benefits. The Globe reported today that more than 10 million seniors enrolled in Medicare Advantage could see their plans shrink or be replaced by traditional coverage.

House Republican leaders added their voices today to those who say the focus on health care on Capitol Hill is crowding out other crucial issues, namely what to do in Afghanistan.

“With Afghanistan now becoming such a very troublesome issue, we should be making progress on health care so it doesn’t get in the way of a very, very important national security issue,” Representative Eric Cantor of Virginia, the No. 2 House Republican, told reporters after a private GOP meeting. “Central Asia is the Persian Gulf of the 21st century. We are foolish to be ignoring that threat right now."

"Health care in this building has made it so that it seems we can't get anything else done. We have burning issues out there is this country," Cantor added.

Obama, who is weighing a revamped strategy for Afghanistan and whether to send even more reinforcements than the 21,000 he has already dispatched, is likely to need Republican support for whatever he decides because the vast majority of Democrats are opposed to any escalation of the US mission.

"With all the attention there is on health care, the attention that needs to be paid to what is happening in Afghanistan isn’t happening,” added Representative John Boehner, the House Republican leader.

He and other key lawmakers have demanded that General Stanley McChrystal, the top US commander in Afghanistan, appear before House and Senate committees to explain his report to the White House that calls for additional troops.

"What strategy does he believe is going to be necessary in order to secure Afghanistan so that we deny the Taliban and al Qaeda a safe haven from which to train, operate and organize to come after Americans again? And so, we need General McChrystal up here as soon as possible to help members understand. I think the President ought to take his request as soon as possible,” Boehner added.

“I do believe that there is a lot of danger in the delay. First, with insufficient troops in the field, we put the troops that we do have there at greater risk. Secondly, if the President doesn’t come to a decision soon—what will happen is— we will miss the window of getting more troops into the theater as the spring thaw occurs, when the additional troops are going to be necessary. And so, I would hope that the timetable that’s been discussed by the Administration gets sped up, and gets sped up rapidly.”

As the Globe reported on Monday, some lawmakers and advocates are chafing that the sluggish pace on a health care overhaul has backed up priorities including climate change, transportation, and financial regulation.

On Fox Business Network this afternoon, Boehner said House Democrats should realize that their plan, with a government-run public option, is not going to get through.

"They're still moving in the direction of those big government plan, high taxes and big deficits. At some point it's going to become clear that this can't pass. I don't know whether that's three weeks from now, four weeks from now, six weeks from now, but at some point it's going to become clear," Boehner said.

"And then they're going to have to make a decision - do they accept the defeat or do they hit the reset button and scrap all these big government ideas and work with Republicans to make our current system work better."

Senator John F. Kerry, who has picked up some of the health care mantle from the late Edward M. Kennedy, lashed out today at Republicans complaining that the issue is being rushed.

“Only in Washington could people argue that we’ve rushed this process,” Kerry said in a statement. “This has been America’s battle for decades, and those suffering in a broken system cannot afford the political gaming of stall and delay – they simply will not survive it. We are going to get this done. I’ve been confident of that all along, and I’m confident of it now. We’re going to do it because we have to and because it is the right thing to do. And in the end, I think, we will show something about the character and the compassion of the American people.”

As the Senate Finance Committee started deliberating and amending a proposal from Chairman Max Baucus, Senator Chuck Grassley of Iowa, the panel's senior Republican, said the mid-September deadline preempted bipartisan talks. "I find it utterly and completely appalling," he said.

Baucus unveiled his bill last weeks after months of negotiations toward a possible bipartisan deal proved fruitless.

Kerry's full statement to the committee is below:

In one of his first forays into the thick of the health care debate, Vice President Joe Biden today used a new White House report on premium increases to warn that without an overhaul, families will face higher and higher costs.

"The status quo of rising premiums is simply unsustainable for families, for businesses, for state budgets, and for our national economy," Biden told state insurance commissioners.

According to the White House report, the national average annual family premium for employer-sponsored health insurance rose to $13,375 in 2009, up 5.5 percent during a recession when overall inflation fell by 0.7 percent. The report found that families’ premiums have gone up between 90 percent and 150 percent over the last decade, depending on the state, far faster than wages and inflation.

In Massachusetts, premiums jumped 119 percent between 1999 and 2009, nearly three times the 35 percent increase in wages, according to the report.

Click here for the full report.

Biden's full remarks are below:

With President Obama opening the door a crack to tort reform as part of a health care overhaul, the nation's trial lawyers are trying to slam it shut again.

The American Association for Justice announced today it is launching what it called the first phase of a nationwide ad campaign "to educate lawmakers about the epidemic of preventable medical errors and how tort law changes won’t lower costs or cover the uninsured."

The ads, running in Washington publications and on online news sites, say the estimated 98,000 deaths from preventable medical errors is “like two 737s crashing every day for a whole year.”

But the ad concludes: “Would we blame the passengers or the airlines?”

The group, formerly known as the Association of Trial Lawyers of America, also has a website on the issue.

“Our health care system is clearly broken, and if we are serious about improving it, we need to fix preventable medical errors,” AAJ President Anthony Tarricone said in a statement. “This new ad campaign gives Congress 98,000 reasons why they should put patients’ health first – before the profits of insurance companies. If we work to improve our health care system and reduce medical errors – rather than strip people of their rights – there would be far fewer victims that need legal recourse.”

Obama, in his speech to Congress earlier this month, said while he didn't see malpractice reform as a "silver bullet," he was open to looking at ways to decrease "defensive medicine," when doctors order extra tests and procedures to avoid malpractice lawsuits.

Last week, the White House followed up by announcing $25 million in grants to help states and health care systems test models designed to compensate patients for malpractice but also reduce frivolous lawsuits and lower insurance premiums paid by doctors.

The health care bills in Congress run to the hundreds of pages -- not surprising since they would remake a huge chunk of the US economy.

But in a new video today, the White House that suggests that all Americans need to know can be summarized much more briefly.

"The Obama Plan in Four Minutes" shows the president explaining the basic benefits -- both for those with and without insurance -- in his speech this month to a joint session of Congress. The video ends with Obama's clarion calI for action, with him imploring lawmakers, "Now's the time to deliver on health care."

Meanwhile, with Obama busy at the United Nations on Wednesday, giving a major speech to the General Assembly, Vice President Joe Biden will pick up the slack on health care.

Biden, joined by Secretary of Health and Human Services Kathleen Sebelius and White House health reform Director Nancy-Ann DeParle, will lead a discussion in Silver Spring, Md., on "how health insurance reform will lower costs, cut waste, and improve health care quality for seniors across the country," the White House announced this afternoon.

With Biden taking a larger role in the health care debate, Republicans gleefully reminded that earlier this month, the vice president joked, "I do foreign policy, I don't do health care."

In his remarks at the Brookings Institution, Biden went on to say that one reason why is that foreign policy is "a lot easier than health care, and a lot less complicated." "And that's not a joke," he said.

On the same day that current first lady Michelle Obama jumped into the fray on health care, the last first lady to take on the issue expressed optimism that President Obama's plan will be approved.

Hillary Rodham Clinton, whose "Hillarycare" was soundly rebuffed in the mid-1990s, promoted her experience on health care in her campaign against Obama in the Democratic primaries, saying she had the scars to prove it.

"It won't be pretty. It's like sausage-making. But we will end up with a bill for the president to sign that will be an advance," Clinton, now Obama's secretary of state, said today at the Brookings Institution. "We all have to calm down here, take two aspirin, go to bed, think about it in the morning."

President Obama called on his better half today to help make his sales pitch on health care as his overhaul plan faces brickbats from both the left and right.

First lady Michelle Obama spoke to a family-themed event sponsored by the White House Council on Women and Girls after women had told their stories of health care hardship.

According to the press pool report, the testimony came from a widow with a teenage son who had trouble finding affordable coverage, a cancer survivor who had to declare bankruptcy due to her copay and out-of-pocket costs, and a woman who has a non-cancerous lump in her breast but no insurance and who sat in the first lady's box for the president's health care speech to Congress last week.

Similar stories are happening all over the country because women are " being crushed -- crushed -- by the current structure of our health care," Michelle Obama said. "Crushed."

"This is why we are fighting so hard for health insurance reform," the first lady declared. "This is the face of the fight....People are hurting in this country right now."

And women "know the pain, because we are the ones dealing with it," she added, noting that in most families, mothers are dealing with the health care of their children, relatives, and often their husbands, as well, drawing laughter from the audience that included members of the Business and Professional Women, the YWCA, the Women’s Chamber of Commerce, and the National Council of Negro Women.

The first lady also told the story of her daughter Sasha, who at four months old contracted meningitis, and said she often wonders what would have happened if the Obamas didn't have a good pediatrician and generous insurance.

She said it's "still shocking to me" and it keeps her up at night that women are denied coverage or charged more for insurance, and that many policies don't cover basic services that women need.

"The status quo is unacceptable. It is holding women and families back," Michelle Obama said, then going on to explain major elements of the president's plan.

"I think this is a pretty reasonable plan, I don't know about you," she said, urging the audience to "mobilize like you've never mobilized before" over the next few weeks to educate people about the plan and to rebut false allegations.

"No longer can we sit by and watch the debate take on a life of it own. Now, more than ever, we have to channel our passions into change."

Also according to the press pool report, the first lady plans similar health care events, though not in the next two weeks, when she will be busy with United Nations General Assembly gathering in New York, the G-20 economic summit in Pittsburgh, and the International Olympic Committee meeting in Copenhagen, when the executive committee will choose the host for the 2016 Summer Olympics.

The first lady, who previously has made helping military families her signature issue, has a significantly higher favorability rating these days than her husband.

In the most recent poll measuring both, Gallup found in April that 72 percent of Americans had a favorable impression of Michelle Obama and only 17 percent unfavorable, compared to a 69 percent favorable-28 percent unfavorable split for her husband.

The president's favorability rating has dropped since, during the heated battle over health care, to 63 percent in a Washington Post/ABC News survey earlier this month.

Her full remarks today are below:

In his recent stump speeches on health care, one of President Obama's big applause lines has been a warning to his opponents:

"I won't stand by while special interests do the same old tricks to keep things exactly the way they are....If you misrepresent what’s in the plan, we'll call you out. We will call you out," he told a rally at the University of Maryland on Thursday.

Today, the Democratic National Committee followed up by launching a new "Call ‘Em Out” campaign to help "set the record straight on GOP lies, scare tactics, and mistruths on health insurance reform" with emails and other missives to activists.

The target of the first call to action is Minnesota Governor Tim Pawlenty, a potential Republican challenger to Obama in 2012, who the DNC says is embracing the "salacious and thoroughly debunked charge of death panels" -- committees of bureaucrats who would decide end-of-life care under the health overhaul. The DNC also put up a web video slamming Pawlenty.

"The message to Tim Pawlenty and the opponents of change who would lie or misrepresent the truth should be clear: you are not going to get away with it," DNC spokesman Hari Sevugan said in a statement. "We are going to respond forcefully and consistently with the facts and you will no longer be able to peddle your lies with impunity. Through tools like 'Call 'Em Out,' you will be met with aggressive push back from our supporters who will be armed with the facts and who will hold you accountable for playing politics with the most important issues facing our country today.”

But even many Democrats acknowledge that Republican and other critics of the health care bills got the upper hand during the August congressional recess, making it more difficult to pass a bill.

Also today, Organizing for America, Obama's grassroots political arm housed within the DNC, launched a new TV ad that uses footage from the Thursday rally where the enthusiastic crowd joins the president's chant of "Fired up, ready to go."

President Obama took his health care pitch to a college campus today, telling a cheering crowd at the University of Maryland that he is keeping his promise to not just clean up the messes he inherited, but build a better future.

In a message tailored for the young people who powered his campaign, Obama said his domestic agenda is designed to "ensure your generation" has the same opportunities as his.

He specifically mentioned that Congress is on the cusp of overhauling the student loan system to make it simpler and cheaper for students. "That's the change you worked for, that's the change you voted for, that's the change I will deliver," he said.

The president said another defining struggle for the younger generation is his push for sweeping changes to the nation's health care system. While young people might think they're immune from health problems, one third have trouble paying their medical bills, he said.

Despite all the machinations on the details of the health care bills, Obama said the bottom-line issue is simpler:

"It's about what kind of country you want to be. You gave time to this campaign because you believe America can still do great things.

"I may not be the first president to take up the cause of health care reform," he said. "I am determined to be the last -- with your help."

His full remarks are below:

The part of President Obama's health care speech last week that many Republicans liked most was when he suggested he'd be open to changes on medical malpractice.

"I don't believe malpractice reform is a silver bullet, but I've talked to enough doctors to know that defensive medicine may be contributing to unnecessary costs," Obama told Congress. "So I'm proposing that we move forward on a range of ideas about how to put patient safety first and let doctors focus on practicing medicine."

Today, the White House followed up, announcing a $25 million demonstration project to help states and health care systems test models with the following goals: "Put patient safety first and work to reduce preventable injuries; foster better communication between doctors and their patients; ensure that patients are compensated in a fair and timely manner for medical injuries, while also reducing the incidence of frivolous lawsuits; and reduce liability premiums."

"This is an area we know we can do better," Health and Human Services Secretary Kathleen Sebelius told reporters today. "As many as 98,000 Americans die every year from medical errors. And though malpractice premiums themselves count for only a small percentage of total medical costs, many doctors report that they practice costly defensive medicine because they are fearful of lawsuits."

Tort reform has long been a goal of Republicans and doctors -- and long opposed by trial lawyers who are among the most generous donors to Democrats.

The trial lawyers association immediately weighed in with its concerns.

“Any changes to the malpractice system must focus on patient safety and preventable medical errors, not limiting patients’ legal rights," American Association for Justice President Anthony Tarricone said in a statement.

“The goals outlined by the White House – such as reducing the number of injuries, fostering better communication, compensating patients quicker, and reducing doctors’ premiums – move the debate in the right direction. However, 46 states have already enacted tort reform and health care costs continue to hurt the pocketbooks of American families. Because of these tort reforms, patients injured through no fault of their own are often unable to seek justice.

“It is critical that these demonstration projects preserve Americans’ 7th Amendment right to a trial by jury. The details matter significantly, but any efforts to limit patients’ rights are not acceptable. Promoting greater patient safety and reducing preventable medical errors are tenets doctors, attorneys, hospitals, and all Americans can support.”

UPDATE: "I don't think it's a silver bullet, but I want to explore the ideas," Obama told a health care rally today at the University of Maryland.

But Republicans are skeptical, to say the least.

"The half-trillion in Medicare cuts, the tax hikes, expansion of government health care and nearly a trillion dollars in spending—all real, all supported by the administration. But the 'bipartisan outreach” on medical liability reform is a “demonstration project?' Really?" Senate Republican leader Mitch McConnell's office said in a statement.

"And looking over their proposal, it’s difficult to find any reference to any of the typical medical liability provisions, such as: limits on punitive damages, appropriate standards for awarding punitive damages, limits on non-economic damages, limits on attorneys’ fees, requirements for proportional or 'fair share' liability (no joint and several liability), reasonable statute of limitations."

Obama's proclamation on the initiative can be viewed here, and the White House background paper is below.

He doesn't have any Republican support, and many Democrats aren't all that thrilled, either. But Senate Finance Chairman Max Baucus stuck to his deadline and this morning formally unveiled his plan to overhaul the nation's health care system.

The bill would cost about $856 billion over the next 10 years, require all individuals to purchase coverage or pay a fine, and ban insurers from charging more or denying coverage to people with health problems. It does not include the public option -- a government plan along the lines of Medicare -- but does call for nonprofit coops to compete with private insurers.

The bill would create a new exchange where consumers could compare and buy insurance plans. Medicaid, the government health care program for the poor, would be expanded.

Baucus would pay for the expansion of care with $507 billion in cuts to government health programs and $349 billion in new taxes and fees, including a new tax on generous insurance plans -- so-called Cadillac coverage -- and new fees on insurance companies and medical device manufacturers.

Click here to see "America's Healthy Future Act of 2009."

The Senate Finance bill is expected to be the vehicle for the proposals sought by the White House and described by President Obama in his speech to Congress last week.

"We will act and pass health reform legislation this year," Baucus declared as he promoted his bill in a Capitol Hill news conference this afternoon, saying that it would expand coverage, slow the rise in health care costs, and keep insurers honest.

"It follows the criteria laid out by President Obama," Baucus said, adding that the bill will eventually draw bipartisan support.

"This is a good bill, this is a balanced bill," Baucus said, calling it "a common-sense bill that can pass the Senate."

White House press secretary Robert Gibbs called the legislation an "important building block" that "gets us closer to comprehensive health care reform."

The legislation protects Medicare and preserves patients' right to keep their doctor, he continued, while keeping the deficit under control by offering the most generous coverage possible while keeping the price tag under Obama's target of $900 billion over 10 years.

Still, he acknowledged that there are "honest and principled differences" on the proposals and that his plan "may not represent all of our first choices."

UPDATE: The top House Republican wasn't buying the Baucus plan.

“It looks like the same kind of plan we’ve seen in House," said Representative John Boehner of Ohio. "It’s got a little different language, but it’s still a big government plan, it still calls for higher taxes and more spending and I don’t think it is going to get enough support to get very far in the United States Senate.”

Despite months of negotiations, however, Baucus was unable to get the three Republicans in the so-called Gang of Six to sign on. One of them, Senator Charles Grassley of Iowa, bemoaned what he called an "artificial deadline."

"I’m disappointed because it looks like we’re being pushed aside by the Democratic leadership so the Senate can move forward on a bill that, up to this point, does not meet the shared goals for affordable, accessible health coverage that we set forth when this process began. In addition to concerns about costs to taxpayers and affordability for individuals, there are still some serious outstanding issues that have yet to be resolved like preventing taxpayer funding of abortion services and the enforcement against subsidies for illegal aliens," Grassley said in a statement.

"On top of all that, there’s no guarantee that a Finance Committee bill, even if it becomes bipartisan, will stay that way after it leaves the committee. An overriding issue for some time has been the fact that members of the Democratic leadership haven’t made a commitment to back a broad bipartisan bill through the entire process," added Grassley, who negotiated along with Republicans Mike Enzi of Wyoming and Olympia Snowe of Maine.

But in an op-ed published in today's Wall Street Journal, Baucus said he couldn't wait any longer.

"Health care is a complicated and deeply personal issue; it takes time and effort to get reform right. Legislating every piece of this puzzle would be impossible and counterproductive," he wrote. "What we can do is seize this opportunity to put America back on a fiscally sustainable path. The Senate Finance Committee proposal builds on what already works and fixes what threatens to break the bank for future generations."

Representative James Clyburn of South Carolina, the No. 3 Democrat in the House, said he considers the Baucus bill "a draft" for subsequent negotiation. He said on MSNBC that the House will pass a bill that offers more protections and more coverage -- and that would also be more expensive than the Senate bill, closer to $1 billion.

UPDATE: A key Democratic group criticized Baucus's plan, saying it "absolutely fails to meet the most basic health care needs of working families and it fails to meet the expectations we have set for our nation."

"It fails to put pressure on private insurers to control health care costs. There is no history or logic behind the claim that health care co-ops would provide real competition for the giant private insurers that have a stranglehold on health coverage today," AFL-CIO president John Sweeney said in a statement.

"If you're an individual who does not purchase private health coverage, it sticks you with a hefty tax penalty even though it fails to provide sufficient subsidies to make plans affordable for low and moderate income families. But if you're an irresponsible employer who does not provide coverage, you get off scot free," he continued.

"Outrageously, the plan imposes a 35 percent tax on high-cost health care plans without prohibiting insurers from passing on the tax to consumers who happen to be in groups that are older or sicker than average or live in high cost areas.

"The Senate Finance proposal, sadly, is little more than a throwback to the failed policies of the last three decades that advantaged corporations over taxpayers and bestowed special breaks on the wealthy while ignoring the middle class. The proposal does include the important insurance reform and health care delivery system improvements adopted by earlier congressional committees, and it builds on these by reforming the way we pay for health services to focus on the quality of services instead of the quantity. But the proposal's strong points are nowhere near sufficient to outweigh its problems. However well intentioned the attempts at bipartisanship, the final product reflects the bankrupt policies of the past more than the forward-looking policies needed to drive meaningful health care reform.

"We are counting on finance committee Democrats to fix the bill and side with working families, not insurance companies."

The much fought-over public option -- a government-run plan along the lines of Medicare that would be widely available -- is looking less likely as part of a sweeping health care overhaul.

But a liberal group is not giving up.

Health Care for America Now launched a new ad airing on national cable today slamming insurers for getting rich by jacking up premiums and denying treatment and overpaying CEOS -- and urging supporters to tell Congress that a public plan is the only way to keep insurance companies in check.

"If the insurance companies win, you lose," the announcer says.

President Obama has been walking a thin line on the public option, trying to reassure his allies that it is his preference, but also bowing to political reality by suggesting it's not a deal-breaker. In a Washington Post/ABC News poll published Monday, support for a health care overhaul rose significantly if a public option was deleted.

A public option is not in the plan that Senate Finance chairman Max Baucus is putting together -- and that is likely to be the vehicle for Obama's plan in Congress.

Also today, a faith-based coalition that is helping Obama make the "moral" case for health reform -- he spoke to them in a webcast last month -- is urging its members to call their members of Congress today. And on Wednesday, clergy, advocates, and others will lobby lawmakers personally.

In recent weeks, the coalition said, "the faith community demonstrated widespread support for affordable quality health care for all — 300,000 people listened to the August 19th health care web-cast and call-in with faith leaders and President Obama, clergy in congregations across the country preached about health care reform and called for a civil and honest debate, and the faith community held large public events to build support for affordable health reform nationwide."

A liberal-labor coalition is up with a new TV ad arguing that opposition President Obama's health care overhaul could cost members of Congress at the polls next November.

The spot from Americans United for Change shows a political consultant apologizing to a losing candidate at 11:03 p.m. on Election Day, Nov. 2, 2010.

"Congressman as your political consultant," he says to the camera. "I’m sorry you lost. I was wrong. Turned out the voters hated the stranglehold the insurance companies have on health care, raising premiums, cutting off people with pre-existing conditions, making health care decisions instead of doctors. And they didn’t much like the millionaire insurance CEO’s you were hanging with either. Guess your vote against health insurance reform turned out to be bad politics.”

But a new poll shows why some lawmakers are so skittish about jumping aboard the Obama health care bandwagon.

The Washington Post-ABC News survey published today found that while opposition has eased somewhat since the August town halls, Obama still faces deep skepticism about key elements of the Democratic plan.

In the poll, 48 percent oppose the proposals, while 46 percent favor them, and 48 percent of respondents approve Obama's handling of the issue, while 48 percent disapprove.

The public is also evenly divided -- 51 percent in favor, 47 percent against -- on whether people should be required to have health insurance.

UPDATE: A CNN/Opinion Research Corp. poll released this afternoon also showed the public still largely divided on Obama's health care plan: 51 percent said they favored it and 46 percent opposed it, a slight improvement for the president from 48 percent in favor and 51 percent against in late August.

The survey also showed an uptick in how Americans view Obama's handling of the issue to 51 percent approval and in his overall job performance to 58 percent approval.

The CNN survey, conducted Friday through Sunday, has a margin of error of plus or minus 3 percentage points.

President Obama points today to a new Treasury report to warn that many Americans could face the loss of health insurance -- a plight that could be prevented with his health care overhaul plan.

In his weekly radio and Internet address, Obama says he's continued to hear from worried Americans since his speech to Congress on Wednesday night -- and for good reason since during the last year of economic turmoil, "nearly six million more Americans lost their health coverage – that’s 17,000 men and women every single day.

"We’re not just talking about Americans in poverty, either – we’re talking about middle-class Americans. In other words, it can happen to anyone," says Obama. "And based on a brand-new report from the Treasury Department, we can expect that about half of all Americans under 65 will lose their health coverage at some point over the next ten years. If you’re under the age of 21 today, chances are more than half that you’ll find yourself uninsured at some point in that time. And more than one-third of Americans will go without coverage for longer than one year."

(Click here to read the report.)

"I refuse to allow that future to happen," declares the president, who holds a health care rally later today in Minneapolis. "In the United States of America, no one should have to worry that they’ll go without health insurance – not for one year, not for one month, not for one day. And once I sign my health reform plan into law – they won’t."

Obama then runs down his plan, and vows again to get a bill passed this year.

"Affordable, quality care within reach for the tens of millions of Americans who don’t have it today. Stability and security for the hundreds of millions who do. That’s the reform we seek," he says.

"We have had a long and important debate. But now is the time for action. Because every day we wait, more Americans will lose their health care, their businesses, and their homes – but also the dreams they’ve worked for and the peace of mind they deserve. They are why we have to succeed."

Click here to watch the address. The full remarks are below:

Fresh off his health care speech to Congress that polls suggest reassured the public and that reenergized some fellow Democrats, President Obama takes his health care pitch on the road.

Saturday, he will hold a rally at the Target Center in Minneapolis. On Tuesday, he will speak in Pittsburgh to the convention of the AFL-CIO, one of his biggest backers on health care. And on Thursday, Obama will hold another health care rally in College Park, Md., the White House announced this evening.

When he arrives in Minneapolis, he will be greeted by a TV ad from the Minnesota GOP.

The spot shows Obama vowing to "change the world" at a campaign rally last year in the same arena -- before the announcer says he is proposing a "risky" health care plan, citing news reports to assert that Obama's plan would cut Medicare, ration care, raise taxes, and explode the federal deficit.

"Mr. President, let's slow down and do health care reform the right way," the announcer says.

The bipartisan "Gang of Six" -- three Democrats and three Republicans on the Senate Finance Committee -- are trying to reach a compromise by early next week.

The Senate Finance bill appears to be the most likely legislative vehicle for the blueprint Obama laid out to Congress on Wednesday night. Chairman Max Baucus's plan dovetails with Obama's on most major issues and has the same general cost of $900 billion over 10 years, while bills passed by House Democrats include measures the president has not embraced.

Republican Party chief Michael Steele is raising eyebrows again -- this time for questioning President Obama's use in his health care speech of a letter the president received from the late Senator Edward M. Kennedy.

Making it public for the first time, Obama quoted from it near the end of his speech Wednesday night to urge lawmakers pass health care as a moral issue that showed the country's character.

But Steele called it a "political tool."

Questioned this afternoon on CNN about that characterization, Steele backtracked a little.

"I'm not slamming the president on this," he said. "I just thought something like that was so personal in many respects, and particularly so soon after the senator's death -- I just didn't think it was the right time to reveal that or have that conversation or to say it. That was all. It was just an opinion."

Acknowledging that Kennedy might have wanted the letter read publicly since he championed health care reform, Steele added, "Be that as it may, the reality of it is, that to me is more of a diversion and a distraction from the underlying speech itself. Which, in my view, the president, I think, missed an opportunity to clearly define in a common-sense, straightforward way, exactly how we should go about the business of reforming those aspects of our health care system that we have particular problems with."

Democratic Congressional Campaign Chairman Chris Van Hollen blasted Steele.

“Last night, President Obama called on us to replace acrimony with civility, yet Republican Chairman Steele’s outlandish comments only serve to increase the acrimony and deny the American people the substantive debate on health insurance reform that this critical challenge merits," Van Hollen said in a statement.

“The late Senator Kennedy devoted his life to reforming health care in America and he would have been proud of President Obama’s eloquent call for action last night. Michael Steele’s time would be better spent condemning Congressman Joe Wilson’s outrageous outburst, rather than further poisoning the political discourse by attacking the heartfelt intentions of a dedicated American who spent his life working on health care reform.”

David Axelrod, a senior adviser to Obama, told the Globe Wednesday night that Kennedy's widow had informed the White House of the letter that the senator wanted delivered after his death and that Obama was so moved by it that he wrote the closing part of the speech mentioning it himself.

Following up his more assertive pitch Wednesday night for a sweeping health care bill, President Obama focused this morning on insurance fixes, saying Americans live "at the whims" of insurance companies.

"I will not allow reform to be imperiled or postponed," he told members of the American Nurses Association. "We've talked this issue to death."

Obama cited new Census figures out today that the number of uninsured Americans rose slightly to 46.3 million last year and said that surveys shows that 6 million have joined the ranks of the uninsured during the economic recession.

Then saying, "just in case people weren't tuned in last night," he did a quick rundown of the changes he wants to prevent insurers from denying coverage for preexisting conditions and other changes.

A nonpartisan Massachusetts research group noted this afternoon that the Census estimates showed that Massachusetts had the lowest percentage of uninsured, about 5.4 percent, compared to about 15 percent nationally.

MassBudget credited the state's landmark health care law, which mandated that indivdiduals get coverage and offered state help for those who couldn't afford it. It noted that when the health reform legislation took effect in April 2006, about 9.8 percent of the commonwealth's population did not have health insurance.

Many of the proposals that Obama supports are modeled, at least in part, on the Massachusetts law.

Obama also praised America's nurses for their compassion and skill, noting their care for his daughters Malia and Sasha and for his mother and grandmother in their final days. "I love nurses," he said. "You're the bedrock of our medical profession."

(His full remarks are below.)

He also plans a series of rallies across the country, starting Saturday in Minneapolis, to put more pressure on Congress.

Vice President Joe Biden, making the rounds of morning new shows, predicted that the bill will be done by Thanksgiving, thanks to an emerging bipartisan consensus and the impact of Obama's speech to Congress.

The president "re-centered" the debate and "also debunked a lot of the myths out there, the idea of death panels, that we were going to insure undocumented aliens," Biden said.

Republicans remain unimpressed and unmoved.

“We appreciated having the President here last night. Unfortunately, what the American people got wasn’t a new health care plan, it was just another lecture. He had a chance to really put the government-run plan to bed, but unfortunately he didn’t do it. … When it’s all said and done; when you listen to the President’s speech and thought about it, there was nothing new in the President’s speech last night,” said Representative John Boehner, the top House Republican.

At a Capitol Hill news conference this afternoon, Boehner disputed some of Obama's key assertions. He told reporters that the Democratic bill could force people to change their insurance plans, could offer access to illegal immigrants, and could slash Medicare benefits.

And, Boehner asserted, Americans are angry and worried about sweeping changes to their health care.

Congress, he said, can find "common ground on sensible changes" to the existing system.

UPDATE: Republican National Committee chairman Michael Steele followed up this afternoon with an email to supporters urging them to send a "Declaration of Independence" electronic postcard to Obama and Democratic leaders in Congress.

"Once again, President Obama stepped in front of the prime time TV cameras to attempt to sell the Democrats' leftist health care scheme to legislators and anyone else who might still be paying attention," Steele wrote in the fund-raising solicitation. "The charm offensive isn't working. Americans no longer feel the need to give Barack Obama the benefit of the doubt.

"They have seen through the hype and media adoration to understand that the Obama Democrats are determined to push their far-left agenda on our country whether the American people like it or not," Steele added.

"You can feel the rising mood of freedom-loving Americans across this country. Not afraid, but incensed and determined, that their government not be a menace to our hard-earned liberty and prosperity. They are extremely concerned that the President and his congressional allies are launching an unprecedented assault against the principles upon which America was built."

President Obama is willing to let bygones be bygones, and so is House Speaker Nancy Pelosi.

But at least one member of Congress wants Representative Joe Wilson censured for yelling at the president "You lie!" during his health care speech Wednesday night.

Wilson, a South Carolina Republican, quickly apologized for his outburst, which stunned colleagues, prompted boos from some Democrats, and caused Obama to respond by saying "It's not true."

"This evening I let my emotions get the best of me," he said in a statement. "While I disagree with the president's statement, my comments were inappropriate and regrettable. I extend sincere apologies to the president for this lack of civility."

But Wilson stood by the subject for his shout, which he described today as "spontaneous" -- the assertion that illegal immigrants could benefit from the health care overhaul.

Even so, Obama told reporters today that he accepted Wilson's apology.

"Yes, I do," he said after a cabinet meeting. "I'm a big believer that we all make mistakes. He apologized quickly and without equivocation, and I'm appreciative of that.

"I do think that, as I said last night, we have to get to the point where we can have a conversation about big, important issues that matter to the American people without vitriol, without name-calling, without the assumption of the worst in other people's motives.

"We are all Americans; we all want to do best for our country," Obama added. We've got different ideas, but for the most part, we have the same aims, which is to make sure that people who work hard in this country and who act responsibly are able to get good jobs, good wages, raise their families, make sure those kids have a good education; that they are protected from misfortune or accident by having health care and retirement security in place....Our goals are generally the same, whether we're Democrats or Republicans, and in fact, most Americans don't even think about those labels all that much. They are turned off when they see people using wild accusations, false claims, name-calling, sharply ideological approaches to solve problems. They want pragmatism; they want people to stay focused on the job. And I hope that some of the fever breaks a little bit."

Pelosi also told reporters that she's not interested in sanctioning Wilson. "As far as I'm concerned, the episode was unfortunate. Mr. Wilson has apologized. It's time for us to talk about health care and not Mr. Wilson," she said today.

But according to the Washington Post, Senator Arlen Specter, the Republican-turned-Democrat from Pennsylvania, tweeted, "Rep. Wilson apologized immediately afterward but I don't think that's adequate. There ought to be a reprimand or censure of Rep. Joe Wilson to discourage that kind of conduct in the future."

President Obama tried tonight to thread the proverbial political needle on health care: keep enough liberals on board to pass a bill, reach out to moderates and even some Republicans -- and all the while convince an increasingly skeptical public that an overhaul would make their medical care better and less expensive, not worse and more costly.

Delivering a nationally televised, high-stakes speech on his top domestic priority to a joint session of Congress, Obama laid down his markers for what he wants in a bill and to say he will accept ideas from Republicans as well as Democrats -- as long as a bill gets done.

"I am not the first president to take up this cause, but I am determined to be the last," he said, drawing a standing ovation from lawmakers.

"Our collective failure to meet this challenge – year after year, decade after decade – has led us to a breaking point," he added. "Everyone understands the extraordinary hardships that are placed on the uninsured, who live every day just one accident or illness away from bankruptcy. These are not primarily people on welfare. These are middle-class Americans. Some can’t get insurance on the job. Others are self-employed, and can’t afford it, since buying insurance on your own costs you three times as much as the coverage you get from your employer. Many other Americans who are willing and able to pay are still denied insurance due to previous illnesses or conditions that insurance companies decide are too risky or expensive to cover. We are the only democracy, the only advanced democracy on Earth -- the only wealthy nation -- that allows such hardships for millions of its people."

"The time for bickering is over," Obama declared. "The time for games has passed. 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. Now is the time to deliver on health care."

"The plan I’m announcing tonight would meet three basic goals: It will provide more security and stability to those who have health insurance. It will provide insurance to those who don’t. And it will slow the growth of health care costs for our families, our businesses, and our government. It’s a plan that asks everyone to take responsibility for meeting this challenge – not just government and insurance companies, but everybody, including employers and individuals. And it’s a plan that incorporates ideas from senators and congressmen; from Democrats and Republicans – and yes, from some of my opponents in both the primary and general election."

Obama repeated his proposals to ban insurers from denying coverage based on preexisting conditions, to limit out of pocket expenses, and to require insurance companies to cover routine checkups. He also calls for a new exchange where individuals and small businesses can buy affordable coverage.

Obama disputed "bogus claims" by those trying to kill reform that there would be "death panels" of bureaucrats who would decide end-of-life care, that illegal immigrants would receive benefits, and there would be a government takeover of health care.

On one of the most controversial issues -- the so-called public option, a government-run plan along the lines of Medicare, Obama said it was only one part of his plan and "only a means" to the end of creating needed competition to private insurers to hold down costs and improve policies -- "and we should remain open to other ideas that accomplish our ultimate goal."

"Let me be clear – it would only be an option for those who don’t have insurance. No one would be forced to choose it; it would not impact those of you who already have insurance," he said.

Trying to appeal to Republicans, he said while he does not believe that medical malpractice reform is "a silver bullet," "I have talked to enough doctors to know that defensive medicine may be contributing to unnecessary costs" and he's willing to "move forward on a range of ideas about how to put patient safety first and let doctors focus on practicing medicine."

While he said he'll work toward a bipartisan deal, Obama also warned that his patience has a limit.

"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 said. "I won't stand by while the special interests use the same old tactics to keep things exactly the way they are. If you misrepresent what's in this plan, we will call you out. And I will not accept the status quo as a solution. Not this time. Not now.

"Everyone in this room knows what will happen if we do nothing. Our deficit will grow. More families will go bankrupt. More businesses will close. More Americans will lose their coverage when they are sick and need it most. And more will die as a result. We know these things to be true. That is why we cannot fail. Because there are too many Americans counting on us to succeed – the ones who suffer silently, and the ones who shared their stories with us at town halls, in emails, and in letters."

Obama called on Edward M. Kennedy's legacy and memory as part of his call to action on health care, especially for bipartisan cooperation for the greater American good.

He said one of the letters he had received recently was from Kennedy, in which the late senator "expressed confidence that this would be the year that health care reform – 'that great unfinished business of our society,' would finally pass. He repeated the truth that health care is decisive for our future prosperity, but he also reminded me that 'it concerns more than material things.' 'What we face,' he wrote, 'is above all a moral issue; at stake are not just the details of policy, but fundamental principles of social justice and the character of our country.' ”

"I’ve thought about that phrase quite a bit in recent days – the character of our country," Obama said.

"On issues like these, Ted Kennedy’s passion was born not of some rigid ideology, but of his own experience. It was the experience of having two children stricken with cancer. He never forgot the sheer terror and helplessness that any parent feels when a child is badly sick; and he was able to imagine what it must be like for those without insurance; what it would be like to have to say to a wife or a child or an aging parent – there is something that could make you better, but I just can’t afford it.

"That large-heartedness -- that concern and regard for the plight of others -- is not a partisan feeling. It is not a Republican or a Democratic feeling. It, too, is part of the American character. Our ability to stand in other people’s shoes. A recognition that we are all in this together; that when fortune turns against one of us, others are there to lend a helping hand. A belief that in this country, hard work and responsibility should be rewarded by some measure of security and fair play; and an acknowledgement that sometimes government has to step in to help deliver on that promise."

(His full remarks are below.)

The official Republican response came from Representative Charles Boustany Jr. of Louisiana, a former heart surgeon.

In excerpts released in advance by House Republicans, Boustany said that "Republicans are pleased that President Obama came to the Capitol tonight. We agree much needs to be done to lower the cost of health care for all Americans. On that goal, Republicans are ready -- and we’ve been ready -– to work with the President for common-sense reforms that our nation can afford.”

But Boustany also said it's time to start over, not cobble together the bills already passed by Democratic-controlled committees in the House and Senate.

“It’s clear the American people want health care reform, but they want their elected leaders to get it right," he plans to say. "Most Americans wanted to hear the President tell Speaker Pelosi, Majority Leader 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. That’s what I heard over the past several months in talking to thousands of my constituents. Replacing your family’s current health care with government-run health care is not the answer. In fact, it’ll make health care much more expensive.”

Boustany repeated the Republican assertion that the Democratic bill would mean bigger government and higher taxes, saying that it " creates 53 new government bureaucracies, adds hundreds of billions to our national debt, and raises taxes on job-creators by $600 billion. And, it cuts Medicare by 500 billion dollars, while doing virtually nothing to make the program better for our seniors.”

(His full prepared remarks are below.)

Democrats spent much of today trying to trash Boustany, pointing out that at one point he seemed to support the "birther" movement that questioned whether Obama was born in Hawaii (despite a verified birth certificate) and thus ineligible to be president, that he supported end-of-life counseling (that have been mischaracterized as "death panels') and that he had been sued for malpractice (though not an unusually high number of times).

Senator Edward M. Kennedy didn't live to see an universal health care bill pass in Washington.

But when President Obama spoke tonight to Congress to plead with them to pass a bill, he was there in spirit.

President Obama called on Kennedy's legacy and memory as part of his call to action on health care, especially for bipartisan cooperation for the greater American good.

He said he had received a letter recently from Kennedy. "He had written it back in May, shortly after he was told that his illness was terminal. He asked that it be delivered upon his death.

"In it, he spoke about what a happy time his last months were, thanks to the love and support of family and friends, his wife, Vicki, and his amazing children who are all here tonight," Obama continued. "And he expressed confidence that this would be the year that health care reform – 'that great unfinished business of our society,' would finally pass. He repeated the truth that health care is decisive for our future prosperity, but he also reminded me that 'it concerns more than material things.' 'What we face,' he wrote, 'is above all a moral issue; at stake are not just the details of policy, but fundamental principles of social justice and the character of our country.' ”

"I’ve thought about that phrase quite a bit in recent days – the character of our country. One of the unique and wonderful things about America has always been our self-reliance, our rugged individualism, our fierce defense of freedom and our healthy skepticism of government. And figuring out the appropriate size and role of government has always been a source of rigorous and sometimes angry debate," the president said.

"For some of Ted Kennedy’s critics, his brand of liberalism represented an affront to American liberty. In their mind, his passion for universal health care was nothing more than a passion for big government. But those of us who knew Teddy and worked with him here -- people of both parties -- know that what drove him was something more. His friend, Orrin Hatch, knows that. They worked together to provide children with health insurance. His friend John McCain knows that. They worked together on a Patient’s Bill of Rights. His friend Chuck Grassley knows that. They worked together to provide health care to children with disabilities.

"On issues like these, Ted Kennedy’s passion was born not of some rigid ideology, but of his own experience. It was the experience of having two children stricken with cancer. He never forgot the sheer terror and helplessness that any parent feels when a child is badly sick; and he was able to imagine what it must be like for those without insurance; what it would be like to have to say to a wife or a child or an aging parent – there is something that could make you better, but I just can’t afford it.

"That large-heartedness -- that concern and regard for the plight of others -- is not a partisan feeling. It is not a Republican or a Democratic feeling. It, too, is part of the American character. Our ability to stand in other people’s shoes. A recognition that we are all in this together; that when fortune turns against one of us, others are there to lend a helping hand. A belief that in this country, hard work and responsibility should be rewarded by some measure of security and fair play; and an acknowledgement that sometimes government has to step in to help deliver on that promise."

UPDATE: Obama's senior adviser David Axelrod told the Globe that Victoria Reggie Kennedy called to say the senator had written the letter in May he wanted delivered to Obama after his death.

"The president read it and it became the basis of the closing" section of the speech that Obama wrote himself in longhand, Axelrod said in a brief interview. "It was something that moved him a lot."

The full letter is below.

Several of Kennedy's children and his widow were in places of honor in the House chamber.

House Speaker Nancy Pelosi announced this afternoon that Congressman Patrick Kennedy of Rhode Island would escort Obama to the well, then watch from the gallery.

Ted Kennedy, Jr., and Kara Kennedy and her two children, Grace and Max, will watch from the front row of the speaker's box.

Kennedy's widow, Victoria Reggie Kennedy, sat with First Lady Michelle Obama in her box.

Others invited for those primo seats are patients who illustrate the problems of health care and the benefits of an overhaul, along with doctors and other health professionals. Among the latter category is Dr. Wayne Myers, an organic farmer and pediatrician from Waldoboro, Maine, who the White House said "has been active in rural health care for many years" and "understands the health care challenges present in accessing care and affordable insurance in rural areas."

The full guest list is below:

President Obama reacted to his own speech by sending out an appeal tonight to the 13-million-strong email list of his grassroots group, Organizing for America.

"I just finished laying out my plan for health reform at a joint session of Congress. Now, I'm writing directly to you because what happens next is critical -- and I need your help," Obama wrote in the email. "Change this big will not happen because I ask for it. It can only come when the nation demands it. Congress knows where I stand. Now they need to hear from you."

"We've come closer to real health reform in the last few months than we have in the last 60 years. But those who profit from the status quo -- and those who put partisan advantage above all else -- will fight us every inch of the way," he added.

"We do not seek that fight, but we will not shrink from it. The stakes are too high to let scare tactics cloud the debate, or to allow partisan bickering to block the path. Your voice, right now, is essential."

UPDATE: In an instant CNN/Opinion Research poll, 56 percent of respondents said they had a "very positive" overall reaction to Obama's speech, and another 21 percent "somewhat positive," while 12 percent said "somewhat negative" and 9 percent "very negative."

Also, 70 percent said Obama's proposals would move the country in the right direction, up from 60 percent in a similar poll conducted Saturday through Tuesday, and 67 percent said they favored Obama's plan to reform health care, up from 53 percent before the speech.

The new poll has a margin of error of plus or minus 5 percentage points, and 18 percent of the respondents identified themselves as Republicans, 45 percent as Democrats, and 37 percent as independents.

Other reaction to his address to Congress divides, not suprisingly, along party lines.

Republican National Committee Chairman Michael Steele: “The president has proven his ability again to speak very well and say very little. He continued to try and sell his government-run health care experiment even though it will increase costs, increase taxes and increase the deficit. He said he wants to work with Republicans, but Nancy Pelosi and liberals in the House have opposed Republicans every step of the way. If the Democrats are serious about passing health care reform this year, they should stop pointing fingers and truly start working with Republicans to pass common-sense bipartisan health care reform that Americans want and deserve.”

Brad Dayspring, spokesman for Representative Eric Cantor, the second-ranking House Republican: “Tonight the President failed to say anything different or offer clear specifics, and with that in mind the reason for this overhyped speech is strangely unclear. The President has now delivered over 100 speeches where he’s discussed health care and said the same thing. He's held prime time press conferences, hosted television specials from the White House, and addressed a joint-session of Congress and only thing he’s made explicitly clear is that the status quo is unacceptable, a fact that we all agree on. While the President continues to blame unnamed special interests and Republicans, the fact is that the Democrats overwhelmingly control both the House and the Senate. The President and his party have failed to lead by offering reform that Americans are comfortable with. Families understand that a costly government-run plan will force them to pay more and get less.”

Senator John F. Kerry, a Massachusetts Democrat: “Tonight President Obama regained the initiative in a debate that must be won this year - not for a party, but for people who desperately need relief. This was a presidential moment and real presidential leadership. Americans need a real debate -- no more distortions, no more political games, no more scare tactics, it’s time for leaders everywhere to find the common ground to do what’s right for our country.
It won’t be easy, it will require tough decisions and hard-fought compromise, but letting another year go by without reforming health care is not an option. Now is the moment to achieve affordable insurance for those who don’t have it, stability for those who do, and cost controls for the businesses struggling to provide it to their workers.

"I was pleased to see the President made a compelling case for one of the ideas I’ve advanced on the Finance Committee – a meeting in the middle to control costs by placing an excise tax on insurers who offer high cost plans – a proposal that should be targeted to protect hard working Americans. Now we need to find Republicans willing to find those kinds of compromises for the greater good. That’s what our friend Ted Kennedy did at times like these, and there’s no greater action we can take now to honor his legacy than to deliver on the cause of his life.”

Representative Edward J. Markey, a Massachusetts Democrat: “Tonight the President offered a strong case for comprehensive health care reform, and I commend him on an excellent speech,” said Markey. “President Obama’s plan will offer stability and security for those with health insurance. No one should have to fight off a deadly disease while also fighting with their insurance company. The President’s plan puts a stop to denial of coverage based on a pre-existing condition and contains other vital reforms to protect Americans who already have coverage. President Obama’s plan also will finally enable the more than 45 million Americans without health insurance to get quality, affordable health coverage by creating a new insurance exchange where individuals and small businesses can shop for health insurance at competitive prices.

“We are now entering a new phase in the debate. Our current system is broken and in urgent need of an overhaul. Now is the time to heed the President’s call and pass comprehensive health care reform. The stakes are too high and the costs of inaction are too great to delay any longer.”

All sides are furiously trying to set expectations in advance of President Obama's big health care speech tonight to a joint session of Congress.

It's not clear how much the address, scheduled for 8 p.m. EDT, will be highlighted by new specifics -- or will be a more coherent restating of what the president wants in a health care overhaul.

Obama will "speak clearly to the American people about what's in health care reform; for those that are fortunate to have insurance, to demonstrate for them that his plan will bring them security and stability; and for those that don't have health insurance, that we'll provide an affordable way for them to get accessible insurance," White House press secretary Robert Gibbs told reporters on Air Force One as Obama headed to New York to speak at a memorial service for revered newsman Walter Cronkite.

On one of the most contentious issues, Obama will make his case for why he believes a government-run option is the best way to create more competition to private insurers, but he isn't expected to say he would veto a bill without it, a senior administration official told the Associated Press.

Obama, himself, in an interview aired today on ABC's "Good Morning America," offered few specifics, but did outline this preview of his address: "So, the intent of the speech on is to, A, make sure that the American people are clear exactly what it is that we are proposing. B, to make sure that Democrats and Republicans understand that I’m open to new ideas, that we’re not being rigid and ideological about this thing, but we do intend to get something done this year.”

The challenge facing Obama tonight -- as he tries to mollify liberals and not give up on a bipartisan deal -- was put in starker relief by a new poll out today.

The Associated Press-GfK survey says that 52 percent of Americans disapprove of Obama's handling of health care, up from 43 percent in July. The poll also shows that 49 percent disapprove of his overall job performance, an increase from 42 percent in July.

Also in the poll, 49 percent said they oppose the bills under consideration in Congress, while only 34 percent favor them, and respondents were evenly split over whether lawmakers should keep trying to pass a bill this year or start over again.

The survey, conducted Thursday through Tuesday, has a margin of sampling error of plus or minus 3.1 percentage points.

UPDATE: Even before his speech, the White House announced this afternoon that Obama will take his health care pitch on the hustings.

He plans a "rally" -- not the town hall format he has been holding -- on Saturday in Minneapolis where he "will discuss what’s at stake for the American people in this debate – why we need health insurance reform and why we need to act now."

Republicans expect the president not to stake out much new ground tonight.

Representative John Boehner, the House GOP leader, said today the real question is whether Obama has been listening to the American public.

“I think the American people have made it pretty clear that they don’t really want another lecture, they want a new plan. They understand that we have a good system that works well for many people. Everybody understands that we’ve got problems in the current system that can be addressed. But to replace the entire current system with a big government-run plan is not what the American people want and certainly isn’t what I want.”

And the government-run public option isn't the only problem with the Democratic bills, Boehner said.

"It’s not the only bitter pill in their plan," he said. "They have a mandate on every employer to offer insurance and if they don’t there is a big tax. At a time when we are trying to create jobs this will make it more difficult to create jobs, and, as a matter of fact, probably cost our economy jobs. This $3,800 tax that has been proposed in one of the Democrat plans on individuals if you don’t buy health insurance is another non-starter. And so it really is time to stop, hit the reset button, and sit down in a bipartisan way and begin to deal with what we can deal with to help make our current health care system work better.”

Meanwhile, the American Medical Association issued an open letter to Obama and Congress urging them to reach a health care deal. "As our nation's elected leaders, you have an historic opportunity to improve the health and well-being of the American public," wrote J. James Rohack, the AMA's president. (Click here to read the letter.)

But it does not appear that the best hope for a bipartisan compromise will be in place before Obama speaks.

Senate Finance Committee Chairman Max Baucus had set a deadline of sorts of this morning for the "Gang of Six" to weigh in on his proposal, which would cost about $900 billion over 10 years, financed in part by new fees on insurers, drug companies and others in the industry, and does not include the public option.

But the key Republican in the negotiating group -- Senator Olympia Snowe of Maine -- is in no hurry to sign on to the Baucus plan before hearing from the president. "That's the cart before the horse, as they say in Maine," she said, according to the AP.

After Baucus met privately with Democrats on the committee, the chairman told reporters this afternoon that while he still hopes for a bipartisan deal, he will formally introduce his bill next week -- with or without Republican assent -- and have his panel debate it the week after that.

"I very much hope and do expect Republicans will be on board," he told reporters. "I don't know how many, but if there are not any, I will move forward anyway."

In the game of musical chairs occasioned by the death of Edward M. Kennedy, Senator Christopher Dodd announced this afternoon that he will stay as chairman of the Banking Committee and not take over the health panel, where he had filled in for Kennedy during his illness.

Instead, Senator Tom Harkin of Iowa will move from Agriculture to the health committee. Harkin, as was Kennedy, is firmly in the liberal wing of the Democratic party.

Senator Blanche Lincoln of Arkansas will rise to the chairmanship of Agriculture.

"We all had hoped that Teddy would be able to come back to see this through," Dodd said in a statement. "Unfortunately, that wasn’t possible. But I intend to keep the promise I made. And so, I am pleased that I will able to continue the role he asked me to take on as the HELP Committee’s leader on health care reform."

"But we have important work to do on the Banking Committee, and I intend to see it through as chairman. The Banking Committee is of vital importance to Connecticut, responsible for issues central to the economic security and prosperity of the people of my state."

Dodd's perch on Banking, where he will work on financial regulation overhaul with House Financial Services Chairman Barney Frank of Massachusetts, will give him continued access to campaign cash in his tough reelection fight next year.

But it also got him in political hot water when critics accused him of getting too cozy to Wall Street during the meltdown.

Meanwhile, Service Employees International Union quickly applauded Harkin's move, saying that it is counting on his help to pass a health care bill, as well as a bill to make it easier for unions to organize, and an immigration overhaul.

"America’s working families have learned to count on Senator Harkin to stand up and fight for the issues that will help to ensure the American Dream is alive and well for their children and grandchildren. As the son of a coal miner, Senator Harkin understands how Congress and organized labor can work together to pass legislation that ensures quality and affordable healthcare, a fair economy, a safe workplace and a secure retirement," SEIU Secretary-Treasurer Anna Burger said in a statement.

John Sweeney, president of the AFL-CIO, the nation's largest labor federation, also praised the leadership changes.

"It is great news for America's workers that a longtime friend of working families is taking the helm at the Senate Labor Committee. Although no one can replace Senator Kennedy, Tom Harkin brings just the right balance of passion and skill to the job of protecting working men and women, educating our children and looking out for our health," Sweeney said in a statement.

"We are also pleased that Senator Dodd will stay on as Chair of the Banking Committee to continue the important work of cleaning up Wall Street and putting in place sensible regulations to make sure we do not have a repeat of the recent financial meltdown. Both Senators Harkin and Dodd face great challenges as they work to make meaningful progress on the issues that affect the lives of working people, and we look forward to working closely with both of them in the months and years ahead."

The idea of "death panels" -- hardhearted government bureaucrats who would decide when to pull the plug on terminally ill patients -- has been rather thoroughly debunked.

But former Alaska Governor Sarah Palin raises their specter again in an op-ed piece published in the Wall Street Journal today, on the eve of President Obama's much-anticipated health care speech.

"In an interview with the New York Times in April, the president suggested that such a group, working outside of 'normal political channels,' should guide decisions regarding that 'huge driver of cost . . . the chronically ill and those toward the end of their lives . . . .' Palin writes.

"Given such statements, is it any wonder that many of the sick and elderly are concerned that the Democrats' proposals will ultimately lead to rationing of their health care by—dare I say it—death panels? Establishment voices dismissed that phrase, but it rang true for many Americans. Working through 'normal political channels,' they made themselves heard, and as a result Congress will likely reject a wrong-headed proposal to authorize end-of-life counseling in this cost-cutting context. But the fact remains that the Democrats' proposals would still empower unelected bureaucrats to make decisions affecting life or death health-care matters."

After the firestorm of controversy over the "death panels" in Democratic bills, bipartisan negotiators on the Senate Finance Committee agreed to drop the end-of-life provision.

But the Democratic National Committee hit back this morning at Palin, last year's Republican vice presidential nominee.

“The way Sarah Palin is trying to scare Americans you'd think it's Halloween already," DNC spokesman Hari Sevugan said in a statement. "But, by continuing to peddle what Pulitzer Prize winning independent fact checkers have found to be ‘pants on fire’ lies and doubling down on the GOP recommendation to end Medicare for future generations, the only thing that's in costume here is Sarah Palin's supposed concern for the health care of Americans. What the American people find truly scary is that insurance rates have doubled this decade and continue to rise at a rate three times faster than their wages, and that rather than take on the insurance industry Republicans have become their biggest defenders. And what Sarah Palin should find truly scary is that her reputation as a serious leader can in fact sink even lower than it already has when she continues to stand by such outlandish claims.”

The rest of Palin's piece is far less controversial -- more of the Republican mantra that too much government would make health care worse, not better.

"Common sense tells us that the government's attempts to solve large problems more often create new ones. Common sense also tells us that a top-down, one-size-fits-all plan will not improve the workings of a nationwide health-care system that accounts for one-sixth of our economy. And common sense tells us to be skeptical when President Obama promises that the Democrats' proposals "will provide more stability and security to every American," Palin writes.

"With all due respect, Americans are used to this kind of sweeping promise from Washington. And we know from long experience that it's a promise Washington can't keep.

President Obama's health care speech to a joint session of Congress on Wednesday night has many of the trappings of a "State of Union" address, and perhaps more at stake with his top domestic priority in the lurch.

So the opposition party is treating it as such, announcing today that a doctor who is also a congressman will deliver the Republican response immediately afterwards.

Representative Charles Boustany of Louisiana has been tapped to make the speech. The GOP says that he has more than 20 years of medical experience and has long advocated for changes that lower health care costs and maintains the doctor-patient relationship.

“As a doctor, I know we must lower costs and improve care, which we can accomplish by focusing on strengthening the doctor-patient relationship and working in a bipartisan way,” he said in a statement. “Health care is a kitchen table issue that affects all Americans, and I believe we need an honest discussion about how we come together to fix what’s broken, while building on what works. That’s why I’m pleased the President will speak to Congress tomorrow night, and I look forward to presenting commonsense reforms that Republicans and all Americans can stand behind.”

“Dr. Boustany has been a tireless advocate for reform that lowers health care costs and expands access for the American people at a price our nation can afford,” Representative John Boehner, the top House Republican, said in a statement. “He understands why a Washington bureaucrat – as Democrats have proposed – should never get between a doctor and his patient. I’m pleased Charles has agreed to speak to the American people about a Republican vision for reform and the need for both parties to come together to craft a responsible proposal at a time when people across the country are focused on jobs.”

UPDATE: Health professionals, as a group, are the most generous donors to Boustany's campaigns. They gave him $240,250 for the 2008 election and $48,300 so far for the 2010 election, according to the nonpartisan Center for Responsive Politics.

The Democratic Congressional Campaign Committee said Boustany was a "fitting choice" for Republicans opposed to a health care overhaul, noting his votes against expanding the children's health insurance program and funding community health centers.

Boustany is a "credible voice for special interests, but not for hardworking Louisianians who struggle with health insurance companies,” Jessica Santillo, the southern regional spokeswoman for the DCCC, said in a statement. “Louisianians deserve an honest debate on how to rein in health cares costs, improve care, and increase access, not more of Congressman Boustany’s attempts to block solutions and protect the status quo.”

Also, the Republican National Committee plans to respond minute by minute to Obama's speech, announcing this afternoon a "live blog will offer 'real-time' fact-checking during President Obama's address concerning his proposed government-run health care experiment and how it will impact all generations of Americans."

Republicans use their Labor Day weekend radio-Internet address to try to pound it into Americans' heads that President Obama's health care plan would be a job killer that would balloon the federal deficit.

Obama, who plans to make his case before a joint session of Congress on Wednesday night, is being buffeted by liberals in his own party as well as Republican opponents on what he should insist be in a health care bill.

Representative John Kline of Minnesota talks about what he heard from constituents in the town halls he hosted during the August congressional recess.

"What I hear from them is what my colleagues are hearing from Americans all across this great nation -- a sense of uncertainty about the health care legislation moving through Congress like a runaway freight train. They ask: 'What will happen to my coverage, and my choice of doctors? Will I have to stand in line to receive treatment? Or get approval from someone in Washington before getting a knee replacement or filling a prescription for the latest diabetes medication?' " Kline says.

"Access to quality care and the comfort of a familiar physician isn’t the only thing on my constituents’ minds. With trillion dollar price tags becoming almost commonplace in Democrat-controlled Washington, American families are worried about what all this spending means for their jobs -- and their children -- and their children’s children.

With so many worries, Kline says it's time to start over -- and to try to draft a truly bipartisan bill.

"Democrats have crafted this legislation behind closed doors, creating a partisan blueprint that – at last count – clocked in at more than 1,000 pages. It’s complicated, it’s convoluted, and it’s quite simply not going to work.

"It’s time to press the ‘reset’ button," Kline says. "Health care reform doesn’t have to be a partisan battle. It doesn’t have to take away coverage from Americans who like what they have. It doesn't have to put federal bureaucrats in charge of what procedure is covered and what medication is not.

"Our goal must be to fix what’s broken in our health care system while preserving those features that work well. We can drive down costs without sacrificing quality. We can expand coverage without orchestrating a government takeover. And we can do all of these things without squeezing small businesses and destroying more jobs at a time when our economy needs them most."

His full address is below and can be viewed here.

Republicans have their senior's bill of rights, trying to win the elderly to their side in the health care debate.

Democrats retaliated this evening with a new TV ad that accuses the GOP of wanting to kill Medicare, the main government health program for seniors.

The Democratic National Committee cited a vote earlier this year in the House in which 137 Republicans voted for a budget proposal offered by the Republican leadership that the DNC says would have ended Medicare for Americans under age 55. Instead, the proposal called for younger workers to enroll in private plans and receive subsidies equal to the average Medicare benefit.

"Republicans want to end Medicare," the announcer says in the spot. "You heard right, Republicans actually voted to abolish Medicare for future generations -- one of the most important programs for seniors.

"America's seniors have relied on Medicare for over 40 years -- and Democrats are working to strengthen Medicare," the narrator continues, over images of smiling seniors. "But the plain truth is, Republicans have opposed Medicare from the start.

"Their leaders have called for cutting Medicare -- and now for killing it. The Republican Party -- no friend of seniors," the announcer concludes over photos of House Republican leader John Boehner and Republican National Committee chairman Michael Steele.

The DNC says the ad will air on national cable in and in 10 the districts of 10 Republican members of Congress, including Boehner, his No. 2 Eric Cantor, and favorite liberal target Michele Bachmann of Minnesota.

In unveiling the seniors' bill of rights earlier this week, the RNC vowed to protect Medicare, which it asserted was in jeopardy under the proposals of President Obama and Democrats to find savings and efficiencies.

“Let’s agree in both parties that Congress should only consider health reform proposals that protect senior citizens,” Steele says in his ad. "For starters, no cuts to Medicare to pay for another program. Zero."

President Obama's grassroots group is bringing its health care overhaul push to Boston on Labor Day, with newly minted US Senate candidate Martha Coakley and a possible competitor, Representative Michael Capuano, featured at the rally.

Organizing for America announced this afternoon that the rally will be at 11 a.m. Monday at the Parkman Bandstand on Boston Common. It plans to present 30,000 declarations of support for Obama's proposals from Massachusetts residents to the Bay State congressional delegation.

"The rally will be an opportunity for supporters of reform to show their backing for President Obama’s principles for health insurance reform which have been simple and consistent -- reform will lower costs, protect choice and ensure all Americans have access to quality, affordable health care," the announcement said.

Besides Coakley, now Massachusetts attorney general, and Capuano, Representative John Tierney and leaders of the Service Employees International Union and Health Care for America Now! will attend.

Organizers said there will be a moment of silence for the late Senator Edward M. Kennedy. Coakley announced Thursday she is seeking the seat, and Capuano is also considering a run.

Organizing for America says it held more than 2,000 health care events during August, culminating in a two-week bus tour that ended Thursday and stopped in Phoenix, Albuquerque, Denver, Des Moines, St. Louis, Indianapolis, Columbus, Pittsburgh, and Charlotte.

Democrats, ramping up their rebuttal to GOP attacks on health care, unveiled a web video today going after Representatives John Boehner and Michele Bachmann and commentators Glenn Beck and Rush Limbaugh.

The video shows the critics repeating debunked claims, including that the health care bill would create death panels of bureaucrats who would decide who lives and dies, and using terms such as "communist" to describe the plan.

“Since Congressional Republicans and their right wing allies can’t win with the facts on health care, they’ve resorted to using fear, fiction, and scare tactics of the worst kind to shamelessly try and ‘kill’ health insurance reform,” Ryan Rudominer, spokesman for the Democratic Congressional Campaign Committee, said in a statement. “This new web video is just another way that we are exposing their lies and over-the-top rhetoric while empowering our grassroots supporters to hold them accountable for trying to deny families quality, affordable health care.”

The video is part of Democrats' strategy of advertising, phone calls, letters to the editor, fact checks, and telephone town halls in targeted Republican districts to try to regain momentum.

Republicans and other critics have taken the upper hand during the August congressional recess, one reason why President Obama plans to give an unusual "State of the Union"-like speech to a joint session of Congress next Wednesday to make his case for a health care overhaul.

President Obama will address a joint session of Congress next Wednesday as he tries to regain momentum on the health care debate.

With a bipartisan deal looking less likely and many Americans confused by the debate, the White House has been signaling that Obama will try to sharpen his message on what exactly he wants Congress to put in a health overhaul.

Obama has held a series of town halls, and a prime time news conference, but senior adviser David Axelrod said in a series of interviews late Tuesday and early today that the president was considering giving a major health care speech soon after he returns from his Camp David vacation and Congress reconvenes next week.

"We're entering a new season," Axelrod told CNN today. "It's time to synthesize and harmonize these strands and get this done."

So far, Obama has left the details of bill drafting to Democrats in Congress. But as the Globe reported today, Democrats are increasingly dismayed by Republican recalcitrance and are considering using the "nuclear option" of a parliamentary maneuver to ram through a health care bill with a simple majority in the Senate. And as the Globe reported last week, Obama has stepped on his own message at times.

A CBS News survey released Tuesday said that two in three respondents said they were confused by the proposals before Congress, and 60 percent said that Obama has not clearly explained his health proposals.

The address, scheduled for prime time Wednesday night, will be only Obama's second as president to a joint session of Congress. His first, in late February, amounted to his "State of the Union" address and focused on the financial crisis and deepening recession.

"The weight of this crisis will not determine the destiny of this nation," Obama said then. "Those qualities that have made America the greatest force of progress and prosperity in human history we still possess in ample measure. What is required now is for this country to pull together, confront boldly the challenges we face, and take responsibility for our future once more."

The war of words and ads over health care has left most Americans confused, according to a new poll released today.

The CBS News survey found that two in three respondents -- including 69 percent of Republicans and 58 percent of Democrats -- call the proposals before Congress confusing, while only 31 percent said they have a clear understanding of the proposed changes.

Moreover, 60 percent of Americans say that President Obama has not clearly explained his health proposals, though he has held a series of town halls and other events. (Click here to see the entire poll.)

The at-times heated town hall meetings during the August congressional recess didn't help matters, and 49 percent of those who said they heard of the sessions said angry protestors featured on cable TV did not reflect the views of most Americans.

Not surprisingly, there was a partisan division, with 66 percent of Republicans saying the protestors did speak for most of the public, but 73 percent of Democratic respondents said they did not.

The poll, conducted Thursday through Monday, has a margin of error of plus or minus 3 percentage points.

Republicans immediately jumped on the poll findings. "Over a month ago, President Obama changed his message from 'health care reform' to 'health insurance reform.' Though the message changed, the underlying product didn’t," Brad Dayspring, a spokesman for Representative Eric Cantor, the No. 2 Republican in the House, said in a statement. "New polling from CBS shows that the American people weren’t fooled."

The truce during the mourning for Senator Edward M. Kennedy is a memory, Congress returns to work in a week, and the calendar has turned to September.

So it's time to rejoin the battle over the health care overhaul.

Senator Judd Gregg of New Hampshire, the top Republican on the Budget Committee, is warning that he has lots of objections ready if Democrats try to push a health care bill through the Senate with a simple majority.

Democrats might need to resort to the procedural maneuver, known as reconciliation, because with Kennedy's seat vacant, they control 59 votes -- one shy of what is needed to overcome potential filibusters.

Gregg told The Hill newspaper in an article published online today that Republicans could file "hundreds" of points of order objections, each one requiring 60 votes to overcome.

"We are very much engaged in taking a hard look at our rights under reconciliation," Gregg told The HiIl. "It would be very contentious."

The Republican National Committee this morning unveiled a new TV ad that promotes its "seniors' bill of rights" for any health care changes -- aiming squarely at a constituency worried what reform would bring and at a voting bloc least supportive of President Obama.

“Let’s agree in both parties that Congress should only consider health reform proposals that protect senior citizens,” RNC Chairman Michael Steele says in the ad. "For starters, no cuts to Medicare to pay for another program. Zero.

"Make it illegal to ration health care based on age,” he continues. "Prevent any government role in end-of-life care. And stop bureaucrats from getting between seniors and their doctors. A few things we should all agree on. The Seniors’ Bill of Rights. Stand with us and stand with senior citizens. After all, they’ve earned it.”

Democrats, however, point out that Steele has seemingly contradicted himself in recent days over whether he supports savings (or cuts, according to critics) in Medicare -- the government health program for seniors -- to help bring health spending under control.

Democrats also note that the AARP declared that “nothing in the bills that have been proposed would bring about the scenarios the RNC is concerned about.”

"Michael Steele and the Republicans are unbelievable," Democratic National Committee spokesman Brad Woodhouse said in a statement today responding to the RNC ad. "After failing to stop the President on the Recovery Act, the budget, equal pay for women and children's health care, Republicans have decided that they have no other choice when it comes to blocking health insurance reform than to lie to the American people and try to scare seniors - all in their admitted effort to 'break' the President on this issue and 'kill' reform for political gain.

"The RNC's 'Senior's Bill Of Rights' is nothing more than a scare tactic built on a foundation of lies about the effort to reform health insurance. Which begs the question, why can't Republicans debate health insurance reform on the merits instead of making stuff up out of whole cloth? Because they know the crux of what President Obama has proposed -- lowering costs, preserving choice, expanding access and reversing decades of unfair insurance industry practices -- is popular with the American people and they don't stand a chance of blocking reform if they deal with the issue honestly."

Democrats -- in the form of President Obama's grassroots group Organizing for America -- are continuing their "Health Insurance Reform Now: Let’s Get it Done!" bus tour today in Columbus, Ohio, and Wednesday in Pittsburgh. The events, in part, are designed to hammer home the message of Obama's eight health "guarantees" for Americans who already have health insurance: "1) no discrimination for pre-existing conditions, 2) no exorbitant out-of-pocket expenses, deductibles, or co-pays, 3) no cost-sharing for preventive care, 4) no dropping of coverage for the seriously ill, 5) no gender discrimination, 6) no annual or lifetime caps on coverage, 7) extended coverage for young adults, and 8) guaranteed insurance renewal."

President Obama, in a message overnight to his 13 million-strong grassroots group, said that Senator Edward M. Kennedy "a true leader who challenged us all to live out our noblest values."

"I personally valued his wise counsel in the Senate, where, regardless of the swirl of events, he always had time for a new colleague. I cherished his confidence and momentous support in my race for the Presidency. And even as he waged a valiant struggle with a mortal illness, I've benefited as President from his encouragement and wisdom," Obama added in his message to members of Organizing for America. (His full message is below.)

Obama did not mention the issue that he and Kennedy were most closely working on in the months before his death and that his grassroots group is now crusading on -- a health care overhaul.

But Vice President Joe Biden says that Kennedy's death -- and the outpouring of tributes -- could break the partisan gridlock on Capitol Hill.

"God willing maybe his loss and all about him will be the catalyst to make people come around and, you know, begin to compromise to get something done," Biden said in an interview aired this morning on NBC's "Today" show.

The vice president, however, also acknowledged that the impact could go the other way -- that Kennedy's absence will make a bipartisan deal even more difficult. Several key Republicans, including last year's presidential nominee, Senator John McCain, have argued in recent days that a health care deal would be closer if Kennedy had been in the Senate the last few months.

Biden said that Kennedy's attitude and persistence should be an example.

"Everything was about possibilities. I never, ever, ever in 36 years of being with him ever saw him down in terms of, 'We can't get this done,' 'things aren't going to get any better,' 'the deficit's too big,' 'we can't get this passed' -- never, never, never," Biden said.

"I watched him on the renewal of the civil rights legislation. I watched him on hate crimes legislation. I watched him go back at it and go back at it, and I watched him change people's minds."

Health and Human Services Secretary Kathleen Sebelius said today that Kennedy's death would "make things more difficult" on health care legislation, MSNBC reports.

Asked about the possibility of naming the bill in Kennedy's honor, she said that would be an appropriate tribute, but said "it would be best to pass health care."

But conservative radio talk show host Rush Limbaugh took a decidedly different stance.

"Placing [Kennedy’s] name on a health-care bill, in memoriam, or using his name as a sympathy ploy to advance a health care bill that would deny Americans the choices Senator Kennedy had is an insult and is supreme hypocrisy,” he said on his show Wednesday. "The senator's passing is going to give them the opportunity to use the sympathy play to get as much done in his name as possible."

Meanwhile, a second group opposing Democrats' health care plan announced today it is withdrawing its TV ads out of respect for Kennedy.

The Associated Press reports that the US Chamber of Commerce said it is suspending its $7.5 million, 21-state campaign, which criticizes the government-run coverage that many Democrats favor, until early next week.

On Wednesday, Conservatives for Patients Rights also said it was temporarily halting its ads, including one running in the Boston area that was aimed at Obama vacationing on Martha's Vineyard.

UPDATE: Asked today about how President Obama looks at some liberal groups' "win one for Kennedy" push on health care, White House spokesman Bill Burton replied, "Our country lost a beloved leader and the politics and implications of that are the last thing on the president's mind right now."

Pressed on whether Kennedy's death is being used in a "political way," Burton said, "We've all experienced a pretty big loss and Americans are going to have different reactions and find different ways to memorialize his life. [The president]'s not going to make a comment on what every single person does to memorialize or remember or talk about Senator Kennedy and his passing. There will be a time when it's appropriate to have discussions on different ramifications, but I don't think anybody thinks that now is it."

In their latest assault on President Obama's health care plans, Republicans are aiming for a vulnerable spot -- the fears of seniors that their care will get worse or more costly.

"Republicans want reform that should, first, do no harm, especially to our seniors," Republican National Committee Chairman Michael Steele writes in an opinion piece in today's Washington Post. "That is why Republicans support a Seniors' Health Care Bill of Rights, which we are introducing today, to ensure that our greatest generation will receive access to quality health care. We also believe that any health-care reform should be fully paid for, but not funded on the backs of our nation's senior citizens."

The bill of rights for seniors includes protecting Medicare from major cuts, preserving the doctor-patient relationship, banning any rationing of care or interference in end-of-life decisions, guaranteeing that seniors can keep their current coverage, and protecting current veterans' health care programs.

Obama and Democrats plan on substantial savings in Medicare, but insist that those changes would not mean less care. They also support more research to determine the most cost-effective treatments, but adamantly deny that would lead to rationing of care -- which they argue is being done by private insurers already.

"Barack Obama campaigned on 'post-partisanship,' " Steele concludes. "As president, however, Obama has shown that he is beholden to his party's left-wing ideologues. It's not too late for him to honor his pledges for bipartisan health-care reform. Reversing course and joining Republicans in support of health care for our nation's senior citizens is a good place to start. Doing so will help him restart the reform process to give Americans access to low-cost, high-quality health care." (Read his full op-ed here.)

The Democratic National Committee responded by saying that the health overhaul would help seniors by holding down costs and closing the so-called donut hole in prescription drug coverage under Medicare Part D. It also said that Republicans are continuing to mislead the public in their attempt to kill the overhaul.

“It should be no surprise that the Republican Party - which whipped many Americans into a frenzy at town hall meetings on health care this month by spreading one lie about reform after another - has now taken to scaring seniors who have nothing to fear and much to gain from reform," DNC spokesman Brad Woodhouse said in a statement. "But what's really incredible is that this feigned interest in Medicare and the plight of seniors is coming from the Republican Party -- the very party which opposed Social Security and only four years ago tried to dismantle it -- and the very Republican Party which opposed the creation of Medicare to begin with. Republicans are fighting against reform for one reason - to 'break' President Obama and gain political advantage. As a result, when it comes to their arguments against reform -- for Republicans it's any port in a storm.”

He may be on vacation, but through the magic of prerecorded video and audio, President Obama is keeping up his health care campaign today.

In his weekly radio and Internet address, Obama both tries to debunk what he calls "outrageous myths" and seeks to rally support.

Taking on his critics, he says that while he welcomes a vigorous debate, "it also should be an honest debate, not one dominated by willful misrepresentations and outright distortions, spread by the very folks who would benefit the most by keeping things exactly as they are."

In the Republican response, Representative Tom Price of Georgia, a doctor by trade, says while that the status quo on health care is unacceptable, giving the government too much control -- represented by the "one-size-fits-all approach" of Obama and congressional Democrats -- would make the situation worse.
"Now whether it’s the government choosing what should be in your family’s health care plan, or a bureaucratic board deciding what treatments are appropriate and who should receive them, the president’s plan is a 1,000-page expression supporting the notion that Washington knows best when it comes to your family’s health care," Price says. "And that’s simply not true."

Obama ticks off some false claims by opponents: "Let’s start with the false claim that illegal immigrants will get health insurance under reform. That’s not true. Illegal immigrants would not be covered. That idea has never even been on the table. Some are also saying that coverage for abortions would be mandated under reform. Also false. When it comes to the current ban on using tax dollars for abortions, nothing will change under reform. And as every credible person who has looked into it has said, there are no so-called 'death panels' -- an offensive notion to me and to the American people. These are phony claims meant to divide us.

Obama also says he does not support a "government takeover" of health care, and tries to clarify the "public option" -- a government plan along the lines of Medicare to compete with private insurers. "It would be just an option; those who prefer their private insurer would be under no obligation to shift to a public plan," he says.

The president, who has used his weekly address to state his case on health care for more than a month now, then goes on to list the help that he wants to give people who already have insurance, including protections from being denied coverage for preexisting coverage and being charged exorbitant out-of-pocket expenses.

"Taken together, the reforms we’re seeking will help bring down skyrocketing costs, which will mean real savings for families, businesses, and government," he says, trying to rally more support.

"It has never been easy, moving this nation forward. There are always those who oppose it, and those who use fear to block change. But what has always distinguished America is that when all the arguments have been heard, and all the concerns have been voiced, and the time comes to do what must be done, we rise above our differences, grasp each others’ hands, and march forward as one nation and one people, some of us Democrats, some of us Republicans, all of us Americans," Obama adds, perhaps somewhat more hopefully than realistically.

In rebuttal, Price says that as opposition to Obama's plan has grown, the president says he wants to "stamp out some of the disinformation floating around out there.

"The problem is the president, himself, plays fast and loose with the facts," Price says." So as someone who’s taken care of patients, I’d like to take a moment to clear up a couple of the President’s worst offenses."

He asserts that while Obama says Americans can keep their insurance plan, a provision in the bill would require every plan within five years to meet new guidelines "that your current plan might not match, even if you like it."

Price also says that a public option plan, "when the government is setting the rules and is backed by tax dollars," will "destroy – not compete – with the private sector.
"But perhaps the most striking misinformation the president has put forth is that there are only two options out there for America -- that it's his way or the highway. That it's either the government running the show -- or insurance companies. The truth is there is a third way -- a better way, a patient-centered way to reform health care," Price says.
And Republicans are offering that approach, he says: "We have plans to increase coverage and lower costs without putting a bureaucrat between you and your doctor.  We believe that what’s good for patients is good for American health care."

Obama's full address can be viewed here and is below.

Price's full address can be viewed here and is below.

Would President Obama's health care push be going more smoothly if his first choice for health reform czar was working for it?

It's a Washington parlor game hypothetical, but it's also interesting that the last person that Obama talked to today on the topic before starting his 10-day vacation was Tom Daschle, the former Senate majority leader who was the nominee to be both health and human services secretary and health czar.

His nomination was derailed by tax issues, and Obama split the job between Kathleen Sebelius as health secretary and Nancy DeParle as health czar. While accomplished in their own right, neither has the combination of congressional clout and political savvy Daschle possesses.

"The president invited Senator Daschle to the White House for a quick check-in on the health insurance reform process and to exchange views on the process moving forward," the White House said in a statement after today's private session.

"Senator Daschle is one of the foremost experts on health care and on the legislative process, and has been a friend and sounding-board for the President for several years. The two agreed that substantive reform that lowers costs, reforms the insurance industry, and expands coverage is too important to wait another year or another administration, and they agreed to stay in touch over the coming weeks and months as this critical effort moves forward.”

It was his most curious turn of phrase as President Obama tried to rally the troops on health care.

Speaking Thursday to Organizing for America, his grassroots army, Obama compared the worries that he's lost his momentum on health care to August 2007, when he was well behind in the Iowa caucuses -- which he eventually won as a springboard to the Democratic nomination -- and to last August, when the buzz over Sarah Palin temporarily boosted the Republican ticket.

"The media was obsessed with it, and cable was 24 hours a day, and 'Obama's lost his mojo,' " the president said to laughter. "You remember all that? There's something about August going into September where everybody in Washington gets all wee-weed up. I don't know what it is. But that's what happens."

The "wee-weed up" part raised some eyebrows, and White House spokesman Robert Gibbs was asked for a definition today.

"I don't know if I should do that from the podium. It's a phrase I use, but..." he said, telling reporters he wanted to keep the briefing "family friendly."

"I think wee-weed up is when people just get all nervous for no particular reason," Gibbs continued. "So this is just sort of an August pundit pattern between people getting overly nervous for something that still has a long way to go.

Finally, Obama's chief spokesman gave it up: The PG-rated term for "wee-weed" is bed-wetting.

Senator Olympia Snowe of Maine and the two other Finance Committee Republicans in the "Gang of Six" trying to come up with a bipartisan health bill are under pressure from the right not to give away the store.

The conservative Club for Growth launched TV ads targeted at Snowe, Mike Enzi of Wyoming, and Charles Grassley of Iowa.

The spot notes the key role the three senators are playing. "There's no harm in talking," the announcer says.

But the announcer then warns that what Democrats are talking about includes a government-run health plan, bureaucrats deciding coverage, new regulations that would kill small business, and tax hikes.

"Tell Senator Snowe not to cave in to the liberals on health care," the announcer concludes.

The Gang of Six had a conference call Thursday night, and according to the Washington Post, they agreed to continue working toward a bill that could win support from the rank-and-file in both parties, despite increasing reports that Democrats and President Obama are prepared to go it alone, if need be.

The group agreed to talk again on Sept. 4, three days before Congress reconvenes after its August recess, the Post said.

If President Obama turns on the TV while on holiday on Martha's Vineyard, he likely won't escape attacks on his health care plan.

Conservatives for Patients' Rights, the group founded by former health executive Rick Scott that has helped organize protests at congressional town halls, is putting up a TV ad called "Surf's Up."

"The beach is nice this time of year," the announcer says over a seaside scene. "But while President Obama vacations, concerns mount about his health care plan."

The announcer criticizes the public option that Obama prefers -- a government plan like Medicare that would compete with private insurers -- and says it would lead to government-run health care, higher taxes, and higher deficits.

"Let's get on with real reform to lower costs and protect patients rights," the announcer concludes.

The group plans to spend $150,000 airing the spot in the Boston-area TV market, including on NESN during games next week between the Red Sox and Obama's beloved Chicago White Sox, CNN says.

Another poll out today is cause for concern for President Obama's health care agenda as he leaves for vacation first at Camp David, then Martha's Vineyard.

In the Washington Post/ABC News survey, 49 percent of Americans say they believe Obama will be able to drive significant improvements in the health care system, down nearly 20 percentage points from before he took office.

As Republicans and other critics continue to hammer his health care proposals, confidence in Obama's overall leadership is also eroding, according to the poll: 49 percent of respondents express confidence that he will make the right decisions for the country, down from 60 percent at the 100-day mark in his presidency.

His overall job approval rating, 57 percent, is down 12 percentage points from its April peak, and his disapproval number has risen to 40 percent, its highest yet.

The national survey was conducted Aug. 13-17 and has a sampling error of plus or minus 3 percentage points.

An NBC News/Wall Street Journal poll released earlier this week suggested that Obama and Democrats had lost control of the health care message as many Americans believed what critics had been saying about the proposals.

A liberal-labor coalition is trying to turn the contretemps over "death panels" on its head with its latest TV ad that says the real death panels are the insurance company committees that deny coverage.

The ad from Americans United for Change, which it says will start airing next week, points out that opponents' claims that Democratic health bills would create committees of bureaucrats who would decide who would receive life-saving care have been widely debunked. (But a key negotiator in the Senate says it won't be in the bill because of the room for misinterpretation.)

"Unfortunately, there are real death panels in America," the announcer says.

Linda Peeno, a former medical director for both Humana Insurance and Blue Cross/Blue Shield, is shown testifying at a congressional hearing, "In the spring of 1987, as a physician, I denied a man a necessary operation that would have saved his life and thus caused his death…and I am haunted by the thousands of pieces of paper on which I have written that deadly word, 'denial.' "

"We need health insurance reform now," the announcer concludes.

“Conservative politicians and pundits will do anything to keep the 'death panels' fantasy alive and well as part of an unscrupulous and concerted effort to kill health insurance reform. But where’s the hysteria from these same conservatives over the real death panels that exist right now in America with the big insurance companies denying millions of Americans the care they need by citing 'pre-existing'’ conditions?” Jeremy Funk, Americans United for Change's communications director, said in a statement today.

It is among the groups supporting President Obama and congressional Democrats in their health overhaul push -- and fighting Republican and conservative groups running ads and organizing protests as members of Congress hear from their constitutents during the August recess.

President Obama is making his health care pitch today to two very different audiences -- one friendly, one not so much.

Obama is on the air with Philadelphia-based talk radio host Michael Smerconish, who is broadcasting his program from the Diplomatic Room in the White House. Smerconish's audience is generally conservative and will likely include quite a few foes of the president's health care proposals, though the host endorsed Obama last year.

Smerconish, who said he has received more than 5,000 emails in the last 24 hours, asked whether Kathleen Sebelius, secretary of health and human services, misspoke when she said on

"She didn't really misspeak," Obama replied, asserting that his message has stayed the same -- that a public option is one way, but not the only way, to control costs. "The press got a little excited and some folks on the left got a little excited."

Obama also disputed that he favors a government takeover of health care. "I would love the private marketplace to handle this without any government intervention," he said. "The problem is, it's not working."

The president said he wants to preserve the private market, but add consumer protections.

In response to a listener's question, Obama strongly disputed claims that the Democratic health care bills would provide coverage to illegal immigrants.

"No one has talked about giving health insurance to illegal immigrants. I want to make that absolutely clear," he said.

But he said it will continue to be the case that if an illegal immigrant shows up in the emergency room, he or she will get treated.

Obama said he doesn't want a situation that a child with tuberculosis isn't treated, then returns to the playground and threatens to infect "our kids."

Plus, he said, there should be "a basic standard of decency" to provide care when someone faces a life-threatening illness or injury.

Another listener asked whether Obama's "knees were buckling a little bit" even with Democrats controlling Congress and the White House.

"I guarantee to you Joe that we're going to get health care reform done," Obama declared, bemoaning what he called "hand-wringing" and media fascination with every legislative twist and turn. "Passing a big bill like this is always messy."

He also said he wants to give Republicans a chance to be part of a compromise, but won't compromise his core principles on health care. (The full transcript of the interview is below.)

Representative Eric Cantor's office responded to Obama's interview by questioning the sincerity of his bipartisan push.

"We would love to know when, exactly – time, date, place – the President or his staff reached out to Republican Leaders?" Brad Dayspring, spokesman for the No. 2 House Republican, said in an email.

"In fact, the White House blatantly ignored our outreach effort. In May, House Republican Leaders sent the President a letter detailing Republican principles, asking to work together on meaningful, bipartisan reform that Americans could support. And the President’s response? Meeting? Nah. Work together? No thanks. Further discussion? Nope. Instead, they went with, ' Thanks for the letter.' ”

Later this afternoon, Obama held an online-phone strategy meeting with Organizing for America, the current iteration of his presidential campaign that is armed with 13 million or so email addresses.

UPDATE: Obama did the pep rally in a small room at the Democratic National Committee, where about 50 volunteers chanted "Yes, we can," Obama's campaign slogan.

According to the press pool report, Obama talked about the hardships of his longshot campaign, and compared them with his push for health care reform.

"Now, we all know this has been an emotional debate. We've seen tempers flare. Accusations have been hurled. And sometimes it seems like one loud voice can drown out all the civil, sensible voices out there," Obama said.

"But remember one thing: Nothing's more powerful than millions of voices calling for change. That's how we won this election. You know this. And that's why, since OFA launched its health reform campaign in June, you've hosted 11,000 events in more than 2,500 towns in every single state and every single congressional district, which is remarkable."

"We are not going to give up now," Obama said after answering questions. (Listen to the event here.) The full transcript of the event is below.

He needs to rally his troops, whom Democratic officials acknowledge have not been as energized by the complex health care debate as by Obama's "change we can believe in" campaign last year. Valerie Jarrett, a top Obama adviser, warned liberal bloggers last week that the health care push is "an uphill battle, and it won't happen unless we energize our base."

David Plouffe, Obama's campaign manager, told supporters in the email invitation for today's huddle that "the special interests and partisan attack groups who oppose reform will not let up, and they will tell whatever lies they can to spread fear. There's a lot more work for all of us to do."

Late Wednesday, the group told backers it has launched its own truth-squadding website (the White House already has one) called "Setting the Record Straight."

"It feels like a new lie about health insurance reform crops up each day. Government taking over all health care? Not true. Euthanasia for seniors? Couldn't be more false. Rationing of care? Reform will stop rationing, not increase it," wrote Organizing for America director Mitch Stewart.

"These lies create fear and anger, and we're seeing the results around the country....It's time to set the record straight -- and, more importantly, expose the special interests and partisan attack organizations behind the lies and misinformation."

Vice President Joe Biden today announced that $1.2 billion in grants are available from the economic stimulus package for projects to accelerate the use of electronic health records -- an area where Massachusetts is at the forefront.

“With electronic health records, we are making health care safer; we’re making it more efficient; we’re making you healthier; and we’re saving money along the way, ”Biden said in the announcement in Chicago. “These are four necessities we need for healthcare in the 21st-century.”

The grants include $598 million to establish 70 Health Information Technology Regional Extension Centers, which will provide hospitals and doctors with hands-on technical assistance, and $564 million to states and agencies to support information sharing with a nationwide system of networks.

"With these programs, we begin the process of creating a national, private and secure electronic health information system. The grants are designed to help doctors and hospitals acquire electronic health records and use them in meaningful ways to improve the health of patients and reduce waste and inefficiency,” added David Blumenthal, the administration's national coordinator for health information technology who is a former doctor at Massachusetts General Hospital and Harvard professor.

“They will also help states lead the way in creating the infrastructure for health information exchange, which enables information to follow patients within and across communities, wherever the information is needed to help doctors and patients make the best decisions about medical care.”

But some specialists warn against expanding current electronic record systems, saying they are cumbersome and cannot easily share information.

Mitt Romney is probably one of the last people President Obama is looking to for advice on how to get a health care bill done.

But the former Massachusetts governor, who sought the GOP presidential nomination last year and could very well run again in 2012, offered some guidance anyway this morning.

Romney said on CBS's "Early Show" that the president is to blame for the slowing momentum on the bill, faulting Obama for giving too much say to House Speaker Nancy Pelosi and other Democratic liberals.

"If the president wants to get something done, he needs to put aside the extreme liberal wing of his party," Romney said.

While Obama has been stumping for a sweeping health care bill, he has left the details of the drafting to Congress, where majority Democrats are divided. Members of the Blue Dog coalition of conservative Democrats have balked at some provisions, and more moderate Democrats in the Senate are still trying to cut a deal with Republicans. The intraparty divisions emerged clearly this week when it appeared that Obama was backing away from insisting that a public option be part of any bill.

Jason Reed/Reuters

Kennedy flashed a trademark smile in April after President Obama signed the Edward M. Kennedy Serve America Act at a Washington school.

By Frank Phillips, Globe Staff

Senator Edward M. Kennedy, in a poignant acknowledgment of his mortality amid a critical time in the national health care debate, has privately asked the governor and legislative leaders to change the succession law to guarantee that Massachusetts will not lack a Senate vote in the event of his death.

In a personal, sometimes wistful letter sent Tuesday to Governor Deval L. Patrick, Senate President Therese Murray, and House Speaker Robert DeLeo, Kennedy asks that Patrick be given the authority to appoint someone to the seat temporarily while voters choose a new senator in a special election.

While Kennedy, who is battling cancer, does not specifically mention his illness or the health reform debate raging in Washington, the implication from his letter is clear: He is trying to make sure that the leading cause of his life -- better health coverage for all -- advances in the event of his death.

Kennedy said in his letter, which was obtained by the Globe, that he supports the current law, which gives voters the power to fill a Senate vacancy. But he said the state and country need two Massachusetts senators.

"I strongly support that law and the principle that the people should elect their senator,” Kennedy wrote. ''I also believe it is vital for this Commonwealth to have two voices speaking for the needs of its citizens and two votes in the Senate during the approximately five months between a vacancy and an election.''

Wanting their voices heard in the health care debate as well, two religious-based groups are holding events today -- but only one will get a cameo appearance by President Obama.

Faith in Public Life had Obama plus a senior administration official for a live webcast call-in this afternoon called “40 Minutes for Health Reform."

UPDATE: The coalition said that an estimated 140,000 people listened in on the call.

In the conference call with the liberal religious leaders, Obama called health insurance coverage for all Americans a "core ethical and moral obligation." He disputed claims that Democratic bills fund abortions, give benefits to illegal immigrants, or create "death panels" that would decide who gets expensive end-of-life treatment.

"I know that there's been a lot of misinformation in this debate and there are a some folks out there who are, frankly, bearing false witness," Obama said. "I need you to spread the facts and speak the truth."

The group says that "people of faith who have experienced the consequences of our broken system will share their stories" and that "clergy working in their own communities to reform health care will highlight ways they are impacting the debate. "

The group, which is sponsored by more than 30 religious denominations and organizations, says it includes lay leaders, clergy, and others from across the political spectrum and from different ideologies, religious traditions, and races.

Republican National Committee Chairman Michael Steele put his own spin on the meeting with faith leaders, who talk about the moral dimension of health care.

“President Obama was hoping to be on offense during the month of August to travel the country and put on the hard sell for government-run health care," Steele said in a statement this afternoon. "Instead, President Obama is frantically struggling to shore up his base. The religious left talks about their desire for ‘social justice.’ No bill that funds abortion or strips health care services away from seniors and low-income Americans can or should be considered just, and that is precisely what the president’s plan does.”

Meanwhile, another organization will hold a counter-conference call later tonight to offer an anti-abortion alternative and mobilize its voters on health care. More than 320,000 pro-life voters will be invited to take part in the teleconference.

“Tens of thousands of pro-lifers across America have already contacted their legislators to urge the preservation of our long-standing tradition of limiting taxpayer funds for abortion, but now is the time to turn up the heat," Susan B. Anthony List President Marjorie Dannenfelser said in a statement. "Without language to explicitly exclude an abortion mandate, the legislation will result in Americans footing the bill for abortion on-demand in the largest expansion of government-backed abortion since Roe v. Wade.”

UPDATE: That group claimed that 160,000 took part in its conference call.

Charmaine Yoest, president of Americans United for Life, added in a statement:

“The call for reform as a ‘moral imperative’ rings hollow with Americans because the overwhelming majority firmly oppose taxpayer funding for abortion coverage. Abortion is not healthcare. Real healthcare respects life. As the Hippocratic Oath reminds us, health care grounded in a moral imperative protects the most vulnerable among us including the unborn and the elderly. Real healthcare does not fund the destruction of unborn children and it does not delay or deny care to the sick, elderly and weak among us, but that is the prospect we currently face.”

And Tony Perkins, president of the Family Research Council, said in a statement:

“The Religious Left, that has blindly put their faith in this Administration’s attempted takeover of health care, has repeatedly said they do not want to get into the weeds on the policy aspects of health care reform. Instead they say their focus is on the moral mandate that all people have health care. Ensuring that taxpayer are not forced to fund abortions and that the conscience rights of health care workers are protected is not getting into the weeds, but rather it is ensuring that health care reform is kept on a higher moral plain.”

There's quite a bit of buzz today that Democrats might go it alone on a health care overhaul, giving up on a bipartisan bill because of Republican intransigence and unwillingness to compromise.

But that prospect isn't all that new.

In April, congressional Democrats reached a deal that would let the Senate pass a bill with a simple majority of 51 votes, rather than the 60 votes needed to overcome a Republican filibuster. Under that agreement, the parliamentary maneuver -- known as reconciliation -- would be used only if the Senate fails to pass a bill by Oct. 15.

The New York Times and CNN, among others, are reporting that there is more focus on just getting enough Democrats' votes to pass a health care bill after the Republican criticism during the town halls being held by members of Congress during the August recess.

But the White House is already pushing back, with spokesman Robert Gibbs telling reporters this morning that it's still only mid-August and there is plenty of time to shape a bill that could win broad support.

Gibbs told reporters this afternoon that the White House still wants a bipartisan deal and believes that key Republicans are still working toward one in good faith.

"The president believes strongly in working with Republicans and Democrats, independents, any that seek to reform health care, that want to see costs cut, coverage increased, insurance reforms implemented that no longer discriminate against families and individuals," he said.

But asked whether that preference trumps Obama's oft-stated goal of getting a bill passed this year, Gibbs replied, "It does not."

And Senate Finance Chairman Max Baucus said he's still optimistic that his bipartisan "Gang of Six" is on track to produce a compromise bill by Sept. 15.

Republicans, instead of going ballistic about being frozen out, are treating the possibility as old news. The office of Representative Eric Cantor, the No. 2 House Republican, said today that House Speaker Nancy Pelosi has made it clear for a while now that Democrats would pass a bill without GOP support and that the White House has not made much effort at reaching out to Republicans.

“The announcement that Democrats will abandon bipartisanship in order to pass their costly government takeover of health care is nothing new," House Republican leader John Boehner said in a statement today. "From day one, the White House has taken a go-it-alone approach on health care. Months ago, Republicans sent the president a letter noting areas of potential common ground on health care reform and requesting a meeting with him to discuss a bipartisan way forward.  The administration rejected our efforts to work together, choosing instead to craft a costly government takeover of health care and to march forward on a partisan basis solely with Democrats in Congress. 
  
“Now, Democratic leaders find themselves all alone in support of a plan that will drive health care costs higher than ever, increase the federal deficit, slash Medicare, and let government bureaucrats make personal medical decisions that only patients and doctors should make," Boehner added. "The more the American people learn about this plan, the less they like it.  It’s time for President Obama, Speaker Pelosi, and congressional Democrats to scrap this costly plan, start over and work with Republicans on reforms that make health care more affordable and accessible for middle-class families and small businesses.”

A town hall held by Representative Barney Frank has joined the pantheon of at-times rowdy face-offs on health care this month.

But instead of a shouting critic getting the best of the congressman, this time it was a zinger from the Newton Democrat that drew the most notice and was featured on CNN.

His town hall Tuesday night in Dartmouth drew more than 500 people, who asked how the nation could afford a health care overhaul and who protested a bigger government role. He admonished the protestors, saying that shouting prevented a serious debate on the issue.

He reserved his most biting response, however, for one questioner, a woman who went to the microphone carrying a poster of President Obama with a Hitler-style mustache. The exchange has been replayed repeatedly on cable TV today.

"Why do you continue to support a Nazi policy?" she asked Frank.

"On what planet do you spend most of your time?" he shot back, as the crowd applauded.

Blasting the woman -- apparently a supporter of fringe presidential candidate Lyndon LaRouche -- for comparing a bid to improve health care to the Nazis, Frank went on to say that it was "a tribute to the First Amendment that this kind of vile, contemptible nonsense is so freely propagated."

And for good measure, he added, "Ma'am, trying to have a conversation with you would be like trying to argue with a dining room table. I have no interest in doing it."

With the health care fight focusing on the so-called public option, a new poll shows that Americans are divided on the issue.

According to the NBC News/Wall Street Journal survey released today, 47 percent of Americans oppose a government plan to compete with private insurers, while 43 percent support it. That's the reverse of last month, before it became such a big issue, when 46 percent backed the idea and 44 percent were against it.

The poll also found that 48 percent agreed with opponents' argument that a public plan would reduce choice of doctors and limit treatment options, while 45 percent agree with supporters' description that the public plan would help lower costs and extend coverage to the uninsured.

UPDATE: The poll also found that Obama's marks on the handling of health care are dropping to 47 percent disapproval and 41 percent approval. But that's still better than Republicans, who earned 61 percent disapproval on the issue.

But 54 percent of respondents said they were worried about the health care overhaul "going too far." And majorities said that the overhaul would cover illegal immigrants, mean a government takeover, and lead to tax-funded abortions -- though the bill sponsors dispute that. A minority, 45 percent, said the changes would mean "death panels" -- the widely debunked notion that a provision would create committees of bureaucrats who would decide when to stop medical care to the elderly.

The poll, conducted Saturday through Monday, has a margin of error of plus or minus 3.5 percentage points.

President Obama's grassroots organization will hold a forum on Thursday with the president on the health care fight and how it can help.

"The President will update us on the fight to pass real health insurance reform -- what's happening in D.C. and what's happening around the country. He'll lay out our strategy and message going forward and answer questions from supporters like you. And we'll unveil the next actions we'll organize together," Obama's former campaign manager, David Plouffe, wrote the 13 million members of Organizing for America this afternoon.

"This is a critical time in this President's administration, and in the history of our country. I hope you can join us," he said in the invitation to take part by phone or via the web.

In the email, Plouffe says that Organizing for America has organized nearly 12,000 events since it began its health care push in June and that about 60,000 members visited members of Congress during their recess. But the New York Times reported over the weekend that many members aren't as excited and involved in health care as they were during the campaign.

It's a tale of two letters as the health care debate continues apace today.

Sixty House Democrats have written a letter of protest to Health and Human Services Secretary Kathleen Sebelius, who prompted a rebellion by liberals, by saying Sunday that the "public option" -- a government health plan to compete with private insurers -- was not an "essential element" of a health care overhaul as far as the Obama administration was concerned.

Their letter (first reported by the firedoglake.com and Plum Line blogs) is signed by the co-chairpersons of the Congressional Progressive Caucus and the chairwoman of the Congressional Black Caucus. (Read it here.)

"The opportunity to improve access to health care is a onetime opportunity," they wrote. "Americans deserve reform that is real-not smoke and mirrors. We cannot rely solely on the insurance companies’ good faith efforts to provide for our constituents. A robust public option is essential, if we are to ensure that all Americans can receive health care that is accessible, guaranteed and of high-quality."

UPDATE: Sebelius, herself, tried to get back on message today, repeating the White House line that Obama hasn't changed his position and still prefers a public option, though the administration is open to other ways to offer competition to private insurers.

"All I can tell you is that Sunday must have been a very slow news day because here's the bottom line: Absolutely nothing has changed. We continue to support the public option. That will help lower costs, give American consumers more choice and keep private insurers honest," she said during a speech on Medicare to the US Commission on Aging.

"If people have other ideas about how to accomplish these goals, we'll look at those, too. But the public option is a very good way to do this. I've seen it work for state employees in states like Kansas where a public option is side-by-side with private insurers, offering competition and choice for state employees. It's what it does when it provides choice in markets that are often dominated by one insurance company, a monopoly that can charge what it wants because it has no competition."

On the other side, House GOP leader John Boehner has written to Pharmaceutical Research and Manufacturers of America (PhRMA) President and CEO Billy Tauzin, urging him to reconsider the powerful drug industry's support of Obama's overall thrust, or as Boehner puts it "Washington Democrats’ government takeover of health care." (Read it here.)

The drug industry agreed to kick in $80 billion in savings over 10 years to help pay for the overhaul and help fund a pro-reform ad campaign. In return, the White House agreed not to push for additional concessions.

"Appeasement rarely works as a conflict resolution strategy," Boehner writes. "This is as true in the arena of policymaking as it is in schoolyards across America. When a bully asks for your lunch money, you may have no choice but to fork it over. But cutting a deal with the bully is a different story, particularly if the “deal” means helping him steal others’ money as the price of protecting your own."

"The simple truth is, two wrongs don’t make a right. And the short-sighted health care deal PhRMA struck with the Obama Administration at your urging provides confirmation of this time-tested maxim on an epic and tragic scale."

"PhRMA would do well to halt this short-sighted, misguided campaign and listen to the American people, rather than continue to collaborate on an effort to spin them," Boehner adds.

The liberal backlash is already starting.

Seeking Republican support for its healthcare overhaul, the White House suggested over the weekend that it would be open to dropping the so-called public option -- a government-run insurance plan to compete with private insurers and keep them honest on price and quality.

The Obama team hinted that it would consider a nonprofit health cooperative -- being proposed by key senators -- as an alternative to a government plan.

Howard Dean, the former Vermont governor and Democratic Party chief during last year's campaign, urged the president today to stay firm with a public option.

"You can't really do health reform without it," Dean, a leader of the party's liberal wing, said on morning news shows. He called a direct government role "the entirety of health care reform."

On MSNBC, Dean said this afternoon that a while a few small coops have worked in places like Washington state, "it doesn't work" nationally.

The problem, he said, is it was tried in the form of Blue Cross/Blue Shield, which started as a nonprofit and which now acts like a private insurer.

Without a public option, the overhaul bill would just funnel more money to an industry that has acted "abominably," Dean said.

House Speaker Nancy Pelosi renewed her support for a public option, quoting Obama's own words.

“As the President stated in March, ‘The thinking on the public option has been that it gives consumers more choices and it helps keep the private sector honest, because there's some competition out there.'

“We agree with the President that a public option will keep insurance companies honest and increase competition," Pelosi said in a statement. "There is strong support in the House for a public option.  In the House, all three of our bills contain a public option, as does the bill from the Senate HELP Committee. A public option is the best option to lower costs, improve the quality of health care, ensure choice and expand coverage. The public option brings real reform to lower costs over the 10-year period of the bill.”

Representative Anthony Weiner, a New York Democrat who has compared leaving private insurers in charge to "making a pyromaniac the fire chief," predicted that the bill won't win a majority in the House without the public plan.

"I would love to be one of the big supporters of the Obama plan, but I've got to know that it includes a public option." he said this afternoon on CNN.

"Look, the president has to lead on this and he has to say very clearly a public option is important that we could -- that we hold these insurance companies accountable and provide some competition," Weiner added. "I would love to be the one carrying the ball for him, but unless he says a public option is the way to go, I'm going to be a no and so will a lot of people."

Senator Russ Feingold, a Wisconsin Democrat, weighed in with his own statement:

"A public option is a fundamental part of ensuring health care reform brings about real change. Opposing the public plan is an endorsement of the status quo in this country that has left tens of millions of Americans uninsured or underinsured and put massive burdens on employers.  I have heard too many horror stories from my constituents about how the so-called competitive marketplace has denied them coverage from the outset, offered a benefit plan that covers everything but what they need or failed them some other way.  A strong public option would ensure competition in the industry to provide the best, most affordable insurance for Americans and bring down the skyrocketing health care costs that are the biggest contributor to our long-term budget deficits. I am not interested in passing health care reform in name only.  Without a public option, I don't see how we will bring real change to a system that has made good health care a privilege for those who can afford it.”

The AFL-CIO, the nation's largest labor federation that has been a loyal Obama ally, also said it would "forcefully" urge the White House and Senate to keep the public option in the bill.

"A quality public health insurance option is a crucial part of health care reform to keep private insurance companies honest, hold down costs and ensure that everybody has a health care choice available. Key to holding down costs for families, for businesses, and for the federal budget is forcing insurance companies to compete. And the only way to force real competition on the insurance companies is a strong public plan option," president John Sweeney said in a statement.

"Unfortunately, the usual suspects opposed to reform are trying to hijack the reform process and attacking the public health insurance plan option because they are afraid of competition and they want to keep gouging working families. But unless we take decisive steps to stop the crippling rise of health costs, we will have squandered this moment of opportunity."

UPDATE: Though many observers heard a change in the language that Obama used at a town hall on Saturday and that Sebelius used, the White House insisted today that Obama's position had not shifted significantly.

"His preference is a public option," White House spokesman Robert Gibbs told reporters on Air Force One returning from the president's four-day Western trip. "If there are other ideas, he's happy to look at them....I think this is true not only for the issue of health care, but for virtually every other issue that he'll ever deal with in public life is he has goals about what he wants to accomplish and he's not necessarily wedded to only one way of getting there. I think he's said that a hundred times."

Gibbs added, "I challenge you guys all to go back and see what we've said about this over the course of many, many, many, many months, and you'll find a boring consistency to our rhetoric."

Republicans, meanwhile, are not welcoming the possible concession.

Instead, the Republican National Committee sent out a list of comments from Democrats to back up its case that co-ops could be a disguise for another form of the public option.

" 'Public option' by any other name is still government-run health care," the RNC said, adding that the reports of the demise of the public option are "greatly exaggerated."

Still, the issue could divide the Democratic coalition that has been united behind Obama on health care.

Even as Kathleen Sebelius, the health and human services secretary, was saying on CNN Sunday that the public option was not an "essential element" for reform, the Democratic National Committee was all over Dick Armey, a former House Republican leader and now head of the conservative group FreedomWorks, for saying on NBC that a government insurance option would amount to tyranny.

"If you give a government program and let me choose to be in or choose to be out, that's generosity. If you force me in, irrespective of my desires, that's tyranny," Armey said.

DNC spokesman Brad Woodhouse responded, “If Dick Armey thinks government involvement in health care is tyranny, he must be forgetting or ignoring the fact that Medicare is a government plan that has been praised as one of the most successful programs ever -- a plan which is popular among seniors and runs better and with lower administrative costs than virtually any private insurance plan. If Republicans like Dick Armey are going to continue to rail against government involvement in health care, they should come forward to call for the abolition of Medicare and Medicaid and if not, just admit that their rhetoric is just part of their political strategy to 'break' the President and derail reform.”

President Obama, all about health care all the time recently, returned his attention today again to the wars in Afghanistan and Iraq.

For the first time, an African-American commander-in-chief addressed the nation's largest group of combat veterans, the Veterans of Foreign Wars convention in Phoenix.

While Obama has been stumping for his health care plan, renewed violence is threatening the handover of security to the government in Iraq, where 130,000 US troops remain. Obama has pledged to withdraw all combat troops by next August.

"The transition to full Iraqi responsibility for their own security is now underway. This progress is a testament to all those who have served in Iraq, both uniformed and civilian. And our nation owes these Americans -- and all who have given their lives -- a profound debt of gratitude," Obama told 13,000 VFW members.

"As Iraqis take control of their destiny, they will be tested and targeted. Those who seek to sow sectarian division will attempt more senseless bombings, more killing of innocents. This we know," he added. "But as we move forward, the Iraqi people must know that the United States will keep its commitments."

In Afghanistan, US and coalition forces dealt with the bloodiest month yet in July and casualties are piling up this month as well in advance of a key national election. About 62,000 US troops are fighting there, including most of the 21,000 additional forces that Obama dispatched to lead a new strategy to root out al Qaeda and its Taliban allies in the remote border region with Pakistan.

"They've gone into new areas -- taking the fight to the Taliban in villages and towns where residents have been terrorized for years. They're adapting new tactics, knowing that it's not enough to kill extremists and terrorists; we also need to protect the Afghan people and improve their daily lives. And today, our troops are helping to secure polling places for this week's election so Afghans can choose the future that they want," Obama said.

"These new efforts have not been without a price. The fighting has been fierce. More Americans have given their lives. And as always, the thoughts and prayers of every American are with those who make the ultimate sacrifice in our defense. As I said when I announced this strategy, there will be more difficult days ahead. The insurgency in Afghanistan didn’t just happen overnight. And we won’t defeat it overnight. This will not be quick nor easy," the president added.

"But we must never forget. This is not a war of choice. This is a war of necessity. Those who attacked America on 9/11 are plotting to do so again. If left unchecked, the Taliban insurgency will mean an even larger safe haven from which al Qaeda would plot to kill more Americans. This is not only a war worth fighting. This is fundamental to the defense of our people."

In his speech, the president also reprised "a vision American leadership" that amounts to the "Obama doctrine" on the use of military force: "I have made it a priority to enlist all elements of our national power in defense of our national security -- our diplomacy and development, our economic might, and our moral example. Because one of the best ways to lead our troops wisely is prevent the conflicts that cost American blood and treasure tomorrow."

"I will only send you into harm's way when it is absolutely necessary," he added. "When I do, it will be based on good intelligence and guided by a sound strategy. I will give you a clear mission, defined goals, and the equipment and support you need to get the job done."

The Obama doctrine also includes a top-to-bottom review of Pentagon spending and weapons procurement to root out waste and fraud. "We cannot build the 21st century military we need -- and maintain the fiscal responsibility that Americans demand -- unless we fundamentally reform the way our defense establishment does business," he said. "It's a simple fact. Every dollar wasted in our defense budget is a dollar we can't spend to care for our troops, or protect America, or prepare for the future."

He threw in a joke about an expensive new presidential helicopter he doesn't want: "Maybe you heard about this. Among its other capabilities, it would let me cook a meal while under nuclear attack. I’ll tell you something. If the United States of America is under nuclear attack, the last thing on my mind will be whipping up a snack."

Obama also stressed his efforts to help returning veterans, including the new GI Bill that includes enhanced educational benefits.

"We will fulfill our responsibility to our forces and our families," he said. "That is why we're increasing military pay, that's building better family housing and funding more childcare and counseling to help families cope with the stresses of war. And we've changed the rules so military spouses can better compete for federal jobs and pursue their careers.

"We will fulfill our responsibility to our wounded warriors. For those still in uniform, we're investing billions of dollars for more treatment centers, more case managers, and better medical care so our troops can recover and return to where they want to be -- with their units."

Many veterans are also wary about what a health care overhaul would mean to them, especially after the Obama administration initially floated the idea of charging vets' private insurance for treatment related to service injuries.

The proposal was designed to generate more than $540 million a year for the Department of Veterans Affairs, but after veterans' groups leaders complained in March, the White House said that the president, after hearing concerns that the proposal "might, under certain circumstances, affect veterans and their families' ability to access health care," has "instructed that its consideration be dropped."

To ease those concerns, Obama made a blanket promise today: "One thing that reform won't change is veterans health care. No one is going to take away your benefits. That is the plain and simple truth."

Obama's full remarks are below:

The war of words over health care continues today in dueling radio/Internet addresses.

In one corner, President Obama, who in his weekly remarks, said that with health care overhaul close, the special interests are doing their best to scare and mislead Americans.

In the other corner, Senator Orrin Hatch of Utah, who delivering the Republican address, says that Democrats are rushing through a health care bill and that their solution is mostly throwing taxpayers' money at the problem.

They're both trying to win the public as members of Congress spend the month of August at home listening to their constituents before returning next month to resume work on legislation that Obama wants on his desk this year.

Obama directly addresses one Republican claim that a provision to offer counseling on hospice care and other end-of-life issues amounts to government "death panels" that would decide who deserves medical treatment -- and who doesn't . Though the claim has been widely debunked, a bipartisan group of senators have agreed to drop the provision, which is in House Democrats' bill, from the Senate draft.

"That rumor began with the distortion of one idea in a Congressional bill that would allow Medicare to cover voluntary visits with your doctor to discuss your end-of-life care -- if and only if you decide to have those visits. It had nothing to do with putting government in control of your decisions; in fact, it would give you all the information you need – if you want it – to put you in control of your decisions," says Obama, who said "it's disappointing, but it’s not surprising" that reform opponents are resorting to such tactics.

"Those who would stand in the way of reform will say almost anything to scare you about the cost of action," Obama adds. "But they won’t say much about the cost of inaction. If you’re worried about rationed care, higher costs, denied coverage, or bureaucrats getting between you and your doctor, then you should know that’s what’s happening right now. In the past three years, over 12 million Americans were discriminated against by insurance companies due to a preexisting condition, or saw their coverage denied or dropped just when they got sick and needed it most. Americans whose jobs and health care are secure today just don’t know if they’ll be next to join the 14,000 who lose their health insurance every single day. And if we don’t act, average family premiums will keep rising to more than $22,000 within a decade."

But for his part, Hatch pushes back at Democrats who have called the much-publicized protests at some town halls "un-American."

"Although I strongly encourage the use of respectful debate in these town halls, we should not be stifling these discussions," he says. "There is nothing ‘un-American’ about disagreements. In fact, our great nation was founded on speaking our minds."

The reason people are protesting is that they have legitimate worries about the proposals being offered by Obama and congressional Democrats.

"A big reason for this concern is that nearly 85 percent of Americans have coverage and they are really worried about what reform means for them. Especially our seniors," Hatch says.

“Republicans in Congress agree with the majority of Americans who believe that just throwing more taxpayer dollars at a problem will not deliver meaningful reform. Telling the American public that the solution for solving a $2.5 trillion health care system is to simply spend another trillion dollars in our current economy, just does not make sense," Hatch adds.

Instead, any overhaul should focus on making coverage more affordable, banning insurers from denying coverage due to a pre-existing condition, and giving states more flexibility to cover the uninsured, he says.

Obama's speech can be viewed here, and his full address is below. Hatch's speech can be viewed here, and his full remarks are below.

President Obama, trying to regain momentum on his health care plan, took to Montana this afternoon to continue his critique of insurers.

In the second of three town halls this week designed to convince Americans who have insurance that an overhaul would benefit them, Obama blasted insurance companies that revoke or water down coverage when patients get seriously ill.

"They get sick, and suddenly that's when they get dropped," he said, saying that responsible Americans are being held hostage by rogue insurance firms.

"It's wrong....We're going to fix it when we pass health insurance reform this year," he told a crowd of about 1,300 in an airplane hangar in Belgrade, just outside Bozeman.

When Americans hear such horror stories, he said, they should think, "There but the grace of God go I."

Obama addressed what he called the emotional debate and the tempers flaring at some congressional town halls.

"TV loves a ruckus," he said. But what people aren't seeing on television and what "makes me proud" are many constructive meetings across the country where people are having difficult conversations about health care issues.

"That's how democracy is supposed to work," the president said.

"For all the scare tactics out there, what is truly scary ... is if we do nothing," Obama said, imploring, "Fight the fear."

Obama made a point of saying none of the questions had been pre-screened for the town hall.

But the initial questions were as friendly as they were in New Hampshire earlier this week.

A young single mother of two, including a disabled son with diabetes and epilepsy, asked whether he would lose Medicaid under Obama's plans.

The president said savings in the Medicaid program would not lower benefits. "You are a heroic mom," Obama added. "Your son's lucky."

The first semi-combative question came from a man who identified himself as a National Rifle Association member and who asked how Democrats plan to pay for health care without a tax increase.

Obama said if the bill costs $800 billion to $900 billion over 10 years, two thirds can come from savings and eliminating subsidies to insurance companies. The other third will have to come from some form of tax increase.

The president said he still prefers his proposal to limit income tax deductions for higher-income Americans. The congressional bills have different ideas, but he said he will keep his campaign commitment not to raise taxes on families making less than $250,000 a year.

For his last questions, Obama asked for a skeptic.

He got an insurance salesman who asserted that insurers have good ideas for health reform, and asked why Obama is "vilifying" insurance companies.

Obama acknowledged that insurers are offering some good proposals, but some insurers are funding campaigns against any kind of reform. He said he wants to keep private insurers, but he also wants to ban certain practices that are unfair to Americans.

Obama, sans tie to be Western casual and since his trip is also partly family vacation to national parks, joked that it was nice to be in a state with moose, elk, and bull: "In Washington, you mostly have just bull. So this is a nice change of pace."

(His full opening remarks and answers to questions are below.)

To emphasize the message of the day, Obama was also introduced by Katie Gibson, a cancer survivor who was told in 1995 that she had less than a year to live and lost her coverage when she and her husband moved to Montana.

Setting up the town hall, Obama's grassroots group from his campaign, Organizing for America, released a web video this morning that details the story of one woman whose coverage was dropped after she was diagnosed with breast cancer.

The web video shows Robin Beaton of Waxahachie, Tex., testifying last month before the House Subcommittee on Oversight and Investigations about how her insurer retroactively dropped her coverage three days before she was scheduled to have surgery to remove tumors.

Saturday in Colorado, Obama's message of the day is expected to be insurers that charge exorbitant out-of-pocket costs.

In the first town hall this week, Tuesday in Portsmouth, N.H., Obama highlighted insurers who don't cover preexisting conditions. He was introduced by Lori Hitchcock, a 52-year-old, single, self-employed Portsmouth resident who could not get insurance after being diagnosed with Hepatitis C in 2003.

Obama's healthcare plan, and bills drafted by congressional Democrats, would ban all three insurer practices.

Montana is the home state to a key player in the congressional debate, Senate Finance Chairman Max Baucus, a Democrat. He spoke breifly before Obama, saying that he's going around the Big Sky state busting myths and telling the truth.

But unlike New Hampshire, which Obama won last November, Montana is a Republican state that went for GOP nominee John McCain.

And Obama will be greeted with a TV ad running in the state and financed by Conservatives for Patients' Rights, an advocacy group led by a former healthcare executive that has been helping organize protests at congressional town halls.

The spot shows a patient talking with her doctor, then a bespectacled, bow tie-wearing government bureaucrat appears with a clipboard labeled, "FEDERAL HEALTH POLICE."

The announcer urges viewers to oppose the public insurance option that Obama and many Democrats in Congress want as part of the overhaul. "It's not too late to put patients first," he says.

Though the idea that the health care overhaul bills call for "death panels" that would decide end-of-life care has been widely debunked, the Senate Finance Committee is dropping the controversial provision from its version.

Senator Charles Grassley of Iowa, the panel's top Republican and one of six committee members trying to negotiate a bipartisan bill, said in a statement today that the provision "could be misinterpreted and implemented incorrectly."

The provision in the House bill would allow Medicare to pay doctors for voluntary counseling sessions on end-of-life issues, including living wills and hospice as an option for the terminally ill. It is supported by the American Medical Association and the National Hospice and Palliative Care Organization.

But the provision has generated a huge uproar, particularly after Sarah Palin, the 2008 Republican vice presidential nominee, called it "downright evil."

In a Facebook posting late Wednesday night, Palin argued that the elderly and ailing could be coerced into accepting minimal end-of-life care to reduce health care costs. "With all due respect, it's misleading for the president to describe this section as an entirely voluntary provision that simply increases the information offered to Medicare recipients," she wrote. "It's all just more evidence that the Democratic legislative proposals will lead to health care rationing."

White House spokesman Robert Gibbs said today that "death panels" are the biggest misconception the administration is trying to rebut.

In an email to Obama supporters and a letter posted on the White House website, senior adviser David Axelrod included the claim that the health care proposals would encourage "euthanasia" among eight "common myths."

"It does not. It’s a malicious myth that reform would encourage or even require euthanasia for seniors. For seniors who want to consult with their family and physicians about end-of life decisions, reform will help to cover these voluntary, private consultations for those who want help with these personal and difficult family decisions," Axelrod wrote.

In his town hall on health care on Tuesday in Portsmouth, N.H., President Obama took on the issue head-on.

"The rumor that's been circulating a lot lately is this idea that somehow the House of Representatives voted for 'death panels' that will basically pull the plug on grandma because we've decided it's too expensive to let her live anymore," he told the crowd.

"It turns out that I guess this arose out of a provision in one of the House bills that allowed Medicare to reimburse people for consultations about end-of-life care, setting up living wills, the availability of hospice, et cetera. So the intention of the members of Congress was to give people more information so that they could handle issues of end-of-life care when they're ready, on their own terms. It wasn't forcing anybody to do anything. This is I guess where the rumor came from.

"And somehow it's gotten spun into this idea of 'death panels.' I am not in favor of that....I want to clear the air here."

In his statement, Grassley said, "On the end-of-life issue, there's a big difference between a simple educational campaign, as some advocates want, and the way the House committee-passed bill pays physicians to advise patients about end of life care and rates physician quality of care based on the creation of and adherence to orders for end-of-life care, while at the same time creating a government-run program that is likely to lead to the rationing of care for everyone.

"On the Finance Committee, we are working very hard to avoid unintended consequences by methodically working through the complexities of all of these issues and policy options. That methodical approach continues.  We dropped end-of-life provisions from consideration entirely because of the way they could be misinterpreted and implemented incorrectly. Maybe others can defend a bill like the Pelosi bill that leaves major issues open to interpretation, but I can't."

The White House asserted again today that the screaming at health care town halls all over cable TV is not representative of what's happening across the country.

To buttress that point, the Democratic National Committee sent out a list of reports in local newspapers about less heated events.

"Outside the echo chamber of 24-hour cable news, Americans all across the country are attending town halls, holding coffee shop conversations and engaging in respectful, honest debates about the best way to achieve health insurance reform. As the president continues to forge ahead, making historic progress in his effort to reform America’s broken health insurance system, please see below for coverage of the conversations you haven’t been hearing," the DNC said.

White House spokesman Robert Gibbs said today there are more reasoned discussions on health care going on in the town halls.

"I think people are getting the feedback that they're having very good conversations about what's in the legislation -- what people would like to see, what options they want to have, why they think it's important," he said.

"I said this yesterday, I'll say this again: while I appreciate that you all have decided that every town hall meeting ends in pushing, shoving and yelling...they're not completely indicative of what's going on in America."

Still, the administration will continue trying to rebut attacks on Obama's proposals, he said.

"I think he believes very strongly, as we talked about yesterday, that it is important to address misconceptions or misimpressions that have been left out there about the bills. I do believe that the president feels strongly that when he makes his case, it helps the case for overall health care reform," Gibbs told reporters during his daily briefing.

"So he felt very satisfied with what happened in New Hampshire. He was able to address concerns that people had."

Meanwhile, White House senior adviser David Axelrod sent an e-mail to Obama supporters listing eight reasons why an overhaul of the health care system is essential and listing what he called eight “common myths” about the overhaul effort. The e-mail asks supporters to forward the message to someone who “has a question about reform.”

“Let’s start a chain e-mail of our own” to counter “the viral e-mails that fly unchecked and under the radar,” Axelrod wrote.

President Obama is on the campaign trail for his health care plan, trying to fend off what he calls "wild" accusations and rumors.

But Republicans are trying to turn the tables.

The Republican Naitonal Committee has launched a new website that includes material accusing Obama and Democrats of making inflated claims that under the overhaul anyone can keep their doctor or coverage if they want, and that middle-class Americans won't see higher taxes under the proposals.

"There is no place for outlandish rumor or outrageous rhetoric in the debate for the affordable and accessible health care reform we all want," RNC Chairman Michael Steele wrote supporters today in a fund-raising email.

"The Republicans want an honest and open debate about how to reform health care, but it is the Democrats who do not want to have a legitimate discussion on the issues. Nancy Pelosi, Harry Reid and their liberal special interest cronies are resorting to calling concerned citizens who have questions about their health care schemes 'astroturf,' 'un-American,' and even 'political terrorists.' "

The RNC also has a web video that asserts that health care is Obama's latest experiment, after the economic stimulus package, and America can't take the risk. "Now we face his most dangerous experiment of all -- government takeover of health care," the announcer says.

Meanwhile, 2008 GOP vice presidential nominee Sarah Palin is fighting back against Democrats (and independent fact-checkers) who have assailed her claims that the healthcare bills call for "death panels" that would decide end-of-life care. The bills do offer end-of-life counseling that is voluntary.

"Yesterday President Obama responded to my statement that Democratic health care proposals would lead to rationed care; that the sick, the elderly, and the disabled would suffer the most under such rationing; and that under such a system these ‘unproductive’ members of society could face the prospect of government bureaucrats determining whether they deserve health care,” she wrote on her Facebook page Wednesday night.

"With all due respect, it’s misleading for the president to describe this section as an entirely voluntary provision that simply increases the information offered to Medicare recipients.”

A powerful, deep-pocketed new coalition is launching a $12 million TV ad campaign today in support of a health care overhaul.

Calling themselves Americans for Stable Quality Care, the group includes three vested interests in the debate: PhRMA, the drug companies' lobby; the American Medical Association, the big doctors' group; and the Federation of American Hospitals. It also includes two groups supportive of President Obama, FamiliesUSA and the Service Employees International Union.

Notably, the coalition does not include the insurance industry, which has been increasingly cast by Obama and Democrats as the bad guy in the debate.

"What does health insurance reform mean for you?” asks the ad’s narrator. “It means you can’t be denied coverage for a pre-existing condition, or dropped if you get sick. It means putting health-care decisions in the hands of you and your doctor. It means lower costs, a cap on out-of-pocket expenses, tough new rules to cut waste and red tape, and a focus on preventing illness before it strikes. So what does health insurance reform really mean? Quality, affordable care you can count on."

The battle for public opinion on a healthcare overhaul appears to be at a stalemate.

A new Gallup Poll released today found that support for President Obama's handling of the issue has stayed status quo over the past three weeks -- as conservative activists have swarmed congressional town halls to register their opposition and as the White House has stepped up its sales pitch.

In a poll conducted Aug. 6-9, 49 percent of Americans said they disapproved of the president's handling of healthcare and 43 percent approved -- compared to 50 percent disapproval and 44 percent approval in a survey done July 17-19.

Obama's marks on healthcare are the lowest of four issues, with the others being education, foreign affairs, and the economy. And his approval ratings on issues are lower than his overall job approval rating of 54 percent.

The president held a town hall in Portsmouth, N.H., on Tuesday to hit back at his critics and try to clarify what his healthcare proposals don't include. He has two more scheduled this week, in Bozeman, Mont., and Grand Junction, Colo.

The new survey has a margin of error of plus or minus 4 percentage points.

UPDATE: A USA Today/Gallup Poll released later today about the protests found that 57 percent of Americans believe genuine concerns were behind them, while 48 percent said organizing by activists was also a factor.

While 51 percent said angry attacks represented "democracy in action," 59 percent said shouting down others attending the town halls was an "abuse of democracy."

All the shouting is having limited impact. Thirty-six percent of respondents said the protests haven't made any difference in how they view the healthcare debate, while 34 percent said they were more sympathetic toward the protesters' views and 21 percent were less sympathetic.

The poll, conducted Tuesday, has a margin of sampling error of plus or minus 4 percentage points.

Why wasn't President Obama's town hall on healthcare in New Hampshire Tuesday as much of a shouting match as some held by members of Congress?

At one point, Obama, himself, sought out a question from someone skeptical or suspicious of his plans, with limited success. Critics have suggested that the audience was, if not hand-picked, heavily stacked in the president's favor, even though anyone could sign up for the free tickets through the White House website and it says the winners were picked randomly by computer.

White House spokesman Robert Gibbs gave his own explanation today -- a combination of a skewed picture of how raucous the congressional town halls have actually been, plus respect for the presidency.

"I doubt we're seeing a representative sample of any series of town hall meetings despite the food fight on cable every day," Gibbs said at his daily briefing .

"People want to take the opportunity to find out from the president -- to have him answer their questions about why he's doing what he's doing and the concerns they may have on the legislation," he added. "I think most people took that opportunity as something that was positive.

"I think some of you were disappointed yesterday that the president didn't get yelled at," Gibbs told reporters, chiding them for paying too much attention to the back-and-forth between protestors outside.

"The president wanted to have -- what I think what happened -- which was a rational discussion about health care reform legislation. I think that's what ensued. Did everybody agree? I think the answer to that is obviously no."

UPDATE: Meanwhile, conservative activists are questioning how an 11-year-old girl from Malden was called on by Obama to ask a question -- and noting the political activities of the girl's mother. Read about it on our sister blog.

Asked what the biggest obstacle was to passing a healthcare overhaul bill, Gibbs replied, "The people that want to keep the status quo. The people that believe that somehow what we have is working for the millions of Americans who are watching their healthcare premiums skyrocket every day, who are watching small businesses drop their coverage, who are part of the 12.5 million people over the past three years that have been told by an insurance company in seeking to buy insurance on a private market that they're not eligible because of what somebody has decided there's a pre-existing condition.

"I think that would be what the president would believe is the greatest obstacle and has been for 40 years, are people that -- that have a vested, in some senses monetary interest, in keeping things as they are."

Speaking of which, a new TV ad funded by the US Chamber of Commerce launched today. The business lobby opposes a proposal favored by some congressional Democrats to generate money to cover the uninsured by taxing the most generous employer-provided health benefits.

The spot shows an expanding red balloon as the announcer says, "Inflated taxes, swelling deficits, and expanded government control over your health."

The balloon bursts. "Tell Congress: 'Let’s slow down and reform healthcare the right way,' " the announcer says.

By Nandini Jayakrishna, Globe correspondent

PORTSMOUTH, N.H. -- President Obama's town hall on healthcare today -- his first since shouting matches and heckling met lawmakers trying to talk to their constituents -- was civil and sedate in comparison.

But activists on both sides sparred outside Portsmouth High School, some using bullhorns to get heard.

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But Greg Meyer, 39, of Hampton Falls, N.H., did not want to choose a side. He said if he could, he would stand in the middle of the street between the two sparring groups.

"If we did not believe in that separation, maybe we'd find a way to work together," Meyer said. "I'm on the side of the dialogue."

Supporting the proposals from Obama and his Democratic allies in Congress were AFL-CIO members, Planned Parenthood representatives, and others, dancing to the beat of African drummers.

“I am here because fairness and equality dictate it, we need the public option for health insurance, there should be no restrictions for pre-existing conditions," said Stuart Russell, 66, of Concord, N.H., wearing a sticker that said “I am a healthcare voter.”

Terry Lochhead, 62, of Canterbury, N.H., representing the New Hampshire Alliance for Retired Americans, also said that she supports a public insurance option that Obama is pushing and said that prescription drug prices are too high for the elderly. “It’s ridiculous, people can’t get discounts,” she said.

Mark Mackenzie, president of the AFL-CIO's New Hampshire branch, said the price of healthcare is going through the roof. "We need to begin the process of reining in costs that are out of control.”

He said there is a lot of hype and misinformation in the public and the myths about the Democratic proposals need to be debunked. "If it were a program that would destroy healthcare for people in this country, we wouldn’t stand here," he said.

On the other side of the street from the school, Republicans and other opponents played music including "Proud to be an American."

One opponent, William Kostric, who said he was in his 30s and from Manchester, had a handgun strapped to his leg. Kostric -- who was holding up a sign declaring, "It is time to water the tree of liberty," a slogan popular with anti-government activists -- said he was licensed to carry a gun.

"It’s a political statement,” Kostric said, adding "If you don’t use your rights, then you lose your rights.”

Police asked him to move away from school property, where guns are not allowed, but he was not arrested. He moved to church property a short distance from the school.

Portsmouth police spokesman Lt. Frank Warchol said that as long as a weapon is not concealed and is not carried on the school property, a person is not breaking state law.

"We can't do anything about it," he said. "Obviously he's on our radar screen at this time."

UPDATE: Kostric was interviewed later this afternoon on MSNBC, where under questioning from "Hardball" host Chris Matthews he defended his right to bring a weapon to the event.

Asked about the history of presidential assassinations, Kostric said he was not threatening violence by bringing a gun to a presidential event.

David Call, 60, of Scandish, Maine, said that the healthcare system does not need to be overhauled and that Obama is pushing his proposals too fast.

“If it took the president six months to pick a dog, shouldn’t he spend six months on healthcare?" Call asked. "Slow down, what’s the rush?”

Call also reacted against the top two House Democrats asserting in an opinion piece published Monday that it was "un-American" to disrupt the town hall meetings. “We’re not un-American because we speak up against our government," he said.

Laurie A. Turner, 44, of Manchester, N.H., a history teacher, also said she opposes the reform plans. “It’s gonna take a lot of power out of the hands of the people,” she said.

Hal Posselt, 62, of Concord, N.H., for one, is hoping for real dialogue instead of shouting between the two sides.

"I’m so tired of hearing all the noise out there -- too much noise, not enough thinking and reasoning,” he said. The various plans need to be explained to the public better, he said.

UPDATE: After the event, Lisa Gravel, 39, of Manchester, N.H., a foe of Obama's healthcare overhaul plans, said she was disappointed she could not get into the meeting.

“Everyone coming out of there was clearly an Obama supporter,” she said, holding a sign that read ‘Stop Trashing Our Constitution.’ “He’s not having a healthy debate. He really doesn’t want to hear what I have to say or what any of the people on this side of the street have to say. I find that dishonest.”

As he came out of the gym, Bruce Gottlieb , 56, said he favored the overhaul and and thought the president made a strong case for it, but added that he would have liked Obama to delve into specifics about the program he envisions.

"It was too general,” said the West Hartford, Conn. native. “I’m leaving a little disappointed.”
 

President Obama told a civil, restrained town hall meeting this afternoon in Portsmouth, N.H., that his healthcare overhaul will be good for Americans who already have insurance as well as those who don't.

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Americans are being "held hostage" by insurers, he told about 1,800 people at Portsmouth High's gym, framed by a huge American flag behind the stage.

"I believe it is wrong," he added, and it is bankrupting families and businesses.

"Your health insurance should be there for you when it counts -- not just when you're paying premiums," he declared, adding that it will be once the health overhaul passes. "Nobody in America should go broke because they get sick."

"This is what reform is about" -- not all the chatter and shouting, the president added.

The long vigorous debate is part of democracy, he said. But, he said, "I hope we talk with each other and not over each other," adding "where we disagree, let's disagree over what's real," not falsehoods and rumors.

Greeted by a cheering crowd, he said it was great to be back in New Hampshire -- though he joked that most of his memories of the state "were cold."

He was introduced by a "real person" embodying the preexisting condition message of the day -- Lori Hitchcock, a 52-year-old, single, self-employed Portsmouth resident who was diagnosed with Hepatitis C in 2003. Because no insurance company will sell health coverage to her because of her pre-existing condition, she has been uninsured for two years, the White House said.

Obama said her story is the same one he reads in letters every day.

Obama reprised his argument that the stimulus package and other steps are lifting the country out of recession and "the jobs picture is beginning to turn," but that healthcare reform is one of the pillars needed to "lay a new foundation for economic growth."

He also repeated his debunking of "myths," saying that Americans won't have to give up their insurance if they like it and that he isn't for a government takeover of the healthcare system.

"I don't think government bureaucrats should be meddling, but I also believe that health insurance bureaucrats shouldn't be meddling," he said to applause.

No one, he asserted, is holding insurers accountable for unfair practices. So while an estimated 46 million uninsured Americans need help, it's just as important to achieve reform for those with insurance, he said.

He said that health reform is closer than ever, but the special interests are gathering force to try to stop it.

"Now is the hard part," he said.

Asking for help knocking on doors and convincing neighbors, Obama said, "I never said change would be easy....Change is hard. And it doesn't start in Washington. It starts in places like Portsmouth."

"Yes we can," the crowd chanted, a reprise of Obama's campaign rallies.

"I remember that," Obama replied.

Asked by a state legislator whether he would pass a healthcare bill over Republican objections if necessary, Obama said some Republican friends on Capitol Hill are sincerely trying to find a bill that they can support, naming Senator Olympia Snowe of Maine, among others.

But given Americans' plight and the healthcare's impact on the federal budget deficit, he said, "We have to get it done."

While he hopes for a bipartisan bill, "the most important thing is getting it done for the American people," the president said.

He used humor to dispute claims by 2008 Republican vice presidential nominee Sarah Palin and others that "death panels" will decide end-of-life care that will basically "pull the plug on Grandma." The truth, he said, is that there is a provision in the House bill to offer end-of-life counseling, but only for those who want it.

The first sort-of unfriendly question came from a Maine man who identified himself as a Republican and who said he was worried about a public insurance plan putting private insurers out of business.

"I think it's an excellent question, so I appreciate the opportunity to respond," the president replied, before explaining his opposition to a single-payer system like in Canada and to his support for improving the current system of employer-based coverage.

He asked for a question from someone who is "skeptical or suspicious" of his plans, saying he didn't want people to think that the crowd was full of plants.

It took until the very last query before the town hall ended after nearly an hour of questions.

A Derry, N.H., man said he had turned himself in on the portion of the White House website where people could report false emails and rumors.

Obama jumped to say that was another example of the media distorting what was happening. The reporting feature is not a way to compile an enemies list, the president said.

"Come on guys," he said. "All we're trying to do is answer questions.

The man's question was why Obama hadn't chastised Congress because there are two forms of healthcare -- one for members of Congress and one for the public.

Obama replied that without healthcare reform, the gap between the plan members of Congress get and what most Americans get will continue to be wide. But the health overhaul would give Americans an option of a plan very similar to the one that members of Congress get, he said.

"The status quo is not working for you," Obama said. (His full remarks, and the question-and-answer session is below.)

The town hall was Obama's first since the raucous spectacles during events that members of Congress have been having -- including one that Senator Arlen Specter of Pennsylvania is hosting this morning, where one man has already been escorted out and there has been shouting and heckling.

The Democratic National Committee is backing up Obama's slightly retooled message with a new national cable TV ad. Showing images of happy families, the announcer says, "Your family's care comes first....There's something in it for all of us."

Organizing for America, Obama's grassroots group from the campaign, also echoed his message, releasing a web video this afternoon entitled "Coverage Denied."

In the video, Kristen Palmer of Minneapolis, who was featured in a previous video by the group, tells of how she has been denied health insurance coverage due to a pre-existing medical condition -- polycystic kidneys, a genetic disease she shares with her father -- despite the fact that she is healthy and currently suffers no consequences as a result of her medical history.

The White House release on the town hall is below:

President Obama's town hall meeting on healthcare on Tuesday in Portsmouth, N.H., will almost certainly be far less of a free-for-all than the raucous ones that members of Congress have been having, filled with shouting matches, pushing and shoving, and even some arrests.

It is the president's first public healthcare event since the protests at town halls became big news -- and it is happening in the birthplace of the American ideal of town meetings and small-d democracy. (The White House this evening confirmed the start time as 1 p.m. EDT)

As usual for such events, the White House controlled the distribution of the free tickets to get into the gym at Portsmouth High School. And, per usual, the Secret Service will take care of any unruliness.

But that won't stop protestors outside the event.

According to an invitation obtained by NBC News, a group called the New Hampshire Republican Volunteer Coalition is urging members to make sure the other side gets heard and noticed by the media.

"Barack Hussein Obama will be arriving in Portsmouth on Tuesday to hold a STAGED "Town Hall Meeting", where he will essentially hand pick who the guests will be and what types of questions will be asked of him," the call to arms reads. "A MASSIVE protest rally is being organized just outside of the facility where Obama will be holding his 'Town Hall Meeting' to promote his plan for a government takeover of your healthcare decisions."

"There will be news media from all over the world at this event and it will be the ideal opportunity for us to tell the rest of the country exactly how NH voters feel about Obamacare (taxed/rationed healthcare). It will be the most important pro-liberty event of the year in NH and it is critically important that every one of us attend," the invitation continues. "If you can, bring a sign that says something like, 'OBAMACARE=TAXED/RATIONED HEALTHCARE', etc."

Supporters of the Democratic healthcare bills also plan to show their strength outside the town hall.

The AFL-CIO said today that New Hampshire workers "will respectfully make the case for major health care reform and speak out against the ‘mob rule’ tactics of the opposition."

“New Hampshire workers desperately need major health care reform and we will not let our voices be silenced by the corporate funded mobs on the other side,” state AFL-CIO President Mark MacKenzie said in a statement.

Asked about the current discourse at a joint news conference this afternoon at the summit with the leaders of Canada and Mexico, Obama said, "We are having a vigorous debate in the United States, and I think that's a healthy thing."

He repeated that healthcare overhaul is closer than at any time in 40 years and addressing whether there were parts of the more government-heavy Canadian health plan to emulate, said the US must come up with an uniquely American solution.

Opponents, the president said, seem to want to talk about Canadian healthcare.

"I suspect that you Canadians will continue to get dragged in by those who oppose reform, even though I've said nothing about Canadian healthcare reform. I don't find Canadians particularly scary, but I guess some of the opponents of reform think that they make a good bogeyman.

"I think that's a mistake. And I suspect that once we get into the fall and people look at the actual legislation that's being proposed, that more sensible and reasoned arguments will emerge. And we're going to get -- we're going to get this passed."

Speaking of the contentious town halls, Democrats have been complaining that the conservative activists and their Republican allies have been hijacking them.

In an opinion piece in today's USA Today, House Speaker Nancy Pelosi and her wingman Representative Steny Hoyer went further, calling the disruptions downright un-American.

"It is now evident that an ugly campaign is underway not merely to misrepresent the health insurance reform legislation, but to disrupt public meetings and prevent members of Congress and constituents from conducting a civil dialogue," they wrote. "These disruptions are occurring because opponents are afraid not just of differing views — but of the facts themselves. Drowning out opposing views is simply un-American."

Republicans strongly dispute that, arguing that opponents are only venting their frustrations and objections to the Democratic bills.

UPDATE: Asked about the town hall, White House deputy press secretary Bill Burton said today that there will be about 1,800 people in the audience, including members of the general public and those who received tickets through members of Congress.

"New Hampshire is a place where people are really feeling the pinch of healthcare reform, and it's a place where he can talk specifically about getting real consumer protections in place, like making sure people can get covered if they have a preexisting condition," Burton said.

"We expect that there will be a vigorous debate, as there have been at plenty of town halls that President Obama has had as president and as candidate, and we look forward to it," Burton told reporters on Air Force One this afternoon.

Asked about Pelosi and Hoyer calling some of the protests "un-American," Burton said, "Well, I think there's actually a pretty long tradition of people shouting at politicians in America. The president thinks that if people want to come and have a spirited debate about health care, a real vigorous conversation about it, that's a part of the American tradition and he encourages that, because people do have questions and concerns."

"Now, if you just want to come to a town hall so that you can disrupt and so that you can scream over another person, he doesn’t think that that's productive," Burton added. "And as a country, we've been able to make progress when people actually talk out what our problems are, not try to shout each other down. So he thinks that we're going to be able to have a constructive conversation tomorrow and he'll continue to do that at the town hall later in the week and throughout this effort."

"There's obviously a lot of passion on one side of this, and that's why people are showing up and screaming. And again he doesn't think that that's constructive. But, you know, there's passion on the other side, too -- the people who want health care reform and who think that it's wrong that health insurance companies can stop you from getting coverage just because you have a preexisting condition, or drop you from coverage just because you get sick," Burton said.

"There's obviously been some orchestration of some of the folks who go out there, but I don't think that that is as important as the fact that, A, there are people who do have legitimate concerns and questions about health care reform and the President wants to have an opportunity to answer those folks and wants members of Congress to have the opportunity to answer those questions, as well. And that's why it's important that when people go to town hall meetings, if you want to have a tussle over an issue, that's fine; but screaming so that you can't hear the answer to whatever the complaint isn't moving the ball forward for anybody."

Sarah Palin, getting in her two cents on the healthcare overhaul debate, has been of two minds lately.

The former Alaska governor and 2008 GOP vice presidential nominee turned up the volume late last Friday with a posting on her Facebook page that suggested that President Obama's plan would lead to a "death panel" that would ration care.

"And who will suffer the most when they ration care?" she wrote. "The sick, the elderly, and the disabled, of course. The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama’s 'death panel' so his bureaucrats can decide, based on a subjective judgment of their 'level of productivity in society,' whether they are worthy of health care. Such a system is downright evil."

That claim was immediately and loudly disputed by Democrats. (A fact-checking website, Politifact.com, also disputes Palin's characterization.)

"She just made that up,” Howard Dean, the former Democratic National Committee chairman and Vermont governor who is a doctor, said Sunday on CNN. “Just like the ‘Bridge to Nowhere’ that she supposedly didn't support.

“There's nothing like euthanasia in the bill," he added. "I practiced medicine for a long time, and of course you have to have end of life discussions — the patients want that.”

Later Sunday, Palin posted another comment on her Facebook page, urging opponents of Obama's healthcare proposals to be civil at the town hall meetings that members of Congress are having, lest their message be lost in the controversy.
"There are many disturbing details in the current bill that Washington is trying to rush through Congress, but we must stick to a discussion of the issues and not get sidetracked by tactics that can be accused of leading to intimidation or harassment," Palin wrote. "Such tactics diminish our nation’s civil discourse which we need now more than ever because the fine print in this outrageous health care proposal must be understood clearly and not get lost in conscientious voters’ passion to want to make elected officials hear what we are saying. Let’s not give the proponents of nationalized health care any reason to criticize us."

President Obama's allies are ramping up their efforts for healthcare overhaul as the battle moves full bore back into local congressional districts and out of Washington.

Opponents of the healthcare bills being pushed by congressional Democrats have been raging at town hall meetings held by members of Congress, protests organized in part by conservative and business groups and cheered on by Republicans.

So Obama's grassroots group from the campaign, Organizing for America, sent an email out to the millions on its list, urging supporters to visit their members of Congress in their offices. The email names each supporter's representative and offers help on the message.

"All throughout August, our members of Congress are back in town. Insurance companies and partisan attack groups are stirring up fear with false rumors about the President's plan, and it's extremely important that folks like you speak up now," writes Mitch Stewart, director of the group.

"So we've cooked up an easy, powerful way for you to make a big impression: Office Visits for Health Reform. All this week, OFA members like you will be stopping by local congressional offices to show our support for insurance reform. You can have a quick conversation with the local staff, tell your personal story, or even just drop off a customized flyer and say that reform matters to you."

Community activists, organized by Massachusetts Communities Action Network, also plan to go Tuesday to home offices of six members of Congress: Senators Edward M. Kennedy and John F. Kerry, and Representatives Michael Capuano, Barney Frank, Stephen Lynch and Jim McGovern.

Even though Massachusetts has its own landmark healthcare law that has extended coverage to 97 percent of residents, the network says a national healthcare overhaul could still help the Bay State by providing federal assistance to allow the state to cover more moderate-income families, by improving Medicare for seniors, and by helping subsidize coverage for 30,000 legal immigrants.

Meanwhile, faith groups backing a health overhaul that provides universal care are launching a 40-day lobbying campaign.

The effort by People of Faith for Health Reform includes a new national cable TV ad in which several clergy talk about special interests fighting reform. "But God has given us a spirit not of fear, but of love and action," says the Rev. Stevie Wakes of Olivet Institutional Baptist Church in Kansas City, Kan.

"Millions of people of faith are supporting health insurance reform," adds the Rev. John Hay of Indianapolis. "Members of Congress: Will you?"

The campaign also includes prayer events in local districts, sermons on healthcare Aug. 28-30, and events in Washington in September as Congress resumes work after its August recess.

UPDATE: The White House, itself, officially launched a "reality check" website that features videos of top administration officials debunking "myths" about Obama's proposals. They include the claims from opponents about healthcare overhaul forcing the rationing of care, euthanasia of the critically ill, cuts in care for veterans, burdens on small businesses, and cuts in Medicare benefits.

In his weekly Internet and radio address, President Obama uses the hopeful jobs numbers to make his case again for a healthcare overhaul.

He says the July unemployment rate of 9.4 percent, the first decline in 15 months, shows "that we’ve begun to put the brakes on this recession and that the worst may be behind us."

"But we must do more than rescue our economy from this immediate crisis; we must rebuild it stronger than before. We must lay a new foundation for future growth and prosperity, and a key pillar of a new foundation is health insurance reform – reform that we are now closer to achieving than ever before," Obama declares.

While Congress did not meet his original timetable of both the House and Senate passing bills before leaving for the August recess, Obama puts the best face on the progress so far. "Four committees in Congress have produced legislation – an unprecedented level of agreement on a difficult and complex challenge," he says.

And with opponents of the healthcare overhaul taking over town hall events that members of Congress are holding in their districts, Obama takes on his critics, saying that they are misleading Americans.

"That is why it is important, especially now, as senators and representatives head home and meet with their constituents, for you, the American people, to have all the facts," Obama says.

"So, let me explain what reform will mean for you. And let me start by dispelling the outlandish claims that reform will promote euthanasia, cut Medicaid, or bring about a government takeover of health care. That’s simply not true. This isn’t about putting government in charge of your health insurance; it’s about putting you in charge of your health insurance. Under the reforms we seek, if you like your doctor, you can keep your doctor. If you like your healthcare plan, you can keep your healthcare plan. And while reform is obviously essential for the 46 million Americans who don’t have health insurance, it will also provide more stability and security to the hundreds of millions who do."

Obama's address can be viewed here, and the prepared remarks are below:

One of President Obama's biggest allies -- Big Labor -- is coming to his aid on healthcare.

The AFL-CIO, the nation's largest union federation, announced today that it will mount an intensive 30-day grassroots effort to back a sweeping healthcare overhaul, timed during the recess when members of Congress will be home listening to their constituents.

AFL-CIO President John Sweeney, in a call-to-arms memo to union leaders, put the choice starkly: "The question for us is: will we let them make health care 'Obama's Waterloo' or will we make it the next big step in our march to Turn Around America?"

Sweeney said unions must fight for healthcare legislation that helps working people, not insurance companies. (His full memo is below.)

The AFL-CIO also put out a statement assailing the tactics of conservative groups, which are sending activists to congressional town hall meetings to criticize members of Congress.

"Every American has the inalienable right to participate in our democratic process. Our politics is passionate, heartfelt and often loud -- as was the founding of our nation. But that is not what the corporate-funded mobs are engaging in when they show up to disrupt town halls held by members of Congress," said the federation's secretary-treasurer, Richard Trumka.

"Major health care reform is closer than ever to passage and it is no secret that special interests want to weaken or block it. These mobs are not there to participate. As their own strategy memo states, they have been sent by their corporate and lobbyist bankrollers to disrupt, heckle and block meaningful debate. This is a desperation move, meant to slow the momentum for change," the statement continues.

"Mob rule is not democracy. People have a democratic right to express themselves and our elected leaders have a right to hear from their constituents -- not organized thugs whose sole purpose is to shut down the conversation and attempt to scare our leaders into inaction. We call on the insurance companies, the lobbyists and the Republican leaders who are cheering them on to halt these ‘Brooks Brothers Riot’ tactics. Health care is a crucial issue and everyone - on all sides of the issue - deserves to be heard."

UPDATE: The Service Employees International Union is urging attendees at townhall meetings to sign a pledge not be disruptive and to listen to those with whom they disagree.

“At the same time that America’s families are seeking relief from fast-rising and unaffordable health care costs, extreme radicals and corporate front groups are trying to derail health insurance reform by disrupting public meetings. While SEIU and allies across the country are staging more than 400 events to promote a real discussion on the country’s need for healthcare reform, these ‘Astroturf’ organizations, are spreading ludicrous, discredited myths designed to scare people away from much-needed reform," SEIU Healthcare Chairman Dennis Rivera said in a statement this afternoon.

“America’s families want a serious and civil discourse about health insurance reform. They want to know how health insurance reform will protect them and their loved ones.

“We, therefore, challenge everyone attending public meetings about health insurance reform to sign a pledge that they are prepared to engage in a civil dialogue so that the American people can better understand how reform, and the absence of such reform, will affect their lives.

“We are convinced that such a serious and civil discourse – tied to facts, not myths – will substantially increase the public’s support for reform."

With time running out before the Senate starts its August recess, President Obama turns his focus back to healthcare today.

He huddled with the so-called Gang of Six -- the bipartisan group of Senate Finance Committee members trying to make a deal on a healthcare overhaul bill.

UPDATE: White House spokesman Robert Gibbs said that Obama urged the senators to keep seeking a compromise.

"The president invited the group to come to the White House today to provide an update and a status report of sorts on their negotiations amongst themselves and the committee. The president's message to them is to continue to work and find consensus on an issue that we know they've been working hard on, and is very important to the American people," Gibbs told reporters at his daily briefing.

"The president wants them to continue to work and make progress, and wanted to hear directly from them on where they were. It wasn't a negotiating session."

Finance Chairman Max Baucus has set a Sept. 15 deadline for the negotiators to strike a bargain. The Washington Post reports this morning that an emerging bill would come in at about $900 billion over the next decade and eventually cover 94 percent of Americans.

But it would not include the government insurance option that Obama and House Democrats support and, for the first time, tax healthcare benefits provided by employers under the most generous plans -- an idea Obama so far has shunned.

Obama is also hoping for a bipartisan deal, but if one isn't reached Democrats could use a parliamentary maneuver to move ahead without GOP support in the Senate.

"I am glad that in the Senate Finance Committee there have been a couple of Republicans … who've been willing to negotiate with Democrats to try to produce a bill," Obama told NBC News on Wednesday. "But they haven't yet. And I think at some point, some time in September, we're just going to have to make an assessment."

"I would prefer Republicans working with us on that, because I think it's in the interest of everybody. It shouldn't be a partisan issue," he added in the interview. "The bottom line is the American people, the American economy, and the federal budget, have to have some sort of reforms in the health-care system. And failure is not an option this year."

Three House committees led by Democrats passed healthcare bills before starting their recess last Friday, but Democrats are being hammered in town hall meetings in their districts, shouted down by conservative activists and others.

Democrats have hit back, saying Republicans are inciting "mob rule."

The Democratic Congressional Campaign Committee, which is trying to reelect next year those representatives who are being hassled, formally announced today the launch of a new truth-squadding website dedicated, it said, "to exposing the truth-twisting attack by Republicans and their fringe right-wing groups on health insurance reform."

“Republicans are trying to poison the debate on health insurance reform with lies, misleading ads, and scare tactics so we’re launching healthcarefactcheck.com to set the record straight and empower our supporters to fight back with the truth,” Jon Vogel, the committee's executive director, said in a statement. “This website is just another way that we are holding Republicans and their fringe groups accountable for trying anything and everything to protect the profitable status quo for big health insurance companies at the expense of affordable health care for families.”

But the GOP shows no signs of backing down.

Republican National Committee chairman Michael Steele sent a "Dear Friend" fund-raising solicitation overnight, telling supporters that "Obama Democrats" are trying to demonize them as "right-wing extremists.

"We saw this sort of vitriolic rhetoric this past April when Democrats smugly dismissed grassroots protests against their out-of-control spending. These Tea Parties were ruthlessly mocked by the liberal elites and the mainstream media," Steele wrote.

"Now as public support for the Obama Democrats' government-run health care plan unravels, they're using this fear-and-smear tactic to silence ANY American who disagrees with their risky scheme to nationalize one-fifth of our economy and limit your health care choices. It's a page out of their standard playbook of name calling and outright lies to stifle all debate."

The Democratic National Committee today launched a web ad slamming the GOP and allied conservative groups for sending activists to healthcare town halls where they are shouting questions and criticisms.

"The right wing extremist Republican base is back," the announcer intones, over scenes of disruptions at gatherings starting over the weekend as the battle over healthcare moves out of Congress and into home districts.

After losing congressional battles on the budget and after eight years of failed economic policies during the Bush administration, the narrator says, desperate Republicans are organizing "angry mobs."

"Their goal: Destroy President Obama and stop the change that Americans voted for overwhelmingly in November," the announcer says. "They have no plans for moving the country forward so they've called out the mob."

Michael Steele, a spokesman for House GOP leader John Boehner, responded to the ad:

"Out-of-touch Washington Democrats would love to blame their problems on Republicans, but they can't. Their problem in Washington is Democrats fighting against Democrats. Their problem across the country is Democrats fighting against the American people, by backing job-killing tax hikes and regulations in the middle of the deepest recession in decades."

UPDATE: The Republican National Committee also responded, sending out a list of polling results showing doubts about the Democrats' healthcare plans, and asserting that what Democrats call "mob rule" is merely small-d democracy.

"Today the White House and Democrats continue their callous and arrogant campaign to reduce the concerns and opinions of millions of Americans as 'manufactured' -- and have labeled them as 'angry mobs' and 'rabid extremists,' for voicing their opposition to President Obama’s government-run health care experiment," the RNC said.

"This 'mob' the Democrats are referring to include millions of American families, small business owners, doctors, veterans, seniors – and even House and Senate Democrats – who have real concerns over the president’s risky and costly government-run health care experiment. And they should be concerned – as this costly experiment will raise taxes without decreasing costs, increase the deficit, will lead to less choice and lower-quality health coverage.

"Before heading into recess, the Democrats should have read the dozens of public opinion polls showing that a majority of Americans believe President Obama’s government-run health care experiment is a bad idea. It’s no secret that Democrats aren’t even on board. Chaos in Washington has reigned over health care in the last several weeks. Are Democrats so out of touch that they are shocked to find concern among their constituents over their $1.6 trillion government-run health care experiment? Or are the Democrats once again waging a campaign of distraction to shift the focus away from their widely unpopular, big government policy?

"The bottom line? Americans, including Independents and some Democrats, do not like President Obama’s government-run health care experiment – and they are going to show up to say so. It’s called democracy."

Recent polls show that Americans are divided about the healthcare plans proposed by Obama and congressional Democrats. A CNN/Opinion Research Corp. survey released this morning found 50 percent backing Obama's plan, but 45 percent opposed.

While 30 percent said Obama's proposals would help them and 40 percent said it would help other families, 20 percent said the proposals would not help anyone.

In the survey, 71 percent said they were very likely or somewhat likely to attend a town hall even on healthcare hosted by their member of Congress.

As part of the counter-offensive, Obama's grassroots groups is organizing its own healthcare events and getting its members to the town halls.

"This is the moment our movement was built for," the president, himself, told Organizing for America supporters in an email this afternoon.

"For one month, the fight for health insurance reform leaves the backrooms of Washington, D.C., and returns to communities across America. Throughout August, members of Congress are back home, where the hands they shake and the voices they hear will not belong to lobbyists, but to people like you.

"Home is where we're strongest. We didn't win last year's election together at a committee hearing in D.C. We won it on the doorsteps and the phone lines, at the softball games and the town meetings, and in every part of this great country where people gather to talk about what matters most. And if you're willing to step up once again, that's exactly where we're going to win this historic campaign for the guaranteed, affordable health insurance that every American deserves.

"There are those who profit from the status quo, or see this debate as a political game, and they will stop at nothing to block reform. They are filling the airwaves and the internet with outrageous falsehoods to scare people into opposing change. And some people, not surprisingly, are getting pretty nervous. So we've got to get out there, fight lies with truth, and set the record straight."

Democrats are striking back at conservative groups that are taking the credit for helping opponents show up at healthcare meetings around the country.

Town halls with constituents hosted over the weekend by Representative Lloyd Doggett in Texas and by Senator Arlen Specter in Pennsylvania were disrupted by opponents of the healthcare overhaul plans promoted by President Obama and congressional Democrats.

The Democratic National Committee and the Democratic Congressional Campaign Committee sent out missives today arguing that groups such as Conservatives for Patients' Rights and FreedomWorks and are creating fake grassroots enthusiasm -- "astroturf" in political circles -- by stacking meetings with outside activists.

"The Republicans and their allied groups - desperate after losing two consecutive elections and every major policy fight on Capitol Hill - are inciting angry mobs of a small number of rabid right wing extremists funded by K Street lobbyists to disrupt thoughtful discussions about the future of health care in America taking place in congressional districts across the country," DNC spokesman Brad Woodhouse said in a statement this afternoon.

"However, much like we saw at the McCain-Palin rallies last year where crowds were baited with cries of 'socialist,' 'communist,' and where the birthers movement was born – these mobs of extremists are not interested in having a thoughtful discussion about the issues – but like some Republican leaders have said - they are interested in ‘breaking’ the president and destroying his presidency," Woodhouse added.

"These mobs are bussed in by well funded, highly organized groups run by Republican operatives and funded by the special interests who are desperately trying to stop the agenda for change the President was elected to bring to Washington. Despite the headline grabbing nature of these angry mobs and their disruptions of events, they are not reflective of where the American people are on the issues – or the hundreds of thousands of thoughtful discussions taking place around kitchen tables, water coolers and in homes. The right wing extremists’ use of things like devil horns on pictures of our elected officials, hanging members of Congress in effigy, breathlessly questioning the President's citizenship and the use of Nazi SS symbols and the like just shows how outside of the mainstream the Republican Party and their allies are. This type of anger and discord did not serve Republicans well in 2008 – and it is bound to backfire again."

The town hall episodes were discussed at a White House lunch today among Obama and Senate Democrats, said Senate Majority Leader Harry Reid of Nevada.

He said Obama won several standing ovations and gave a coach-like pep talk that revved up the rank-and-file.

"We're ready to take on the world," Reid told reporters.

Senator Chris Dodd of Connecticut, who is shepherding healthcare legislation in the absence of Senator Edward M. Kennedy of Massachusetts, said that while senators want a bipartisan deal, time is of the essence.

During the monthlong recess that starts Friday, 500,000 more Americans will lose their health insurance, Dodd said.

"We need to come back with a renewed sense of purpose," he said.

With House members back in their districts, President Obama's grassroots group is airing radio ads pushing key representatives on healthcare and thanking others on the economic recovery package.

Organizing for America announced that the health ad, entitled "Standing Up," will run in 19 districts. Listen to it here.

The economic ad, entitled "To the Rescue," will run in four districts, the group said. Hear it here.

"These members have been part of one of the most ambitious, historic and successful opening months of a Congressional session in our nation's history," said OFA Director Mitch Stewart. "From expanding health insurance to millions of vulnerable children, to passing a recovery act that rescued our economy from certain disaster, to passing a budget that halves our deficit over the next decade while making critical investments in health care, energy and education, these members have all helped bring about the change President Obama promised to bring to Washington. They are now standing up to the special interests, the lobbyists and the naysayers and working for big solutions to our nation's toughest problems - including fixing a broken health insurance system that costs too much, leaves too many people lacking coverage and puts insurance industry profits ahead of patient care. Thanks to the support of these members and others like them - we will reform the health insurance system in this country and make other critical policy changes to get our economy back on track."

The group is up against conservative organizations that have been finding activists to attend town halls on healthcare that members of Congress have been having with their constituents.

The Obama team hit back hard on what it considered lies and disinformation during the presidential campaign, going toe to toe on the Internet with its foes, including by creating its own "Fight the Smears" website.

Now that he's in the White House, the Obama media operation is doing the same to protect his healthcare push.

When a conservative blogger's claim -- backed up by video clips from the campaign trail -- that Obama planned to do away with private health insurance was given wide exposure on the popular Drudge Report website, the White House responded today with a video of its own.

"Hi. I’m Linda Douglass. I’m the communications director for the White House Office of Health Reform, and one of my jobs is to keep track of all the disinformation that’s out there about health-insurance reform. And there are a lot of very deceiving headlines out there right now, such as this one -- take a look at this one. This one says, ‘Uncovered Video: Obama Explains How His Health Care Plan Will Eliminate Private Insurance.’ Well, nothing can be farther from the truth,” the video says.

Douglass goes on to rebut the claim, showing clips and arguing that Obama's remarks were taken completely out of context.

On its blog, the White House also urged supporters to keep an eye out for misleading healthcare fodder. "Since we can’t keep track of all of them here at the White House, we’re asking for your help. If you get an email or see something on the web about health insurance reform that seems fishy, send it to flag@whitehouse.gov."

Some members of Congress aren't exactly being welcomed home with open arms as they try to take the temperature of constituents on healthcare.

The New York Times reports that Representative Lloyd Doggett was shouted down by an angry crowd in Texas, who yelled, "Just Vote No."

And the Associated Press reports that Senator Arlen Specter and Health and Human Services Secretary Kathleen Sebelius were booed and jeered at a healthcare town hall at the National Constitution Center in Philadelphia.

Democratic congressional leaders and the White House were pushing for votes in the full House and Senate before the monthlong recess, in part because they knew that opponents would mobilize. The House adjourned last Friday after three committees passed legislation, and the Senate plans to go home this Friday after a second committee passes a plan.

Following up on a retreat with Cabinet officials and others over the weekend at the six-month mark of his new administration, President Obama plans to huddle Tuesday with all 60 Senate Democrats.

White House spokesman Robert Gibbs said the unusual gathering is meant to take stock of where legislative priorities stand -- and two are likely to be at the forefront: healthcare overhaul, since a full Senate vote has been put off until after the August recess, and the "cash for clunkers" bill.

"I don't doubt that healthcare will be discussed," Gibbs said at his daily briefing. "I believe the economy will also be heavily discussed; the numbers that we've been talking about, numbers that we'll see throughout the week, unemployment, manufacturing reports -- just in general where the economy is. I think we'll probably -- they'll go through and discuss energy legislation.

Gibbs also said that a topic will be the House-passed bill to pump $2 billion more into the unexpectedly popular program giving car buyers stipends for trading in gas guzzlers for fuel-efficient vehicles. "Without some help from the Senate, in terms of moving the $2 billion from the Recovery and Reinvestment plan's energy efficiency programs into this account, [it] will likely mean that the program will have to be stopped by the end of the week.

Asked why Republicans weren't invited, Gibbs replied, "I would look at this as the president speaking to the Democratic caucus. They have a regularly scheduled caucus lunch that happens every Tuesday. It's just we're having that lunch here at the White House rather than up on Capitol Hill. So I think that explains talking to the -- to Senate Democrats."

With House members already back in their districts and senators in their last week before heading home for a month, a liberal-labor coalition pushing President Obama's healthcare overhaul is squarely on message with Democrats.

A new national cable TV ad unveiled today tries to put the focus on Big Insurance, which Democrats are increasingly targeting as they try to fend off criticism from Republicans about the overhaul's cost and complexity.

While Obama has promoted cooperation from insurers, they are opposing a public insurance option that the president and Democrats say is needed to control costs and offer consumers a choice of coverage.

"Why do the health insurance companies and Republicans want to kill President Obama’s health insurance reform?" the announcer asks in the 30-second spot. "Because they like things the way they are now."

The ad then pictures the CEO of one major insurer, as the announcer says, "Ed Hanway, CEO of insurance giant Cigna, makes $12. 2 million a year. That’s $5,883 an hour. Ed makes more in one day, than the average worker makes all year long."

"Now Ed’s retiring with a seventy three million dollar golden parachute," the announcer adds over an image of Hanway's face attached to a parachute and floating down. "The Republican prescription for the health insurance crisis – be as rich as Ed … you’ll be happy too."

UPDATE: Responding to the criticism from Democrats, namely House Speaker Nancy Pelosi, Janet Trautwein, CEO of the National Association of Health Underwriters, issued a statement.

"It's unfortunate that Speaker Pelosi has resorted to petty name-calling in the debate over health care reform. We all have a stake in achieving meaningful reform that both preserves Americans' freedom to choose their doctors and lowers long-term health care costs. A public option will accomplish neither," said Trautwein, whose group says it represents more than 100,000 licensed health insurance agents, brokers, consultants and benefit professionals nationwide.

"A new government-run health plan will raise costs for Americans with private insurance. By systematically underpaying doctors and hospitals, our country's existing public plans -- Medicare and Medicaid -- raise the average family's premiums by $1,800 a year. A public option will only exacerbate this problem -- and make insurance more expensive."

Tim Pawlenty and Mitt Romney agree in their disdain for the healthcare overhaul plan Democrats and President Obama are trying to push through.

But they have been sparring in recent days over the right approach -- a preview, perhaps, of the 2012 Republican presidential sweepstakes.

The Minnesota governor and former Massachusetts governor, who were both on Senator John McCain's short list for vice president last year, both appear to be laying the groundwork for possible 2012 bids.

Pawlenty, in an opinion piece published in the Washington Post over the weekend and in a letter last week to Minnesota's congressional delegation, not surprisingly promoted his state's plan.

"In Minnesota, our state employee health-care plan has demonstrated incredible results by linking outcomes to value. State employees in Minnesota can choose any clinic available to them in the health-care network they've selected. However, individuals who use more costly and less-efficient clinics are required to pay more out-of-pocket," he wrote.

But more interestingly, he took some pointed swipes at the healthcare overhaul in Massachusetts, one of Romney's biggest accomplishments as governor, though he ran away from the parts most objectionable to conservatives during his presidential campaign.

"Massachusetts's experience should caution Congress against focusing primarily on access. While the Massachusetts plan has reduced the number of uninsured people, costs have been dramatically higher than expected. The result? Increased taxes and fees. The Boston Globe has reported on a current short-term funding gap and the need to obtain a new federal bailout," Pawlenty wrote in the Post. "Imagine the scope of tax increases, or additional deficit spending, if that approach is utilized for the entire country."

Romney, in an op-ed piece in USA Today, even as he accused Obama from rushing through a bad plan, defended the Massachusetts plan against Pawlenty's critique.

"Massachusetts also proved that you don't need government insurance. Our citizens purchase private, free-market medical insurance. There is no "public option." With more than 1,300 health insurance companies, a federal government insurance company isn't necessary. It would inevitably lead to massive taxpayer subsidies, to lobbyist-inspired coverage mandates and to the liberals' dream: a European-style single-payer system. To find common ground with skeptical Republicans and conservative Democrats, the president will have to jettison left-wing ideology for practicality and dump the public option," Romney wrote.

"When our bill passed three years ago, the legislature projected that our program would cost $725 million in 2009. At $723 million, next year's forecast is pretty much on target. When you calculate all the savings, including that from the free hospital care we eliminated, the net cost to the state is approximately $350 million. The watchdog Massachusetts Taxpayers Foundation concluded that our program's cost is 'relatively modest' and 'well within initial projections.' "

In his healthcare pitch, President Obama has been trying to explain in simple terms the benefits to patients and consumers.

But a new Republican web video, released today by House GOP leader John Boehner, tries to use some of his own words against him, raising the specter of government control of the care that people would receive.

Over the strains of the theme song from the long-running daytime soap "Young and the Restless," a pitchman circa 1970s says, "I'm not a doctor, but I play one on TV."

The video then shows Obama suggesting that if a blue pill is the half the price of the red pill and does the same thing, maybe patients should take the blue pill. It also shows him positing that drugs might be better than surgery.

On screen at the end is a faux prescription form headlined "Obamacare." "We aren't doctors, but we know what's best for you."

Democratic National Committee spokesman Hari Sevugan responded to Boehner's video:
"John Boehner isn't an insurance company executive, but he sure plays one in the U.S. House of Representatives. That's the only explanation for admittedly working to 'kill' health insurance reform while premiums for the average American family are rising three times faster than their wages, while small businesses are choosing between offering coverage and creating jobs, and when controlling runaway health care costs is necessary to get the economy fully back on track. John Boehner and the Republicans that would follow him may not officially be insurance agents, but in working to 'kill' reform they are proving that they are certainly agents of the status quo."

President Obama takes his healthcare road show today to two Southern states that proved pivotal to his election in November.

And with healthcare overhaul bills mired in legislative muck and public support dropping, he's retooling his message to speak directly to consumers.

The president held a town hall at Broughton High School in Raleigh, N.C., then another Q&A with employees at the Kroger supermarket in Bristol, Va. Obama became the first Democratic presidential candidate to win both states in more than a generation, contributing to his electoral landslide.

In his primetime news conference last week and in appearances since, Obama has reached out to Americans who already have insurance or Medicare, trying to reassure them that they won't be hurt by the overhaul, either by losing care or getting smacked by higher costs.

Today, in both stops, he stressed the protections for consumers that he will insist be in any overhaul bill.

"First of all, nobody is talking about some government takeover of healthcare," Obama told the crowd in Raleigh. "I'm tired of hearing that.... Under the reform I’ve proposed, if you like your doctor, you keep your doctor. If you like your healthcare plan, you keep your healthcare plan. These folks need to stop scaring everybody."

"But what a lot of the chatter out there hasn’t focused on is the fact that if you’ve got health insurance, the reform we’re proposing will also help you because it will provide more stability and security," he added. "Because the truth is, we have a system today that works well for the insurance industry, but it doesn’t always work well for you. What we need, and what we will have when we pass these reforms, are health insurance consumer protections to make sure that those who have insurance are treated fairly and insurance companies are held accountable."

(His full remarks and answers to questions are are below.)

The consumer protections include:

-- Banning insurance companies for refusing to offer coverage due to pre-existing medical conditions.

-- Capping how much insurers can charge annually for out-of-pocket expenses, deductibles, or co-pays.

-- Requiring insurers to fully cover regular check-ups and tests, including mammograms and eye and foot exams for diabetics.

-- Prohibiting insurers from dropping or reducing coverage for those who become seriously ill.

-- Banning insurers from charging people based on gender.

-- Stopping insurance companies from placing annual or lifetime caps on benefits.

-- Making sure that young adults as old as 26 can be covered under family insurance policies.

-- Requiring insurers to renew policies as long as premiums are paid in full, even if the policyholder becomes ill.

Obama, en route to Virginia, issued a statement noting the progress in Congress today.

In the Senate, key negotiators said they had pared the costs of a plan to cover 95 percent of Americans by 2015 to about $900 billion over 10 years, putting the price tag under the unofficial $1 trillion target the White House has set. In the House, the leadership, the White House, and fiscally conservative Blue Dog Democrats worked out a deal that will allow a bill to move forward in committee, but will delay a floor vote until September.

“I want to thank the members of both the Senate and House of Representatives for continuing their work on health reform to provide more stability and security for Americans who have insurance, and quality, affordable coverage for those who don’t," Obama said. "I’m especially grateful that so many members, including some Blue Dogs on the Energy and Commerce Committee, are working so hard to find common ground. Those efforts are extraordinarily constructive in strengthening this legislation and bringing down its cost.”

Another poll out this afternoon says that Americans are divided about Obama's healthcare plan.

In the Wall Street Journal/NBC News survey, 46 percent said they disapprove of Obama’s handling of healthcare, while 41 percent approved and 13 percent weren’t sure.

The Journal says those numbers are similar to former President Bill Clinton's of 52 percent disapproval and 40 percent approval in July 1994 before his healthcare overhaul plan crashed and burned in Congress.

UPDATE: Republicans, however, are still opposed to the Democratic bills, and House Republicans introduced a plan today that relies on tax credits to help people buy insurance and that also addresses medical malpractice reform.

The top House Republican, John Boehner of Ohio, said on CNN this afternoon that the legislation would create "a giant government bureaucracy that's going to drive up the cost of health care, drive up the cost of health insurance, deny millions of Americans their choice of doctor, and eventually lead to rationing of health care in America. This is not the kind of plan that Americans want."

"I believe that it's time to hit the reset button," Boehner added. "Let's scrap this plan. Let's sit down in a bipartisan way. And let's build on the current system, which is the envy of the world.

"You know, 93 percent of the American people have access to high quality, affordable health insurance. Let's help them be able to hold on to that, reduce the cost of it, and expand access to those Americans who don't have good access."

President Obama reached out this afternoon to a key constituency on his healthcare overhaul plan, seeking support from the 55-plus set.

"We've got to get a better bang for our healthcare dollar," he told a town hall hosted by the AARP.

There needs to more preventive care, and unnecessary subsidies need to be taken away from Medicare providers, the president said.

But, he pledged, "We certainly won't cut corners to cut costs. That doesn't work."

(His full remarks and answers are below.)

The town hall was Obama's latest event in an aggressive push to get a healthcare bill signed this year.

UPDATE: Representative Eric Cantor, the No. 2 Republican in the House, dismissed Obama's pitch.

"I heard what the President was saying, and frankly, he hasn't said anything different today than what he said at last week's press conference," he said on CNN. "The fact is that most Americans are very concerned about what they are learning of the Obama health care reform bill. I don't think that the people of this country feel it is appropriate for us to hear the President say, you know, ‘It's my way or the highway.’ There are plenty of other approaches and I think we can gain a comfort level if we take the time to get it right and not say that we must have full-on this government takeover of our health care system.”

Liberal and labor groups who favor the healthcare overhaul plans of President Obama and congressional Democrats don't have the airwaves to themselves.

Groups opposed to healthcare "reform" are also airing ads on cable TV, trying to win the hearts and minds of the public as negotiations continue in Congress.

Here's one from the conservative Patients United Now that questions the rush to action in Congress.

And here's one from Conservatives for Patients' Rights, which asserts that Americans could be squeezed by the healthcare bill four different ways: higher taxes, a bigger federal deficit, increased insurance premiums, and more government control of healthcare.

A pro-Democratic labor coalition has a reply to Republicans who say the healthcare overhaul push in too much, too fast.

The new cable TV spot released this morning by Americans United for Change says that by calling for delay, Republicans are really trying to kill reform, again.

"The Republicans claim the health insurance reform debate has been moving at lightning speed," the announcer says over an animated snail inching past sign posts starting with the year 1993. "In fact for 15 years, it’s hardly moved at all. Meanwhile premiums have gone up 3 times faster than wages, health insurance profits have soared and 14,000 Americans lose their health insurance everyday."

"Now the Republicans say Congress should slow down? That’s because when something goes slow enough it’s easy to kill it dead in its tracks," the announcer says as a dress shoe squashes the snail.

"Tell Congress you want health insurance reform now," the announcer concludes.

Another liberal group, MoveOn.org, also has a new healthcare ad up.

This one goes after Republicans, quoting them as saying they want to defeat President Obama on the issue, including Senator Jim DeMint's much-cited remark that healthcare could be Obama's "Waterloo."

While Obama is pushing reform, Republicans are "doing nothing -- actually worse than nothing" by turning the issue into a political football, the announcer says as a football is shown spiraling through the air -- then shattering a window.

"Tell Congress this isn't a game," the narrator concludes.

The Democratic National Committee piled on this afternoon with a web video of its own, hammering Senate Republican leader Mitch McConnell for claiming that every GOP senators favors a healthcare bill. Titled "Are you serious?" the ad argues that Republicans have showed they don't want change.

“The Republican playbook on health insurance reform is now plainly clear and it’s well past time for Mitch McConnell to acknowledge that his Party’s strategy is to try and use the health insurance reform debate to score a political win on the backs of struggling American families and small businesses. Now that members of his own caucus are stating publicly their desire to see the President ‘fail’, McConnell’s attempts to profess bipartisanship are falling more than a little flat,” DNC spokesman Brad Woodhouse said in a statement.

“The status quo that the Republican Party is championing is breaking American families, small businesses and state budgets across the nation and only stands to get far worse in the years ahead if nothing is done - as they propose. By standing in the way of health insurance reform, Republicans are protecting their special interest friends and ignoring their duty to serve the interests of their constituents.”

Americans United for Change also launched a radio spot on nine Maine stations today aiming at persuading Senator Olympia Snowe, a key moderate Republican, to support the healthcare bill.

“Americans have been waiting for meaningful health care reform since Truman was president and. Sen. Snowe is a critical voice on the Senate Finance Committee,” Frank Gallagher, the Maine state director of Americans United for Change, said in a statement. “Health care is not going to reform itself. The insurance industry will not suddenly stop lobbying to kill reform or quit raising our premiums, and the Republican leadership has stated repeatedly that they are actively trying to kill it. Sen. Snowe has a long record of going against her party’s leadership to do what’s right for Maine. It’s time for her to do that again.”

Democrats kept up their assault on Republicans on healthcare, announcing a new national TV ad today calling them out for trying to stop healthcare overhaul.

The ad asserts that without sweeping change, insurance premiums and out-of-pocket expenses will continue rising and more people will be denied coverage at all.

"Tell Republicans the cost of doing nothing is just too high," the spot concludes.

“For eight years the Republican Party ignored skyrocketing health insurance costs and American families and small businesses paid a devastating price for their negligence. Now, the ‘Party of NO’ admits their true intention is to ‘kill’ health insurance reform, putting their special interest friends over the people they were elected to serve. Already, families across the country are faced with insurmountable burdens: premiums that are rising at a rate three times faster than wages, insurance companies who are free to deny coverage to those who need health care the most, and rapidly rising co-pays that are forcing families to choose between paying their mortgage and paying their health care bills,” Democratic National Committee spokesman Brad Woodhouse said in a statement.

“The status quo that the Republican Party is championing is breaking American families, small businesses and state budgets across the nation and only stands to get far worse in the years ahead if nothing is done - as they propose. And still, the GOP continues to see health insurance reform as an opportunity to score a political win for their ailing party. This time, however, the stakes are too high, the cost of doing nothing too great, for the Republican Party to engage in the same partisan political games we’ve come to expect from them.”

President Obama hit the road again today in his healthcare push, going to Cleveland to tour a clinic he calls a model for the nation and meet the public in a campaign-style appearance at a high school.

UPDATE: In his opening remarks before taking questions from the audience at Shaker Heights High, Obama reprised his campaign mantra of change.

"I know there are those who like to focus on the political back-and-forth in Washington," he said. "But my only concern is the people who sent us there: the families feeling the pain of this recession; the folks I’ve met across this country who have lost jobs and savings and health insurance, but haven’t lost hope; the citizens who defied the cynics and the skeptics -- who went to the polls to demand real and lasting change. This change was the cause of my campaign, and it is the cause of my presidency."

He continued trying to reassure Americans who like their current insurance, while promising improvements.

"I want to be clear: reform isn’t just about the nearly 46 million Americans without health insurance.... If you already have health insurance, the reform we're proposing will give you more security. It will keep the government out of your health care decisions, giving you the option to keep your coverage if you’re happy with it....And it will keep the insurance companies out of your health care decisions, too, by stopping insurers from cherry-picking who they cover, and holding insurers to higher standards for what they cover," he said.

"You won’t have to worry about receiving a surprise bill in the mail, because we’ll limit the amount your insurance company can force you to pay out of your own pocket. You won’t have to worry about pre-existing conditions, because never again will anyone in America be denied coverage because of a previous illness or injury. And you won’t have to worry about losing coverage if you lose or leave your job, because every American who needs insurance will have access to affordable plans through a health insurance exchange, a marketplace where insurance companies will compete to cover you, not to deny you coverage."

Obama also took on his Republican critics, including GOP chairman Michael Steele for saying that the healthcare overhaul was happening too soon.

"I think that's a little odd. We’ve been talking about health reform since the days of Harry Truman. How can it be too soon?" Obama asked, increduously.

"I don’t think it’s too soon for the families who’ve seen their premiums rise faster than wages year after year. It’s not too soon for the businesses forced to drop coverage or shed workers because of mounting healthcare expenses. It’s not too soon for taxpayers asked to close widening deficits that stem from rising healthcare costs, costs that threaten to leave our children with a mountain of debt," the president added.

"Reform may be coming too soon for some in Washington, but it’s not soon enough for the American people."

(His full remarks are below, along with the question-and-answer session.)

But it doesn't appear the overhaul will happen as fast as Obama wants.

The top Democrat in the Senate said today that his chamber won't vote until after the August recess -- and beyond Obama's hoped-for timetable.

Senate Majority Leader Harry Reid told reporters that the Senate Finance Committee will act on its portion of the bill before the monthlong break, but the bill won't be combined with separate legislation passed by the Senate health committee and sent to the full Senate until September, after the recess.

Reid said the decision to delay a vote was made Wednesday night in the hopes of getting a final bipartisan bill, the Associated Press reports.

Obama downplayed the Senate delay. "That's OK, I just want people to keep working," he said, departing from his prepared remarks and saying he still wants a bill on his desk this year.

"I don't want a delay just because of politics," he told the town hall crowd.

Earlier, Obama toured the Cleveland Clinic, which in his prime-time news conference on Wednesday he said has "set up a system where patient care is the number-one concern, not bureaucracy, what forms have to be filled out, what do we get reimbursed for.

"Those are changes that I think the American people want to see," he added. "....Cleveland Clinic is simply a role model for some of the kind of changes that we want to see.

He said he wasn't expecting an endorsement from the clinic for his healthcare overhaul plan.

But he also probably doesn't want a slap, either, as Democrats received on Monday from the Mayo Clinic, another

The famous nonprofit clinic in Minnesota said Monday that the House Democratic plan "misses the opportunity to help create higher quality, more affordable health care for patients."
"In fact, it will do the opposite," clinic officials said, because the proposals aren't focused enough on patients and results. "The real losers will be the citizens of the United States."
Republicans eagerly jumped on the statement to bash Democrats, but the clinic signed on Wednesday to a more measured letter to Congress. (Read it here.)

"I think it's important to note that the Mayo Clinic was initially critical and concerned about whether there were enough changes in the delivery system and cost-saving measures in the original House bill," Obama said Wednesday night.

"After they found out that we had put forward very specific mechanisms for this MedPAC idea, this idea of experts getting the politics out of health care and making decisions based on the best evidence out there, they wrote in their blog the very next day that we actually think this would make a difference. Okay?"

President Obama, seeking public support for his healthcare plan, is trying tonight to answer a key question on the minds of Americans: What's in it for me?

"I realize that with all the charges and criticisms being thrown around in Washington, a lot of Americans may be wondering, “What’s in this for me? How does my family stand to benefit from health insurance reform?' ” he said, opening his fourth primetime news conference at a pivotal moment early in his presidency.

"Tonight I want to answer those questions. Because even though Congress is still working through a few key issues, we already have rough agreement on the following areas: If you already have health insurance, the reform we’re proposing will provide you with more security and more stability. It will keep government out of healthcare decisions, giving you the option to keep your insurance if you’re happy with it. It will prevent insurance companies from dropping your coverage if you get too sick. It will give you the security of knowing that if you lose your job, if you move, or if you change your job, you will still be able to have coverage. It will limit the amount your insurance company can force you to pay for your medical costs out of your own pocket. And it will cover preventive care like check-ups and mammograms that save lives and money.

"Now, if you don’t have health insurance, or are a small business looking to cover your employees, you’ll be able to choose a quality, affordable health plan through a health insurance exchange -- a marketplace that promotes choice and competition. Finally, no insurance company will be allowed to deny you coverage because of a pre-existing medical condition," Obama said to a nationwide television audience.

"I have also pledged that health insurance reform will not add to our deficit over the next decade -- and I mean it."

The president also asserted that health reform is "central" to rebuilding the US economy "stronger than before."

"This is not just about the 47 million Americans who don't have any health insurance at all. Reform is about every American who has ever feared that they may lose their coverage if they become too sick, or lose their job, or change their job. It’s about every small business that has been forced to lay off employees or cut back on their coverage because it became too expensive. And it’s about the fact that the biggest driving force behind our federal deficit is the skyrocketing cost of Medicare and Medicaid.

"So let me be clear: If we do not control these costs, we will not be able to control our deficit. If we do not reform healthcare, your premiums and out-of-pocket costs will continue to skyrocket. If we don't act, 14,000 Americans will continue to lose their health insurance every single day. These are the consequences of inaction. These are the stakes of the debate that we’re having right now.

He also took on his critics directly, accusing them of putting political games ahead of the country.

"I understand how easy it is for this town to become consumed in the game of politics -- to turn every issue into a running tally of who’s up and who’s down. I’ve heard that one Republican strategist told his party that even though they may want to compromise, it’s better politics to 'go for the kill.' Another Republican senator said that defeating health reform is about 'breaking' me," he said.

"So let me be clear: This isn’t about me. I have great health insurance, and so does every member of Congress. This debate is about the letters I read when I sit in the Oval Office every day, and the stories I hear at town hall meetings….This debate is not a game for these Americans, and they can't afford to wait any longer for reform. They are counting on us to get this done. They are looking to us for leadership. And we can't let them down. We will pass reform that lowers cost, promotes choice, and provides coverage that every American can count on. And we will do it this year."

(His full prepared remarks are below.)

Asked first which specific proposals being talked about in Congress he would support, especially on financing, Obama declined, instead outlining broad principles.

After finding as much savings as possible, he said he proposed what he believed would work best -- limiting income tax deductions for higher-earning families -- but Congress has not accepted that idea. He said he was not foreclosing other options, as long as they don't burden middle-class families. "I want to wait to see what emerges from these committees," he said.

Obama said he understands public skepticism, given the recent history of what Washington has produced.

But if the country just reduced healthcare costs by $2,000 or $3,000 a year -- not the $6,000 difference between the United States and other Western countries -- the help for most families would be significant, he said.

Asked why he was pressing so hard for Congress to act before the August recess, he said he is "rushed" because he gets letters from families every day who say they are being "clobbered by healthcare costs."

"In a country like ours, that's not right," he said.

He also said that without deadlines, nothing happens in Washington. "Inertia is the default position," he added, because change always upsets one special interest or another.

But he also said he won't sign a bill that isn't ready, just to meet a deadline.

"I do think it's important to get this right," he said.

Asked whether the health overhaul will cover all 47 million uninsured, he replied, "I want to cover everybody."

But he acknowledged that without a single-payer system where all Americans are automatically enrolled, some will choose not to get insurance even if they are required to do so and even if there are subsidies, so some will go uncovered.

A good plan should cover 97 or 98 percent of the population, he said.

Asked about infighting among Democrats and whether they would be to blame if a bill isn't passed, Obama said there are legitimate regional differences and concerns. "This is part of the normal give and take of the legislative process," he said.

He also said that Republicans have good ideas that should be incorporated and named in particular Senators Chuck Grassley of Iowa and Olympia Snowe of Maine for their contributions to the bill drafting.

Asked about what sacrifices Americans would have to make to cut healthcare spending, Obama said they would have to give up care that doesn't make them healthier, such as unnecessary tests. "You're wasting money," he said. "We just can't afford what we're doing right now."

He did not touch the controversial issue of healthcare rationing, such as limiting the amount of care for the terminally ill.

He hit back at those who say the healthcare proposals would worsen the record federal deficits. Directly addressing those in the public who he said had been "ginned up" by the accusations, he said that he inherited the vast majority of the deficit and that healthcare reform "is designed to lower it."

Asked about whether he is violating a pledge on openness on the healthcare deliberations and other issues, Obama rejected the charge. He said that the identities of health executives visiting the White House have been public and that the kickoff healthcare event was televised on C-SPAN.

Asked by a reporter for a newspaper in Cleveland, where Obama plans a town hall on Thursday, about the public insurance option, the president said it would be similar to what members of Congress get.

He repeated that the public plan is needed to keep private insurers honest, saying that several firms recently reported record profits even as families pay more for their care.

Asked by the same reporter whether he would accept the public plan, Obama said he would, but pointed out that as president, a White House doctor follows him everywhere.

The political skirmishes and name-calling over healthcare show no signs of ending.

Senator Jim DeMint, a South Carolina Republican -- who raised President Obama's hackles by saying that a defeat on healthcare could be the "Waterloo" for his presidency -- didn't back down today. He might have upped the ante, saying it's time to "put the brakes" on Obama because he is on a dangerous spending spree.

"It's not personal," DeMint said this morning on NBC's "Today" show. "We've got to stop his politics."

UPDATE: Going after DeMint, the Democratic National Committee unveiled a hard-hitting TV ad this afternoon that will run in Washington and his home state.

"Jim DeMint will break families & small businesses," the ad says. "Putting special interests first, putting South Carolina last."

"The only health care plan Jim DeMint supports is no plan at all," the ad concludes.

“The politicization of health care reform by Senator Jim DeMint and Republicans is a desperate and shameful ploy by the ‘Party of NO’ to score a political win on the backs of struggling American families and small businesses," DNC Communications Director Brad Woodhouse said in a statement. "What’s worse is that this strategy originates from the same Republican Party who ignored health care reform for the past eight years, letting costs spiral out of control while protecting their special interest friends."

Representative Eric Cantor, the No. 2 Republican in the House, continued his assault with a web video that accuses Obama and congressional Democrats of jeopardizing the healthcare system.

Democrats "are in a hurry, a reckless rush and still can't answer some fundamental questions," the announcer says, including how much the overhaul would cost. The video also accuses Obama of opening the door to reneging on his pledge not to raise taxes on anyone making less than $250,000 a year, though Democratic plans don't propose that.

“We won't be lectured by Eric Cantor and Republicans on being reckless," responded Democratic National Committee spokesman Hari Sevugan. "While the President is offering a constructive way forward to get something done after we've been trying to reform health care for decades, Eric Cantor and Republicans are offering nothing more than partisan obstruction, the status quo and more cries of ‘NO.’

“What's reckless is saying you want to ‘kill’ health care reform when American families have seen 80 percent hikes in premiums this decade alone. What's reckless is saying you want to ‘break’ the President on health care when small business are going broke paying for insurance. What Eric Cantor and the Republican Party don't understand is that the most reckless thing we can do, as they propose, is nothing.”

The Republican National Committee is up with a web video of its own, a take-off on those TV ads for all kinds of prescription drugs.

With idyllic images of couples frolicking in fields of flowers, the video says that Obama and Democrats are trying to sell "Reforma" on healthcare.

But it warns of dangerous side effects, including government control of healthcare, higher medical costs, and bureaucratic gridlock.

"Not recommended for people who may need actual medical care," it says.

It's like most national elections -- when Massachusetts is a slam dunk for Democrats, so activists instead go to more competitive states to make a difference.

With both Democratic Senators Edward M. Kennedy and John F. Kerry of Massachusetts firmly on board with the healthcare overhaul, President Obama's grassroots supporters in the Bay State are being urged to help sway Maine's two Republican senators, Susan Collins and Olympia Snowe, who are key moderates in the debate.

Organizing for America sent an email this afternoon with a link and encouragement to call voters in Maine and get them to call Collins and Snowe.

"With the health care debate coming down to the wire in Congress, we need every vote we can get. Both of your Massachusetts senators are fighting hard for reform, but the two senators from nearby Maine -- Senator Olympia Snowe and Senator Susan Collins -- are under tremendous pressure to cave to special interests. They need to hear from constituents who want them to stand with the President -- and you can help," wrote Jeremy Bird, deputy director of Organizing for America.

"There are voters in Maine who want to fix our health care system as much as you do, and they may not know how much power they have to make it happen. Let them know, and help bring our country one big step closer to the reform we need."

House Speaker Nancy Pelosi, trying to rally her troops and help President Obama on his healthcare push, is holding a news conference this morning to brag on the House Democratic bill.

She brought with her "real Americans," including a cancer patient from Norwood, Mass., who would benefit from the legislation and are telling their personal stories.

House Democrats' bill would pay for extending insurance coverage with a surtax on Americans with annual incomes of $280,000 or more. But fiscal conservatives, known as the Blue Dog coalition, have objected to the financing and have stalled the legislation after it passed two committees last week.

In response, Pelosi is floating the prospect of imposing the surtax starting with those making $1 million or more a year.

UPDATE: House Republicans said this afternoon that by their count, at least 42 House Democrats have expressed qualms or outright opposition to the bill. (Click here to see the list.)

But Representative Steny Hoyer, a Maryland Democrat in the party's leadership, said today that he's "very hopeful" that the House will pass the bill next week.

“Very frankly, every member of the Caucus, every member, from Blue Dog to Progressive and everybody in-between says ‘they want to vote for healthcare reform bill’ and the American public wants to see one,” he said on Fox News Channel.

“We want to get it right, but, we don’t think simply considering it for another next 16 years will necessarily be the solution to getting it right. We need to get it done.”

President Obama is firmly, stubbornly staying wih his persistent push on healthcare.

But for good reason: While the fate of the sweeping legislation might not be the "Waterloo" turning point of his presidency -- as some Republicans hope from defeating him -- Obama has staked a huge pile of his political poker chips on victory.

This afternoon, in his almost daily remarks healthcare, Obama took on his opponents, saying that they would rather "score political points" than help families struggling with healthcare and that some will try to delay health reform until the special interests kill it.

While acknowledging that there is work to do for a final deal, he went on to tick off the areas of agreement in the working Senate and House versions and the broader consensus with health industry groups.

"We have traveled long and hard to reach this point," Obama said, through decades of Washington failing to fix healthcare. (His full remarks are below.)

UPDATE: Backing up Obama, the Democratic National Committee released a new web video today bashing Republican critics of the president's healthcare plan. It juxtaposes Republicans saying they want Obama to fail, with Obama's response.

“Over the last few days we've learned the true intentions of the Republican party when it comes to health care, and those intentions, while not surprising, are disturbing. Let's be clear - the same Republican party that let health care costs spiral out of control over the last eight years while protecting their special interest friends, is now expressly saying that they want to ‘kill’ health care reform and that their interest is to ‘break’ the President politically," DNC Communications Director Brad Woodhouse said in a statement.

“The Republican approach of working to kill health care reform when so many American families are struggling is not only broken, it's also irresponsible. Republicans would be better served if they focused on killing off this callous attitude within their party that puts fixing their own political problems ahead of fixing problems for American families.”

Republicans countered by saying that Obama is trying to move too fast with a plan that could derail the economic recovery. "Healthcare reform is too important to rush through and get wrong," Senate GOP leader Mitch McConnell of Kentucky argued in a floor speech today.

They also asserted that House Democrats have been told not to cooperate with Republicans on healthcare legislation and that Democrats are making a mountain out of the molehill of Senator Jim DeMint's quotation that a healthcare defeat could be Obama's Waterloo.

"The White House and Democrats are jumping on one quote to set up Republicans as a straw man to mask over their internal party divisions which are delaying their drive for government-run healthcare," Joe Pounder, spokesman for the No. 2 House Republican Eric Cantor, said in a statement.

"However, we recall one remarkable quote from a key House Democrat, Rep. Jim Cooper (D-TN), who wrote that House Democrats are being 'explicitly told not to work with Republicans.' Just to be clear: the White House and Democrats are using a fake straw man argument. Democrats don’t want to work with Republicans but at the same time, want to blame Republicans for their failures."

Obama plans to return to the subject in a primetime news conference Wednesday and a town hall in Cleveland Thursday.

Obama also plans to meet this afternoon with Democrats on the House Energy and Commerce Committee, which hasn't passed the healthcare bill. Two other House panels approved their portions of the bill last week, but fiscally conservative Democrats on the Energy committee are balking at the bill's financing, among other issues.

The House Ways and Means Committee voted last week to pay for healthcare by imposing an income surtax on couples making as little as $350,000 a year and individuals earning as little as $280,000. To try to get conservative Democrats on board, House Speaker Nancy Pelosi is proposing to limit the income tax increases to couples making more than $1 million a year and individuals making more than $500,000.

In an interview aired this morning on NBC's "Today" show, Obama defended his insistence on Congress passing healthcare overhaul legislation before its August summer recess. "If you don't set a deadline in this town, nothing happens," the president said, adding, "And the deadline isn't being set by me. It's being set by the American people."

President Obama continued his full-court press today for sweeping healthcare legislation, holding a roundtable discussion with providers at the Children's National Medical Center in Washington.

Trying to get healthcare overhaul back on track, Obama took a populist bent, asserting that big insurers and pharmaceutical firms and other special interests are reaping huge benefits from the existing healthcare system, while American families struggle.

Unless healthcare is reformed, he said, families will pay more and more of their income for less and less care.

Obama also took on his Republican opponents, incredulously citing South Carolina Senator Jim DeMint's remark last week that a defeat on healthcare would be Obama's "Waterloo" -- undermining his presidency.

"This isn't about me, this isn't about politics, this about a healthcare system that is breaking," the president said

He said the "politics of delay and defeat" should not be allowed to succeed -- and the nation needs a healthcare overhaul this year.

"Let's fight our way through the politics of the moment," he said.

"We've talked this problem to death," he added. (His full remarks are below.)

UPDATE: Senator Mitch McConnell, the top Republican in the Senate, added his criticism of Obama, saying that the healthcare push looks a lot like the push for the $787 billion stimulus package, which he asserted has been a failure.

“By any standard upon which it was sold to us, not that it would do some good two or three years from now, but now, by that standard it has been a failure,” McConnell said this afternoon on Fox News Channel. “People feel like they got burned on the Stimulus vote, there were a few people that voted for it who feel like they got burned. A lot of the rest of us are saying, you know, we told you this might not have been the right thing to do.”

“The American people are now looking at this healthcare proposal and are saying this sounds a lot like what we were just told a few months ago on the stimulus, 'You got to get it done tomorrow or bad things are going to happen,' ” he added. “There is suspicion that this is a do over from the stimulus that we had just a few months ago, being sold to us as something we have to do immediately, that may not work.”

But as various versions of the bill wend their way through Congress, Obama is spending most of his time on the defensive against critics of the reform proposals even as he stakes the early success of his presidency on passing healthcare this year.

Perhaps for good reason -- a new Washington Post/ABC News poll published today showed that the public's approval of Obama's handling of the issue has dropped below the 50 percent threshold for the first time.

In the poll, 49 percent approve of his healthcare proposals and 44 percent disapprove. The approval number is down 8 percentage points from April and the disapproval number is up 15 percentage points as more attention -- and more criticism -- has focused on the proposals.

The poll also found that the president's approval ratings on other major issues, such as the economy and the federal budget deficit, have also slipped in recent months. His overall approval rating is higher than his marks on specific issues -- 59 percent positive and 37 negative -- but it's still the first time since he took office that his overall rating dropped below 60 percent in the Post-ABC poll, and is down six percentage points from just last month. The survey, conducted July 15-18, has a margin of error of plus or minus 3 percentage points.

UPDATE: A second poll out today also found public skepticism about Obama's healthcare plan.

In the USA Today/Gallup survey, conducted Friday through Sunday, Americans by 50 percent to 44 percent disapprove of his handling of healthcare, and by 49 percent to 47 percent disapprove of his handling of the economy.

Sensing some vulnerability, Republicans are on the attack.

GOP Chairman Michael Steele, in a speech this morning at the National Press Club, accused Obama of "risky experimentation" with his healthcare proposals and asserted that Democrats want to impose government-run healthcare.

Asked whether the plans amounted to socialism, Steele said yes.

"Many Democrats outside of the Obama-Pelosi-Reid-Waxman cabal know that voters won't stand for these kinds of foolish prescriptions for our health care. We do too. That's why Republicans will stop at nothing to remind voters about the risky experimentation going on in Washington," Steele said, according to the Associated Press.

Obama wants a public insurance option to compete with private insurers and, he says, keep them honest, but has repeatedly said he does not favor a government-run health care system.

Republicans are backing up Steele's criticisms with a new TV ad that derides Obama's economic stimulus plan as a "massive spending experiment" that has failed to produce jobs. Featuring an ominous voiceover and images of children, the 30-second spot warns that his healthcare plan would "risk everything."

UPDATE: Democratic National Committee chairman Tim Kaine this afternoon issued a lengthy response to Steele, accusing Republicans of being far more interested in scoring political points than helping Americans with their healthcare.

“This morning, Chairman Steele delivered a speech announcing a ‘new’ Republican campaign against the President’s efforts to reform America’s broken health care system. Republican opposition to health care reform, however, is anything but new. In his speech, Chairman Steele spoke at length about the potential risks to reforming our failed health care system. It's sad, but not surprising, that the Republican Party, which for so long has supported the very policies and vested interests that helped get us to this crisis point, are unable to recognize the that the real risk is to do nothing at all, as they propose," Kaine said.

“Despite the crisis that confronts American families, the GOP continues to argue for the status quo on behalf of the special interests. If we do nothing as the Republican ‘Party of NO’ would have us do, we not only will ensure more of the same, but guarantee a growing crisis that will put a burden on our children that they will never overcome," Kaine added.

“It was also stunning - and sad - to hear that Chairman Steele agreed with Senator DeMint's comments that stopping health care reform would ‘break’ the President politically. What's ‘broken’ is a health care system where costs continue to explode, working families can't afford their premiums, small business can't compete, and where the Republican Party is interested in ensuring that we do nothing about these problems purely for their own political gain."

While Republican attacks are to expected, even some of Obama's allies are not happy with the direction the healthcare legislation is going.

Some Democrats, notably Senate Finance Chairman Max Baucus, want to tax the most generous employer-provided health benefits -- an idea Obama hasn't endorsed. But in an op-ed piece in Sunday's Washington Post, AFL-CIO President John Sweeney rails against the proposal.

Unions oppose the idea, arguing that employees have given up salary increases over the years and accepted better health benefits in return.

"Persistent misconceptions about the 'tax-favored treatment' of employer-sponsored coverage are that it (1) leads to overconsumption of health services and (2) favors the wealthy," Sweeney's piece says.

"With rising health costs burdening businesses and families alike, does anyone really believe that employers or workers lack incentive to hold down costs? The tax treatment of health benefits no more contributes to high health-care costs than the deduction for mortgage interest is responsible for housing costs. Clearly, both are affected by far more complex factors."

Senator Edward M. Kennedy -- absent in person during the healthcare debate in Congress, but there "in spirit," as President Obama says -- says in a new first-person magazine article that the push for reform is the "cause of my life."

"Last year, I was diagnosed with a malignant brain tumor. Surgeons at Duke University Medical Center removed part of the tumor, and I had proton-beam radiation at Massachusetts General Hospital. I've undergone many rounds of chemotherapy and continue to receive treatment. Again, I have enjoyed the best medical care money (and a good insurance policy) can buy," Kennedy writes in the new edition of Newsweek.

"But quality care shouldn't depend on your financial resources, or the type of job you have, or the medical condition you face. Every American should be able to get the same treatment that U.S. senators are entitled to."

The Massachusetts Democrat says the time is now for a comprehensive bill that offers universal coverage. Incremental measures won't suffice anymore. We need to succeed where Teddy Roosevelt and all others since have failed. The conditions now are better than ever. In Barack Obama, we have a president who's announced that he's determined to sign a bill into law this fall. And much of the business community, which has suffered the economic cost of inaction, is helping to shape change, not lobbying against it."

Kennedy takes on the skeptics of the cost of reform: "I've heard the critics complain about the costs of change. I'm confident that at the end of the process, the change will be paid for—fairly, responsibly, and without adding to the federal deficit. It doesn't make sense to negotiate in the pages of NEWSWEEK, but I will say that I'm open to many options, including a surtax on the wealthy, as long as it meets the principle laid down by President Obama: that there will be no tax increases on anyone making less than $250,000 a year. What I haven't heard the critics discuss is the cost of inaction. If we don't reform the system, if we leave things as they are, health-care inflation will cost far more over the next decade than health-care reform. We will pay far more for far less—with millions more Americans uninsured or underinsured," he writes.

And he argues, the perfect should not be the enemy of the good: "Everyone won't be satisfied—and no one will get everything they want. But we need to come together, just as we've done in other great struggles—in World War II and the Cold War, in passing the great civil-rights laws of the 1960s, and in daring to send a man to the moon. If we don't get every provision right, we can adjust and improve the program next year or in the years to come. What we can't afford is to wait another generation."

The high-stakes battle over healthcare takes today to dueling Internet and radio addresses.

In his weekly address, President Obama tells Americans that the status quo is unacceptable and the chance for fixing healthcare might not come again for years.

"This is an issue that affects the health and financial well-being of every single American and the stability of our entire economy," he says, after a week during which doubts grew in Congress about how to pay for the overhaul, the official budget keeper warned that the legislation would not control public spending on healthcare, and calls became louder for slowing down the process.

"It’s about every family unable to keep up with soaring out of pocket costs and premiums rising three times faster than wages. Every worker afraid of losing health insurance if they lose their job, or change jobs. Everyone who’s worried that they may not be able to get insurance or change insurance if someone in their family has a pre-existing condition.

"This is the system we have today. This is what the debate in Congress is all about: Whether we’ll keep talking and tinkering and letting this problem fester as more families and businesses go under, and more Americans lose their coverage. Or whether we’ll seize this opportunity – one we might not have again for generations – and finally pass health insurance reform this year, in 2009."

Obama also directly takes on his critics, asserting that it's "simply not true" that the overhaul will lead to record government deficits and saying that it's not true that the plan calls for government bureaucrats instead of families picking doctors.

"Finally, opponents of health reform warn that this is all some big plot for socialized medicine or government-run health care with long lines and rationed care. That’s not true either. I don’t believe that government can or should run health care," the president says. "But I also don’t think insurance companies should have free reign to do as they please."

In the Republican response, Senator Jon Kyl of Arizona warned about "a government takeover of the healthcare system," new "job-killing taxes" on small businesses, and "rationing" of care.

He also accused Democrats of trying to rush through legislation "because the more Americans know about it, the more they oppose it. Something this important needs to be done right, rather than done quickly."

"Republicans have put forward common-sense ideas, including rooting out Medicare and Medicaid fraud, reforming medical liability laws to discourage frivolous lawsuits, strengthening wellness and prevention programs that encourage healthy living, and allowing small businesses to band together and purchase health insurance like large corporations do," said Kyl, the No. 2 Republican in the Senate leadership.

“We know Americans would prefer us to work together to ensure access to affordable quality healthcare for all. But Americans do not want a government takeover of health care that will jeopardize their current coverage, ration care, and create mountains of new debt and higher taxes.

Obama's address can be viewed here, Kyl's can be seen here, and both their remarks are below:

Despite a series of setbacks this week, President Obama declared this afternoon that there has been "unprecedented progress" toward a healthcare overhaul.

In a hastily scheduled, then delayed appearance at the White House designed to reseize momentum on his top domestic priority, Obama urged everyone to "step back" from the "24-hour news cycle."

He spoke a day after the official, nonpartisan bean counter in Congress warned that House Democrats' healthcare bill would increase public spending on healthcare and worsen the federal deficit, adding to the sense that the legislation might be in trouble.

But Obama noted that hospitals and drug companies have pledged givebacks to help pay for the bill, and that the American Medical Association and American Nurses Association endorsed legislation this week. He also asserted that there is broad agreement on major elements of health reform.

"Now we've got to get over the finish line," he said, largely by figuring out how to pay the full cost of health overhaul without adding to the federal deficit.

"The last few miles of any race are the hardest to run," he added, but that doesn't mean slowing down or giving up and he remains "absolutely convinced" that legislation will be passed this year.

It must be passed because if healthcare overhaul isn't done, everyone's health coverage is at risk, the president said.

Obama, who met in recent days with key Senate moderates and Republicans, argued that savings in Medicare and Medicaid, and other efficiencies in the healthcare system would pay for about two-thirds of the cost, estimated at $1 trillion over 10 years.

Obama's chief economic adviser, Lawrence Summers, also made the argument in a speech today defending the administration's economic policies. Summers said the savings projected by the administration are based on wellness and prevention programs that are difficult to figure into the Congressional Budget Office's estimates.

While Obama wants a health overhaul that both extends coverage to the nearly 50 million Americans without insurance and cuts healthcare spending, Douglas Elmendorf, director of the CBO, told a Senate committee Thursday that the legislation drafted so far would fall far short on the second goal.

"We do not see the sort of fundamental changes that would be necessary to reduce the trajectory of federal health spending by a significant amount. And on the contrary, the legislation significantly expands the federal responsibility for healthcare costs," he said.

Despite that warning, two House committees advanced the Democratic bill early today on party-line votes.

The Ways and Means Committee voted to help pay for the measure by imposing a surtax on higher-income taxpayers to raise $544 billion over 10 years. The vote was 23 to 18, with three Democrats joining all Republicans in opposition, the Associated Press reports. The Education and Labor Committee approved its portion of the bill on a vote of 26-22.

In the Senate, however, a group of six Democrats and Republicans urged the White House to pull back from its schedule to get a bill through Congress before its August recess. "We believe that taking additional time to achieve a bipartisan result is critical," the group wrote in a letter obtained by the AP.

The letter was signed by Democratic Senators Ben Nelson of Nebraska, Ron Wyden of Oregon, and Mary Landrieu of Louisiana, Republicans Susan Collins and Olympia Snowe of Maine, and Joe Lieberman of Connecticut, an independent who usually caucuses with Democrats.

Could it be a reprise of the stimulus on healthcare?

There are certainly hints that moderate US senators of both parties could determine the fate of President Obama's agenda yet again.

Obama is holding separate private meetings this morning to discuss healthcare overhaul with Senators Olympia Snowe, a Maine Republican, and Ben Nelson, a Nebraska Democrat. They are among the senators being targeted by new TV ads, launched by Obama's grassroots organization, that say "it's time" for healthcare reform.

Nelson and Snowe's fellow moderate senator from Maine, Susan Collins, played a key role in negotiations to win Senate approval in February for the $787 billion economic recovery package championed by Obama. The stimulus bill passed the House without a single Republican vote, and the administration's horse-trading focused on satisfying Nelson and Collins, who pushed for a smaller package.

After meeting with Obama, Snowe said the president repeated his wish for Congress to pass a bill before its August recess. "He's determined to have that happen," she said on MSNBC.

But Snowe said it's more important to get bipartisan consensus in the Senate Finance Committee, especially on how to pay for the bill. Supporting a Senate vote in September, she also said she wants to give ample time for all senators and the public to review the bill.

"This deserves a thoughtful process," she said.

Asked about Senate Finance Chairman Max Baucus saying today that Obama had hindered his efforts to reach a bipartisan deal by opposing a tax on some employer-provided health insurance benefits to help pay for the deal, Snowe said it would be helpful if Obama endorsed a financing approach.

The panel is "working mightily" to find "offsets" and other savings to reduce the cost of the bill. "It's all part of building a consensus," she said.

Asked to respond to Baucus, deputy White House press secretary Bill Burton told reporters on Air Force One today, "Nobody said it was going to be easy. And there are obviously bumps along the way to getting to final passage of legislation in both the House and the Senate. But we think that we've been able to make a lot of progress. And those comments notwithstanding, this week has been a very great week, if you consider that the House bill and the bill that passed through the HELP Committee are very, very similar. They're about 80 percent exactly the same."

Burton refused to say which version of the healthcare bills the president favors, and said Obama remains hopeful for a bipartisan compromise.

"We're only about midway through this. But he feels very positive about the progress we've been able to make," Burton said. " And once we get something through the House and through the Senate, we'll be able to go to conference and really put the rubber to the road and get something done."

With the power equation in the Senate so tenuous -- just last week Al Franken became the 60th Democratic vote, potentially enough to overcome Republican filibuster -- Snowe and Collins play an outsized role.

Obama and Senator Edward M. Kennedy of Massachusetts are still holding out hope for a bipartisan deal this year on healthcare.

But those prospects appear to be dimming. The Senate health committee passed its $615 billion plan on a strictly party-line vote on Wednesday.

In the House, little, if any Republican support, is expected in votes planned today in the Education and Labor and the Ways and Means committees on a $1.5 trillion plan that House Democrats presented this week. It would be financed in large measure through a tax surcharge on the highest-income Americans.

"It is extraordinary, the breadth of the bill that is being pushed through and the cost associated with it," Representative Eric Cantor, the No. 2 Republican in the House, told reporters this morning. "And ultimately, really, the cost is going to be borne by the people of this country -- the middle class, the wealthy, those who can least afford it, all of us are going to be paying an astronomical cost at a time that we just cannot afford this ambitious grab."

Obama, who during the campaign proposed paying for healthcare by limiting tax deduction for high earners, has not endorsed a specific financing plan. But on CBS's "Early Show" this morning, he said, "Personally, I think the best way to fund it is for people like myself, who've been very lucky, to pay a little bit more."

UPDATE: Today, the American Medical Association endorsed House Democrat's bill, saying it "includes a broad range of provisions that are key to effective, comprehensive health system reform."

“I am grateful that the doctors of the AMA have chosen to support health insurance reform that will lower costs, expand coverage, and assure choice and quality health care for all Americans. Along with the nation’s nurses, these doctors are joining the chorus of Americans who know that the time to reform what is broken about our health care system is now,” Obama said in a statement.

The insurance industry, however, said it opposes key elements of the bill, saying a government plan "will cause millions of patients to lose their current coverage."

With President Obama's goal of a sweeping healthcare bill hanging in the balance, his grassroots group plans a weeklong series of events across the country designed to turn up the heat on Congress.

Organizing for America, Obama's campaign organization now part of the Democratic National Committee, announced this afternoon that it plans door-to-door canvasses, phone banks, roundtable discussions, and community gatherings from Monday through next Sunday, all "designed to build grassroots support for President Obama’s plan and amplify the his call for the House and Senate to pass health care reform bill before the August congressional recess."

The events include door knocks and a phone bank led by State Representative Chris Hamm in Hopkinton, N.H., next Saturday, and signature collecting in Exeter, N.H., next Sunday.

“Presidents since the time of Teddy Roosevelt have called for reform of our health care system - now comprehensive reform is finally within our reach,” Mitch Stewart, the group's director, said in a statement. “The number of Americans who have declared their support for the President’s three principles of reform has been overwhelming and continues to grow each day. During this Week of Action, we’ll continue to build support - person-by-person and block-by-block - for passing a plan this year that lowers costs, guarantees choice – including the choice of a public option and ensures all Americans have access to quality, affordable care.”

It must be a bittersweet time for Senator Edward M. Kennedy.

His most cherished legislative goal -- a healthcare bill that offers universal coverage -- is perhaps closer than ever before.

But his own health -- he is more than a year into treatment for aggressive brain cancer -- is keeping him from being in the thick of the action. He was not present when the Senate health committee became the first congressional panel Wednesday to pass a healthcare overhaul bill.

President Obama, who benefited immensely from Kennedy's endorsement during the Democratic primaries, said on ABC's "Good Morning America" this morning that he had talked to Kennedy last week.

But the president noted that is a difficult time for Kennedy, whom he lauded at a White House healthcare summit in March.

"Obviously, it's painful for Senator Kennedy, who's fought all his life for this moment, not to be there in the heat of battle. But he's there in spirit," Obama said. "Obviously, right now, we just want to make sure that he's taking care of himself and he's healing. But his spirit looms large over this entire process."

Even without him there in person, it was a big day on Capitol Hill for Senator Edward M. Kennedy.

His bill to extend federal hate crimes protections to gays and the disabled made it to the Senate floor with its best prospects since Kennedy, who is fighting brain cancer, first introduced the bill in 1997.

Democrats control both the Senate and House, which passed a version in April, and President Obama supports the legislation as well. The bill, named for Matthew Shepard, the gay Wyoming college student who was beaten to death, would add gender, sexual orientation, gender identity, or disability to current hate crimes law, which applies to acts of violence motivated by prejudice against a person's race, color, national origin, or religion.

Earlier in the day, the Senate health committee became the first congressional panel to pass a healthcare bill this year -- a measure designed to expand insurance coverage, rein in costs, and stop private insurers from discriminating against people based on their medical history.

“This is an historic day for the cause of health care reform that is the cause of Senator Kennedy’s life," Senator John F. Kerry, Kennedy's fellow Massachusetts Democrat, said in a statement.

"Each day I work beside Ted Kennedy is an honor, a privilege, and an education in what it means to be a legislator, and of those thousands of days, none have been sweeter or longer in coming than today’s giant step forward in providing affordable healthcare to all Americans. The HELP Committee under Ted and Chris Dodd’s extraordinary guidance passed a plan that will help all those struggling under the weight of mounting costs by encouraging competition and offering a robust public choice that empowers consumers and keeps the big interests honest. The Senate under Ted Kennedy’s leadership is committed to a healthcare plan that drives down costs, strengthens coverage, and preserves personal choice. This is Teddy’s mission, and we’re committed to making his dream a reality.”

With Congress getting back on track on a healthcare overhaul, President Obama declared this afternoon that "we are now closer to the goal of health reform than we have ever been."

During his foreign trip last week, leaders of the healthcare push ran into a series of roadblocks. But on Tuesday, the House Democratic leadership unveiled a comprehensive bill. And this morning, the Senate health committee passed its version.

"Both proposals will take what’s best about our system today and make it the basis for our system tomorrow -- reducing costs, raising quality, and ensuring fair treatment of consumers by the insurance industry," the president said in the Rose Garden.

"Both include a health insurance exchange, a marketplace that will allow families and small businesses to compare prices, services, and quality so they can choose the plan that best suits their needs; and among the choices available would be a public health insurance option that would make healthcare more affordable by increasing competition, providing more choices, and keeping insurance companies honest. Both proposals will offer stability and security to Americans who have coverage today, and affordable options for Americans who don’t," Obama added.

"This progress should make us hopeful -- but it can’t make us complacent. It should instead provide the urgency for both the House and the Senate to finish their critical work on health reform before the August recess."

Senator Edward M. Kennedy of Massachusetts, who is seeking a landmark healthcare bill as the capstone of his legislative career while fighting brain cancer, missed the health committee vote.

Still, Obama praised the "unyielding passion and inspiration" provided by "our friend Ted Kennedy," as well as the "bold leadership" of Senator Christopher Dodd of Connecticut, who has been shepherding the bill in Kennedy's absence.

Taking on critics he described as the "naysayers and the cynics," Obama repeated his argument that the country can't wait to fix the healthcare system, and renewed his vow to sign a comprehensive healthcare bill this year.

"We are going to get this done," said Obama, who was joined by Dodd and leaders of the 2.9-million-member American Nurses Association, saying that "few understand why we have to pass reform as intimately as our nation’s nurses." "It's time for us to buck up.... It’s up to us now. We can do what we’ve done for so long and defer tough decisions for another day -- or we can step up and meet our responsibilities. In other words, we can lead. We can look beyond the next news cycle and the next election to the next generation, and come together to build a system that works not just for these nurses, but for the patients they care for; for doctors and hospitals; for families and businesses -- and for our very future as a nation."

His full prepared remarks are below:

As Congress races to try to get a healthcare overhaul bill to President Obama's desk before the August recess, both political parties are trying to shape public opinion.

Organizing for America, Obama's grassroots group now housed within the Democratic National Committee, released a new 30 second TV ad today in which five people hurt by the healthcare system all say "it's time" for the sweeping change. The five (their stories are below) are among hundreds of thousands of people who responded to the group's call for personal stories.

“Millions of Americans lose their health insurance when they lose their job, are denied care because of a pre-existing condition, and delay care or skip medication because they can’t afford it,” the group's executive director, Mitch Stewart, said in a statement. “Skyrocketing health care costs are hurting American families and straining already-strapped budgets for businesses and governments. It’s time to reform our health care system to lower costs, preserve patient choice and ensure that all Americans have access to quality, affordable care.”

The ad will run on national cable, on cable in Washington, and on local stations in Arkansas, Indiana, Florida, Louisiana, Maine, North Dakota, Nebraska, and Ohio, calling on moderate senators -- both Republicans and Democrats -- in those states to support the bill.

While Democrats are urging Congress to act, Republican National Committee chairman Michael Steele asked "why the rush?" in an email today to supporters urging them to get involved.

"The Democrats have learned from their missteps last time they tried to force Americans into a socialized health care system -- the abysmal failure of the Clinton Administration's 'HillaryCare,' " he says. "So now, they are rushing 'Obamacare' through Congress, hoping it avoids the same fate."

Like Clinton's ill-fated plan, Obama and the Democrats -- with a public insurance option -- are seeking government-run healthcare, Steele argues.

"President Obama and Congressional Democrats think government is the solution to every problem. They're wrong," he says. "The government already runs car companies, banks and mortgage companies. Republicans believe that the last thing the American people want is government telling them when and where -- or even whether -- they can get medical treatment for their families.

"You and the RNC are all that stand between our sensible Republican plan for real healthcare reform and the Democrats' scheme to take more of your hard-earned income to pay for other people's health care while limiting yours."

The Senate health committee this morning passed its version of healthcare overhaul on a 13-10 party line vote, the first congressional panel to pass a healthcare bill this session.

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Senate health panel
passes overhaul bill

• Healthcare bill offers workers incentive for healthy lifestyle

"We have done the hard work that the American people sent us here to do," Kennedy said in a statement. "We know, however, that our work is not over -- far from it. As we move from our committee room to the Senate floor, we must continue the search for solutions that unite us, so that the great promise of quality affordable health care for all can be fulfilled."

“For the past months, Rhode Islanders have told me that we need to fix health care in this country. I’ve heard from people struggling under skyrocketing costs and fearful that their coverage will disappear; people living with illness or injury because they can’t afford to see a doctor; people suffering from needless, preventable medical errors. All they’re asking for is health care they can rely on, and afford. As of today, we’re one step closer," Senator Sheldon Whitehouse, a Rhode Island Democrat on the committee, said in a statement.

“The reform bill we passed today will let you keep the health insurance you have, if you like it – and if you can’t afford your coverage or you’re uninsured, you’ll have new choices. Its emphasis on quality improvement, disease prevention, and a public insurance option will mean high-quality, efficient health care that invests not only in treating you when you’re sick, but in keeping you well. And never again will an insurance company be able to deny you coverage because of a pre-existing condition."

But Senator Judd Gregg, a New Hampshire Republican, told reporters that Democrats on the committee had "struck out" on healthcare by passing a bill that leaves millions of Americans uncovered and that could cost workers their jobs by burdening businesses.

He and other Republicans complained that the Democratic majority ignored their proposals and amendments.

On Tuesday, House leaders unveiled a $1.5 trillion healthcare bill that would raise taxes on the highest-income Americans and penalize businesses that don't offer coverage and individuals who don't get insurance.

The House bill calls for federal income surtax starting with individuals making more than $280,000 a year and rising to 5.4 percent on those making more than $1 million a year. Employers who don't provide coverage would be hit with a penalty equal to 8 percent of workers' wages, though small businesses would be exempt. Individuals who skip coverage would pay 2.5 percent of their incomes as a penalty, up to the average cost of a health insurance plan.

President Obama, who is ramping up his push to get a healthcare overhaul bill on his desk before the August congressional recess, has scheduled another speech on healthcare this afternoon in the Rose Garden.

Obama responded to the panel's passage with a statement praising elements that he supports, but as he did when House leaders unveiled their bill without fully endorsing it.

“Today, thanks to the unyielding passion and inspiration provided by Senator Edward Kennedy, the HELP committee he chairs has produced a proposal that will finally lower health care costs, provide better care for patients, and ensure fair treatment of consumers by the insurance industry," the president said.

"Like the legislation produced by the House of Representatives, this proposal would offer Americans quality, affordable health care that is there when they need it. No longer will insurance companies be able to deny coverage based on a pre-existing medical condition. No longer will Americans have to worry about their health insurance if they lose their job, change their job, or open a new business.

"This proposal will bring down costs, expand coverage, and increase choice. Through a health insurance exchange, families and small businesses will be able to compare prices and quality so that they can choose the health care plan that best suits their needs. Among the choices that would be available in the exchange would be a public health insurance option that would make health care affordable by increasing competition, providing more choices, and keeping the insurance companies honest.

"This proposal would also control rising costs by investing in preventive care and wellness programs, rooting out waste and fraud in the system, and changing the incentives that automatically equate the most expensive care with the best care.

"When this proposal is combined with other proposals that the Senate Finance Committee is working on, it’s estimated that health reform will cover 97% of all Americans.

"The HELP committee’s success should give us hope, but it should not give us pause. It should instead provide the urgency for both the House and Senate to finish their critical work on health reform before the August recess. I want to commend Senator Kennedy, Senator Dodd, as well as Senators Harkin, Mikulski, Bingaman, and Murray on the leadership they’ve shown and the foundation they’ve laid to reform our health care system.”

President Obama this afternoon praised the healthcare overhaul bill unveiled by Democratic leaders in the House.

Patterned in significant measure after the 2006 Massachusetts law, it would penalize employers who fail to provide health insurance for their workers and individuals who refuse to obtain coverage.

The legislation would be paid for by a federal income surtax -- up to 5.4 percent on the income of taxpayers making more than $1 million a year -- plus hundreds of billions of dollars in cuts in projected Medicare and Medicaid spending.

Obama urged Congress on Monday to get back on track to send him a bill before its August recess, after healthcare legislation went off the rails over disagreements on financing during the week he was abroad.

But in his statement, he did not endorse the surtax as a way to pay for healthcare.

"For decades, Washington failed to act as healthcare costs continued to rise, crushing businesses and families and placing an unsustainable burden on governments. But today, key committees in the House of Representatives have engaged in unprecedented cooperation to produce a health care reform proposal that will lower costs, provide better care for patients, and ensure fair treatment of consumers by the insurance industry," Obama said in a statement issued by the White House this afternoon.

"This proposal controls the skyrocketing cost of health care by rooting out waste and fraud and promoting quality and accountability. Its savings of more than $500 billion over 10 years will strengthen Medicare and contribute to our goal of reforming health care in a fiscally responsible way. It will change the incentives in our health care system so that Americans can receive the best care, not the most expensive care. And it will offer families and businesses more choices and more affordable health care," he added.

"This proposal will also prevent insurance companies from denying people coverage because of a pre-existing medical condition. It will ensure that workers can still have health insurance if they lose their job, change their job or start a new business. And it includes a health insurance exchange that will allow families and small businesses to compare prices and quality so they can choose the health care plan that best suits their needs. Among the choices that would be available in the exchange would be a public health insurance option that would make health care affordable by increasing competition, providing more choices, and keeping the insurance companies honest.

"The House proposal will begin the process of fixing what’s broken about our health care system, reducing costs for all, building on what works, and covering an estimated 97% of all Americans. And by emphasizing prevention and wellness, it will also help improve the quality of health care for every American.

"I thank Chairmen Rangel, Waxman, and Miller for their hard work on this bill that fundamentally reforms the health care system. As this process moves forward, I look forward to continuing to work with all House members in ensuring this legislation helps all Americans and plays an essential role in reducing deficits and bringing fiscal sustainability to our nation.”

UPDATE: Critics say the well-off are being unfairly targeted and would be discouraged from making more money and creating jobs.

The Tax Foundation calculates if the House plan became law, taxpayers in 39 states would face a combined top tax rate of more than 50 percent. Residents of Rhode Island (56.2 percent) and Vermont (55.8 percent) would be among the hardest hit.

"That means government would be taking more than half of every additional dollar from high-income taxpayers," Tax Foundation President Scott Hodge said in a statement.

The House proposal would impose a surtax of 1 percent on married couples with adjusted gross incomes of between $350,000 and $500,000 a year and singles who earn between $280,000 and $400,000; 1.5 percent on couples with incomes between $500,000 and $1 million and singles earning between $400,000 and $800,000; and 5.4 percent on couples earning more than $1 million and singles more than $800,000.

President Obama didn't page Dr. Gupta to be his surgeon general, instead tapping a family doctor from rural Alabama.

He announced this morning he will ask the Senate to confirm Dr. Regina Benjamin for the post, a bully pulpit for public health that has become less visible since C. Everett Koop, who served from 1982 to 1989.

Obama said she Benjamin has ample credentials to be the chief spokesperson for public health -- and more importantly the commitment and empathy that she has shown by staying in her rural health clinic that serves shrimpers who can't afford healthcare.

Benjamin, he said, has seen first hand and up close many of the flaws of the current healthcare system and represents what is best about doctors who will do anything to heal the sick.

Benjamin, 51, said she has personal experience, listing family members who have died from chronic conditions and preventable diseases including diabetes, AIDS, and lung cancer caused by smoking.

She said while she can't change her family's health, she can be a voice for improved public health.

Sanjay Gupta, the high-profile chief medical correspondent for CNN, was under consideration for the post, but withdrew his name in March, citing family and career concerns.

While Benjamin isn't as well-known in the wider public, she did earn notice for rebuilding her nonprofit medical clinic after Hurricane Katrina, won a MacArthur Foundation "genius grant" last year, and became the first black woman and the youngest doctor elected to the American Medical Association's board.

(The full remarks of Benjamin and Obama are below, followed by the White House release.)

Obama also used the Rose Garden ceremony to put in another plug for his healthcare overhaul plan, which has run into a series of roadblocks in Congress in recent weeks.

He insisted, however, that reform is closer than ever, but said he has "no illusions" that it will be difficult to get across the finish line. But he said that an overhaul is needed, and accused his critics of "small thinking."

"This is no longer a problem we can wait to fix," he said.

Citing what he called "chatter" from "naysayers" that emerged during his trip to Europe and Africa last week, he said he wanted to put everyone on notice: "We are going to get this done."

President Obama said today he still hopes that Congress can vote on a healthcare overhaul bill before its August recess, despite a series of setbacks this week for his top domestic priority.

House leaders hoped to unveil their bill today, but have put that off until at least Monday while they try to bring conservative Democrats, known as the Blue Dog Coalition, back into the fold. Democrats in both the House and Senate are scrambling to come up with a way to pay the estimated $1 trillion cost over the next decade.

UPDATE: In the latest approach to financing the overhaul, House Ways and Means Chairman Charles Rangel told reporters this afternoon that the House bill to be unveiled on Monday would raise $540 billion over the next decade by imposing a 1 percent surtax on Americans with an annual income of more than $350,000. A higher surtax is proposed for people earning $500,000 and $1 million, he said.

Combined with savings promised by hospitals and pharmaceutical companies, including cuts to Medicare and Medicaid, the tax revenue is designed to be enough to pay for a bill costing about $1 trillion.

"Our team is working with members of Congress every day on this issue, and it is my highest legislative priority over the next month," Obama told reporters at the close of the G-8 summit in Italy.

He insisted that Washington is closer "at any time in recent history" to "achieving serious health care reform that cuts costs, provides coverage to American families, allows them to keep their doctors and plans that are working for them."

As both parties and both chambers work through the legislation, the president said, his job is to set "clear parameters" -- cutting costs, emphasizing prevention, covering the nearly 50 million uninsured, and doing it in a way that does not add to the federal deficit.

"There are going to be some tough negotiations in the days and weeks to come, but I'm confident that we're going to get it done," Obama added. "What I'm trying to keep focused on are the people out in states all across the country that are getting hammered by rising premiums. They're losing their jobs and suddenly losing their healthcare."

His full answer at the news conference is below:

Subbing for President Obama, who is at the G-8 economic summit in Italy, Vice President Joe Biden this morning formally announced the latest deal with the industry on a healthcare overhaul.

The nation's hospitals have tentatively agreed to forego about $155 billion in government payments for Medicaid and Medicare over the next decade -- about 20 percent of the $1 trillion projected to be needed to extend health coverage to about 47 million uninsured Americans.

Hospitals are cracking under the weight of uninsured patients getting treated in emergency rooms, Biden said, flanked by several hospital CEOs.

The deal follows some concessions by pharmaceutical firms, retail giant Wal-Mart's announcement last week that it would support an employer requirement to help pay for healthcare. The Obama team hopes such agreements build momentum for sweeping healthcare changes; the president wants to sign a bill this year.

"Reform is coming. It is on track. It is coming," Biden said.

Drug companies, doctors, and others are interested in healthcare overhaul. "We have the American public behind us," Biden added. (His full remarks are below.)

But even fellow Democrats in Congress are having qualms about the complexities of how to pay for a healthcare overhaul -- including whether to tax health benefits provided by employers -- and whether to create a new government insurance plan.

The White House just issued a statement this morning reacting to word of a deal with hospitals to help finance a healthcare overhaul.

"I am pleased by the progress we're making on health care reform and still believe, as I've said before, that one of the best ways to bring down costs, provide more choices, and assure quality is a public option that will force the insurance companies to compete and keep them honest. I look forward to a final product that achieves these very important goals," said the statement from President Obama, who is in Moscow for day two of his first Russian summit.

Administration and industry officials told several news organizations late Monday that after talks involving the White House and key Senate Democrats, the nation's hospitals were on the verge of signing off on a deal to reduce their anticipated payments from Medicare and Medicaid by about $155 billion over the next decade.

The government could use that money to help provide health coverage to millions who now lack it. The cost of healthcare overhaul is projected at $1 trillion or more over the next decade.

The new and improved version of the Senate health committee's healthcare overhaul would be cheaper and cover more Americans, its leaders claim.

The plan is estimated to cost $611 billion over 10 years, and offer coverage to 97 percent of Americans. It includes a $750-a-year fee on companies with more than 25 employees for each full-time worker they don't offer coverage, and $375 per part-time worker. It also includes an option for government insurance to compete with private insurers.

"Like the president and a strong majority of Americans, we believe that a strong public option is an important component of any health reform bill that keeps costs down, expands coverage and offers American families a wide variety of affordable options," Senators Chris Dodd of Connecticut and Edward M. Kennedy of Massachusetts wrote in a letter to committee members that was obtained by the Associated Press.

Dodd, who is taking the lead as Kennedy undergoes treatment for brain cancer, briefed reporters this morning on the new proposal, joined by Senators Sheldon Whitehouse of Rhode Island and Sherrod Brown of Ohio.

(The committee's release is below.)

The committee's original draft bill was essentially dead on arrival after the Congressional Budget Office -- the official scorekeeper on the costs and benefits of legislation -- concluded last month that it would cost $1 trillion over the next decade, but would leave millions still uninsured.

While the proposal would extend coverage to 39 million people, the CBO estimated, 15 million who had coverage through their employer would lose it, as would 8 million others.

Dodd and Kennedy say in the letter that the revised proposal "virtually eliminates" the likelihood that many companies would drop coverage for their workers.

UPDATE: President Obama praised the new bill, saying it "reflects many of the principles I’ve laid out," and said that when combined with a Senate Finance Committee version, will enable the Senate to vote on "health reform legislation that does not add to the deficit, reduces health care costs and covers 97% of Americans."

His full statement this morning: "For decades, Washington has failed to act as health care costs continued to rise, crushing businesses, families and placing an unsustainable burden on governments. Today the Senate HELP committee has produced legislation that lowers costs, protects choice of doctors and plans and assures quality and affordable health care for Americans. The Congressional Budget Office has now issued a more complete review of this bill, concluding that it will cost less and cover more Americans than originally estimated. It also contains provisions that will protect the coverage Americans get at work.When merged with the Senate Finance Committee’s companion pieces, the Senate will be prepared to vote for health reform legislation that does not add to the deficit, reduces health care costs and covers 97% of Americans.

"The HELP Committee legislation reflects many of the principles I’ve laid out, such as reforms that will prohibit insurance companies from refusing coverage for people with pre-existing conditions and the concept of insurance exchanges where individuals can find affordable coverage if theylose their jobs, move or get sick. Such a marketplace would allow families and some small businesses the benefit of one-stop-shopping for their healthcare coverage and enable them to compare price and quality and pick theplan that best suits their needs.

"Among the choices that would be available in the exchange would be a public health insurance option. The public option would make health care affordable by increasing competition, providing more choices and keeping the insurance companies honest.

"The legislation also improves the quality of patient care, improves safety for patients and strengthens the commitment to preventive health care – preventing people from getting sick in the first place.

"I thank chairman Kennedy, Senator Dodd, and all the members of the HELP Committee for their hard work on health reform."

President Obama has been urging the public to speak out on healthcare, warning that if they don't, their voices will be drowned out by special interests.

A watchdog group today put some numbers behind that admonition, reporting that health industry groups are vastly outspending consumer groups in lobbying Washington.

The Center for Responsive Politics says that consumer groups that favor Obama's proposals, including a public insurance plan to compete with private insurers, are being "decidedly outspent and out-lobbied by drug manufacturers, insurers, HMOs, and doctors' associations."

In the first three months of 2009, the US Chamber of Commerce, which has spent more money on lobbying since 1998 than any other group, and the Pharmaceutical Researchers and Manufacturers of America paid lobbyists a combined $22.5 million to promote their interests.

In contrast, Families USA, a consumer group on healthcare has spent $10,000 on lobbying this year after spending only $32,000 total in 2008, the center says.

President Obama is seeking to build more public support for his healthcare agenda, holding an online town hall meeting this afternoon at Northern Virginia Community College in Annandale.

But newly released poll results show he has some work to do.

The CNN/Opinion Research Corp. survey found that 51 percent of Americans support Obama's health reform plans, while 45 percent oppose them. Those numbers, however, lag well below his overall job approval standards.

And the vast majority of Americans believe Obama's plans would cause their own medical costs to rise -- 54 percent in the poll said their costs would go up, while 17 percent said their bills would decrease, and 26 percent said costs would stay the same. More worrisome perhaps, only 20 percent of Americans said they would be better off with the healthcare overhaul, while 35 percent said they would worse off, and 44 percent said they would come out about the same.

Also, the number who believe that the healthcare system needs a "great deal" of reform has dipped slightly, to 55 percent now from 62 percent just before the November election.

Still, Americans trust Obama on healthcare more than congressional Republicans or Democrats. When Congress returns next week from its July Fourth recess, key Senate committees plan to resume detailed work on their proposals.

And so far, the poll suggests, Americans aren't buying the arguments of healthcare overhaul critics -- that the proposals would force patients to leave their doctors and that the plans would force private insurers out of business. Only 31 percent believe the former, and 42 percent the latter.

The poll, conducted June 26-28, has a margin of error of plus or minus 3 percentage points.

At the town hall, Obama is answering questions from a live audience, as well as and online communities including Facebook, YouTube, and Twitter.

Kicking off the event, Obama called healthcare one of the most important issues facing American families -- and one of the keys to long-term economic prosperity.

"We are at a defining moment for this nation," he said, reprising a reform theme from his campaign and confronting critics who say he is taking on too many ambitious proposals.

"America has waited too long," he said, to seriously deal with healthcare, as well as education and clean energy.

The president also addressed the concern that a healthcare overhaul designed to extend coverage to every American will cost too much -- more than $1 trillion over the next decade, according to most estimates.

"The costs of inaction, of doing nothing, are even greater and are unacceptable," Obama said, with healthcare inflation rising dramatically and increasing the federal deficit.

Beyond macroeconomics, healthcare problems are hurting real families every day, he said.

Obama vowed to get an overhaul plan through Congress this session.

"We are going to pass it this year," he said to applause. "That is my commitment. We are going to get it done."

But he cautioned that the most difficult work to passing a plan lies ahead. Naysayers are coming up with "every excuse and scare tactic in the book" to stall reform, he said.

To critics, he said he asks, what's their alternative and what they say to Americans who are without insurance or at risk of losing it.

"All of us are in this together," he said.

He urged the public to join the fight, saying that if Congress doesn't believe that Americans want real change, the lobbyists and special interests will carry the day.

(His full remarks, and the question-and-answer session, are below.)

Obama has mobilized his grassroots army to get the word out on healthcare. The post-election vehicle for Obama's campaign, Organizing for America, held a series of service-related healthcare events last week. And today, it sent supporters an email bragging about the turnout, including a video of highlights and a reference to a Boston Globe report about it.

"Last weekend, you were part of something big," wrote Jeremy Bird, the group's deputy director. "Americans like you came together across the country -- in community health centers, outside of supermarkets, in local schools -- to serve together and improve health care in your community. While serving your neighborhoods, you raised your voice and built momentum to finally fix this broken health care system. Thank you for your work."

The White House announced late this afternoon that top officials will go on the road this summer -- not to big cities, but to often-neglected rural areas to discuss how communities, states, and the federal government can work together to strengthen rural America.

Vice President Joe Biden, Commerce Secretary Gary Locke, and Agriculture Secretary Tom Vilsack will kick off the Rural Tour on Wednesday to visit Wattsburg, Pa., to discuss the issue of rural broadband.

“A healthy American economy depends on a prosperous rural America,” President Obama said in a statement. “Rural America is vast and diverse, and different communities face different challenges and opportunities. That’s why we’re going out to hear directly from the people of rural America about their needs and concerns and what my Administration can do to support them.”

The other stops scheduled so far:

July 16, Transportation Secretary Ray LaHood and Vilsack will travel to La Crosse, Wisc., to discuss rural economic development.

July 18, Energy Secretary Steven Chu and Vilsack will travel to Ringgold, Va., to discuss green jobs and a new energy economy, with a focus on weatherization and carbon sequestration.

July 20, Health and Human Services Secretary Kathleen Sebelius, Veterans Affairs Secretary Eric Shinseki, Labor Secretary Hilda Solis, and Vilsack will travel to St. John’s Parish, La., to discuss rural healthcare.

Aug. 12, Housing Secretary Shaun Donovan, Education Secretary Arne Duncan, Interior Secretary Ken Salazar, Chu, and Vilsack will travel to Bethel, Alaska, to discuss rural infrastructure, green jobs and a new energy economy, as well as climate change.

Aug. 16, Salazar and Vilsack will travel to Zanesville, Ohio, to discuss green jobs and a new energy economy, with a focus on renewable energies.

Aug. 17, Duncan and Vilsack will travel to Hamlet, N.C., to discuss rural education.

Sept. 28, Salazar and Vilsack will travel to Scottsbluff, Neb., to discuss production agriculture.

Sept. 30, Donovan and Vilsack will travel to Las Cruces, N.M., to discuss rural infrastructure.

With members of Congress back home this week for the July Fourth recess, left-leaning religious groups today announced a series of radio ads promoting the moral argument for a healthcare overhaul.

In the ads, local pastors say that the status quo on healthcare is “not who we are as a nation” and that “America can do better.” They will air on Christian and mainstream radio in Arkansas, Colorado, Indiana, Louisiana, Nebraska, and North Carolina -- the home states of key senators in the healthcare debate.

The faith-based push also includes meetings with members of Congress, sermons on healthcare, and a new guide to the healthcare debate for people of faith. The groups sponsoring the campaign are PICO National Network, Faith in Public Life, Faithful America, Sojourners, Gamaliel Foundation, and Catholics in Alliance for the Common Good.

Consumer activist Ralph Nader has a simple message for liberals feeling less warm and fuzzy about President Obama: "I told you so."

"Millions of Americans are feeling betrayed. They thought Obama as President meant change we can believe in. They thought Obama as President meant withdrawal from Iraq. They thought Obama as President meant standing up to Wall Street fat cats. They thought Obama as President meant a living wage," Nader, who ran a presidential campaign last year far less successful than his 2000 bid, said in an email to supporters today,

"But for those of you who stood with us during the 2008 Presidential campaign, you knew the score. You do not feel betrayed. You are immune to Obama Betrayal Syndrome," Nader continues. "Because you knew, as we pointed out repeatedly during the campaign, that Obama was the corporate Democrat. Beholden to large campaign contributors from Wall Street. From the military industrial complex. And from the health insurance pharma complex."

Nader's missive seeks donations for Single Payer Action, a new advocacy group pushing a healthcare plan along the lines of the national insurance plan in Canada.

Supporters of such a plan say it is the only way to cover everyone while cutting costs, but Obama is not among them, saying that while it might make sense if starting from scratch, it makes more sense now to build upon the current system, under which most Americans get their health coverage through their employer.

To combat critics who call his plan socialized medicine, the president reassures that he would not force anyone to change their coverage.

But Nader's new group isn't giving up. Single Payer Action members have confronted members of Congress in their home districts to press them on the issue.

"Let's break through the corporate barriers and make single payer for all a reality," he says in the email. "Together, we can make the difference. Onward to a life-saving, cost-saving single payer."

President Obama today offered part two of his healthcare overhaul pitch, and provided more detail on his pledge to find another $300 billion in savings to help pay for it.

Last week, in a detailed two-page letter to key senators laying out his core principles for a healthcare bill, Obama said he wanted to cut an additional $200 billion to $300 billion from Medicare and Medicaid over the next decade, on top of the $309 billion reduction he had already proposed in the government's two main healthcare programs for the poor, elderly, and disabled.

In his weekly radio and Internet address today, he says, "I am announcing an additional $313 billion in savings that will rein in unnecessary spending, and increase efficiency and the quality of care – savings that will ensure that we have nearly $950 billion set aside to offset the cost of health care reform over the next ten years."

"These savings will come from commonsense changes," he adds. "For example if more Americans are insured, we can cut payments that help hospitals treat patients without health insurance. If the drug makers pay their fair share, we can cut government spending on prescription drugs. And if doctors have incentives to provide the best care instead of more care, we can help Americans avoid the unnecessary hospital stays, treatments, and tests that drive up costs."

The proposals include incorporating "productivity adjustments" into Medicare payment changes, reducing subsidies to hospitals for treating the uninsured, getting lower prices on Medicare prescription drugs, adjust payment rates for CT scans, adopting an independent panel's recommendations on payments to nursing homes and other long-term care facilities, and the old standby of cutting "waste, fraud, and abuse."

(To see a White House fact sheet on the proposal, click here.)

"These savings underscore the fact that securing quality, affordable health care for the American people is tied directly to insisting upon fiscal responsibility. And these savings are rooted in the same principle that must guide our broader approach to reform: we will fix what’s broken, while building upon what works. If you like your plan and your doctor, you can keep them -- the only changes that you’ll see are lower costs and better health care," the president says.

Obama, who held a town hall meeting this week on healthcare and has mobilized his grassroots organization to lobby Congress, acknowledged that many in Congress, which is working on drafting healthcare bills, and elsewhere "question whether we can afford to act this year."

"But the unmistakable truth is that it would be irresponsible to not act," he says. "We can’t keep shifting a growing burden to future generations. With each passing year, health care costs consume a larger share of our nation’s spending, and contribute to yawning deficits that we cannot control. So let me be clear: health care reform is not part of the problem when it comes to our fiscal future, it is a fundamental part of the solution."

The full address is below, and the video can be viewed here.

Senator John McCain, hurt during the presidential campaign by his differences with President Obama on healthcare, is trying to turn the tables.

McCain today criticized Obama's insistence on a public insurance option to compete directly with private insurers.

“State run plans have driven the private insurers out…it ends up being more and in some cases prohibitively expensive,” the former GOP presidential nominee said on Fox News Channel.

McCain also pointed out that Obama is at least open to considering a tax on employer-paid healthcare benefits to pay for expanding access -- an idea that the president eviscerated McCain about during the campaign.

“The important thing is we wanted to give American families a $5,000 refundable tax credit which would have more than covered their healthcare insurance needs,” McCain said. "He spent tens of millions of dollars attacking me on that.”

“Life isn’t fair, elections have consequences and its interesting how there’s been numerous shifts on the president's positions on a number of issues since the election,” he added.

President Obama took to the road again today, hosting another town hall meeting, this one on healthcare.

He is trying to build public support behind a goal that has eluded his predecessors for decades -- an overhaul of the healthcare system to cut costs and expand access. It is not only his top domestic legislative priority for the rest of the year, but success is also crucial to getting the federal deficit under control so he can pay for other ambitious initiatives.

And in his opening remarks to the crowd in Green Bay, Wisc., he tried to state the case for healthcare overhaul as simply and clearly as possible.

"Every day in this country, more and more Americans are forced to worry not simply about getting well, but whether they can afford to get well. Millions more wonder if they can afford the routine care necessary to stay well," he said.

"If you like your doctor, you will be able to keep your doctor. If you like your health care plan, you will be able to keep your health care plan," Obama added, urging the crowd not to listen to those who want to try to scare the public otherwise.

"But in order to preserve what’s best about our health care system, we have to fix what doesn’t work."

"Healthcare reform is not just something I just cooked up when I took office," Obama added. "It is central to our economic future – it's central to our long-term prosperity as a nation."

Several bills are starting to wend their way through Congress, but Obama made clear last week that there are principles on which he will not compromise -- lowering costs, expanding access, and offering a public insurance plan to compete with private insurers.

"The question now is, how do we finish the job? How do we permanently bring down costs and make quality, affordable healthcare available to every single American?" Obama asked in the town hall. "My view is that reform should be guided by a simple principle: we fix what’s broken and we will build on what works."

The first question came from a self-employed woman who asked why Obama isn't considering a so-called single-payer system, similar to the government health plans in Canada and Britain.

Prefacing his answer, Obama said there had been confusion in the press and public. He said he opposes what critics call "socialized" medicine -- an entirely government-run system. He said while there are some advantages to a single payer plan, where there are private doctors but they are paid from one source -- the government -- to minimize disruptions and to do what is politically possible, he supports building on the existing system, where most people get their insurance through work.

"We're not starting from scratch," he said.

Obama also said that he's not "ideologically" tied to any solution and is more than happy to steal good ideas.

He also made time to write a school absence excuse note for Kennedy, the daughter of another questioner, and handed it to her. (Will it be on eBay by this afternoon?)

Obama picked Green Bay for the town hall because by several measures, it is a model for controlling medical spending while improving the health of patients.

"We have to ask why places like Geisinger Health systems in rural Pennsylvania, or Intermountain Health in Salt Lake City, or communities like Green Bay can offer high-quality care at costs well below average, but other places in America can’t," Obama said. "We need to identify the best practices across the country, learn from the successes, and then duplicate those successes everywhere elsewhere. And we should change the warped incentives that reward doctors and hospitals based on how many tests or procedures they do, even if those tests or procedures aren’t necessary or result from medical mistakes.

"Doctors did not get into the medical profession to be bean counters or paper pushers; they're not interesting in spending all their time acting like lawyers or business executives," he added. "They became doctors to heal people. And that’s what we must free them to do." (Read his full remarks, including the question-and-answer, below.)

But many doctors also went into the profession to make a good living, and many of the proposals being bandied about could cut into their income, particularly those of highly-paid specialists.

So Monday in Chicago, Obama will face a far less friendly audience for his case for a healthcare overhaul. He plans to speak to the American Medical Association, which with about 250,000 members is the nation's largest group of physicians and which opposes the public insurance option.

Asked about the AMA's stand, White House spokesman Bill Burton told reporters today: "He knew at the beginning of this process that people would oppose and support different elements that were on and off the table, and this is just one part of the process. He's going to talk to the AMA on Monday, and thinks that we'll be able to have an open and honest dialogue about the issues that we're all very concerned about.

"Well, he is going to continue to work with everybody, people who even oppose a lot of the things that we're for right now," Burton added. "But what's important is that we come to the table with a lot more common ground than there has been in the past, giving some momentum to health care reform happening this year."

President Obama plans next week to make his case for a healthcare overhaul to a group that has helped block major changes before -- the nation's doctors.

White House spokesman Robert Gibbs announced today that the president will speak next Monday to the American Medical Association's annual gathering in Chicago.

"He'll start with the recognition that the healthcare system status quo is unsustainable and he'll outline the case for healthcare reform," Gibbs told reporters at his daily briefing. "He'll make clear why we can't afford to wait another year or another administration to bring down costs that are crushing families, businesses, and government.

"In the speech the president will discuss the reasons why past efforts have failed and he'll address the consequences of failing to act again this year," Gibbs added. He'll lay out plainly what healthcare reform will mean for American families and their doctors and what it won't. The president will also address the importance of making sure that reform doesn't add to our deficit, and what we can do to strengthen what works in our health care system and to fix what's broken so that we can build -- what we build provides the best care in the world at the lowest cost.

Earlier today, Obama summoned key lawmakers to the White House again today to push them to reach a deal. Afterwards, there were reports that key Democratic and Republican said a compromise may be emerging on one of the biggest disputes -- whether to create a government-sponsored health plan to compete with private insurers.

The compromise would create nonprofit health cooperatives owned by groups of patients, similar to how electric or other cooperatives operate, and without the government involvement that troubles Republicans and business groups about the public plan, the Associate Press reported.

The senators said Obama was willing to listen to all sides but insisted that Congress must pass a bill this year that reins in costs and helps provide coverage to nearly 50 million uninsured people.

Senator Edward M. Kennedy isn't there in person, but his presence still looms large as the Senate prepares to vote today on a bill that would give the Food and Drug Administration authority to regulate the production, sale, and marketing of tobacco products to protect the public health.

"It has been a long and arduous path with many political obstacles. Fortunately, the legislative journey is nearing a successful conclusion," Kennedy, who has championed the legislation for more than a decade, said in a statement that is being entered into the Senate record.

"Passage of the legislation is much more than a victory for those of us who have long championed this cause. It is a life saving act for the millions of children who will be spared a lifetime of addiction and premature death," Kennedy, who is absent from Capitol Hill while undergoing treatment for brain cancer, added in the statement.

"The need to regulate tobacco products can no longer be ignored. Used as intended by the companies that manufacture and market them, cigarettes will kill one out of every three smokers. Yet, the federal agency most responsible for protecting the public health is currently powerless to deal with the enormous risks of tobacco use." (His full statement is below.)

UPDATE: The Senate voted 67-30 today to limit debate on the bill, and Democrats say they have enough votes to win final passage. But a final vote is not expected until Thursday, Senator Chris Dodd of Connecticut, who is pushing Kennedy's priorities while the senator undergoes treatment, told Bloomberg News.

The House passed a very similar bill earlier this year and resolution of the minor differences would send the bill to President Obama, who supports it.

A major hurdle to passage was cleared away Tuesday when the Senate rejected a competing bill from the two senators from North Carolina, the nation's biggest tobacco producer.

The Senate health committee, which on Tuesday released its first take at a healthcare overhaul, today released the list of witnesses for a public hearing Thursday.

The roster includes a couple of key figures from Massachusetts, given that many of the proposals are in effect under the Bay State's landmark 2006 law. Katherine Baicker, a professor of health economics at the Harvard School of Public Health, and Jonathan Gruber, a health economist at MIT will share their views.

The others who are scheduled to testify: Margaret Flowers, the Maryland co-chairwoman of Physicians for a National Health Program; Ron Williams, the CEO of Aetna Inc.; Randel Johnson, a vice president of the US Chamber of Commerce; William Dennis, senior research fellow at the National Federation of Independent Business; Mary Andrus, co-chairwoman of the healthcare task force at the Consortium for Citizens with Disabilities; Samantha Rosman, a trustee of the American Medical Association; Ray Scheppach, executive director of the National Governors Association; Gerald Shea, assistant to the president of the AFL-CIO; Dennis Rivera, chairman of SEIU Healthcare; Janet Trautwein, executive vice president and CEO of the National Association of Health Underwriters; Sandy Praeger, the Kansas Insurance Commissioner; Scott Gottlieb, a fellow at the American Enterprise Institute; and Steve Burd, president and CEO of Safeway, Inc.

On the second panel: Gary Raskob, dean of the University of Oklahoma College of Public Health; Jeffrey Levi, executive director of the Trust for America’s Health; Fay Raines, president of the American Association of Colleges of Nursing; Wayne Jonas, president and CEO of the Samueli Institute; Delos Cosgrove, CEO of the Cleveland Clinic; Brent James, executive director of the Institute for Health Care Delivery Research at Intermountain Health Care; Charles Kahn, president of the Federation of American Hospitals; John Rother, an executive vice president for AARP; and Judith Palfrey, president-elect of the American Academy of Pediatrics.

After a year of deliberation, the Senate health committee led by Edward M. Kennedy of Massachusetts today formally unveiled its healthcare overhaul bill.

But it's only one of several competing bills that Congress and President Obama will eventually try to reconcile. House Democratic leaders today offered their own proposal that includes a new tax on employer-provided health benefits to help pay for expanding coverage to the uninsured, and a requirement for all individuals to purchase affordable coverage, with an unspecified penalty for those who refuse and a waiver for those who cannot cover the cost.

And the Kennedy panel bill -- the "Affordable Health Choice Act" -- does not for now include one of the most controversial proposals that the committee's Democrats and Republicans are still haggling over -- a public insurance plan that would directly compete with private insurers.

The Kennedy bill also leaves out, pending further negotiation with Republicans, a requirement that employers provide health benefits to workers.

The legislation would require all individuals to have health insurance, ban insurers from refusing to cover pre-existing conditions, and establish online "exchanges" where the uninsured and employees of small companies could shop for affordable insurance.

“Our health care system is a crisis for American families and President Obama and members of Congress of both parties recognize the urgency of the problem. Our goal is to strengthen what works and fix what doesn’t. Over the next few days, we will continue working with our Republican colleagues on common sense solutions that reduce skyrocketing health care costs, assure quality care for all and provide affordable health insurance choices. Much work remains, and the coming days and weeks won’t be easy. But we have a unique opportunity to give the American people, at long last, the health care they need and deserve,” Kennedy said in a statement.

The committee plans a public hearing on the bill on Thursday. To read it, click here. A summary is below.

During Kennedy's battle with brain cancer, Senator Chris Dodd of Connecticut has been deputized to push the legislation. He announced today that Kennedy, who is undergoing treatment, would be unable to attend the committee's working sessions on the bill next week.

“Health care reform cannot and must not wait. Today, we will introduce legislation that will strengthen what works and fix what doesn’t. If you like the insurance you have today, you can keep it. If you don’t like what you have today, we’ll give you better choices, including a public option for health care. This does not symbolize the end of the game or even the end of the first quarter. We still have a lot of work ahead of us and are looking forward to working with our colleagues on a bipartisan basis to resolve the remaining issues and move forward with a mark-up of this legislation next week,” Dodd said in a statement.

The House efforts are being led by three powerful Democrats: Ways and Means Committee Chairman Charles B. Rangel of New York, Energy and Commerce Committee Chairman Henry Waxman of California, and Education and Labor Committee Chairman George Miller of California. To see an outline of their legislation, click here.

“Our Committees are working as one to develop a uniquely-American solution to the health care crisis that is endangering the financial security of individuals and businesses," they said in a joint statement. "This solution will fulfill President Obama's commitment to provide quality, affordable health care for all. This framework will build upon what works by ensuring that patients can keep their health coverage if they like it, preserve patients’ choice and reduce costs. We will also fix what is broken through marketplace reforms, sliding scale credits to make coverage more affordable, and provisions to combat waste, fraud and abuse, strengthen Medicare and Medicaid, and invest in the health care workforce and public health. By improving the current system and offering a public health insurance option to promote honest competition with private insurance plans, we will provide individuals and small businesses with better, more affordable choices.

“We will continue to seek input and work closely with our colleagues, outside stakeholders, and the Administration and are on track to introduce legislation shortly. We anticipate Committee action on health reform in the coming weeks, with legislation on the House Floor prior to the August district work period. Reforming America’s health care system is critical to our country’s long-term economic recovery and long-term fiscal health. We are confident that we will achieve reform that will give Americans peace of mind and return our great nation to a path of prosperity for generations to come.”

Obama met this afternoon with Democrats on the Ways and Means Committee about the healthcare bill. Afterwards, the White House released this statement:

"The President had a productive meeting with Democrats from the House Ways and Means Committee, in which they agreed that health reform legislation must lower costs and expand coverage and must not add to the deficit. The President told the members that he will be spelling out additional savings for Medicare and Medicaid soon. He reiterated his support for his revenue-raising proposal, which would return the itemized deduction rate for the wealthiest Americans back to what it was when Ronald Reagan was President. The President and the members discussed some of the important components of reforming America’s health care system, such as emphasizing primary care, prevention and wellness. They agreed to aim for a timetable in which final passage of the bill would take place in October."

President Obama, who this week staked out his clearest guideposts yet of what he wants in a healthcare overhaul, uses his weekly radio and Internet address to reinforce the point.

"We must attack the root causes of skyrocketing healthcare costs," he says, adding that "any healthcare reform must be built around fundamental reforms that lower costs, improve quality and coverage, and also protect consumer choice."

Obama told Congress that Americans should have the option of a new public health insurance program -- something that Republicans and private insurers oppose, that he is open to requiring individuals to obtain insurance as long as there is a hardship waiver for those who can afford it, and that he wants to cut $200 billion to $300 billion more from Medicare and Medicaid over the next decade.

In his address today, he puts the best face on the state of play in Washington, asserting that an "unprecedented coalition" has "come together for change. Unlike past attempts at reforming our health care system, everyone is at the table – patient’s advocates and health insurers; business and labor; Democrats and Republicans alike."

With Congress just starting the nitty-gritty work of drafting detailed bills, then trying to reach compromise, the president says that fixing the healthcare system cannot be postponed any longer. His grassroots campaign group, Organizing for America, is holding thousands of house parties and other events across the country to kick off a lobbying effort behind his healthcare proposals.

"All across America, our families are making hard choices when it comes to health care. Now, it’s time for Washington to make the right ones," he concludes. "It’s time to deliver. And I am absolutely convinced that if we keep working together and living up to our mutual responsibilities; if we place the American people’s interests above the special interests; we will seize this historic opportunity to finally fix what ails our broken health care system, and strengthen our economy and our country now and for decades to come."

His full speech is below, and can be viewed here.

Senator Chris Dodd, the lead negotiator on the health committee for now on a healthcare overhaul, is asking for ideas from constituents, who not so coincidentally will decide whether he keeps his job after what looks like a tough election next year.

Dodd, a Connecticut Democrat, has a video on his Senate website inviting viewers to submit suggestions to the Senate YouTube channel.

"It's clear everybody the current system isn't working," Dodd says in the video. The healthcare system needs major fixes for economic reasons -- it's costing more and more -- and the "human condition" -- the estimated 50 million uninsured, he said.

But Dodd also made clear a principle also espoused by President Obama -- that those who get their insurance through their employer won't lose it. "If you like what you've got, you can keep what you've got," Dodd said.

"I look forward to your idea, let us hear from you," he concludes.

He is filling in for Senator Edward M. Kennedy of Massachusetts, the health committee's chairman who is undergoing treatment for brain cancer.

President Obama, in a lengthy letter to the key bill writers in the Senate, presses his case for a healthcare overhaul this year, reinforcing that legislation should both expand access and cut costs.

"We simply cannot afford to postpone health care reform any longer," Obama wrote to Senators Edward M. Kennedy of Massachusetts and Max Baucus of Montana. "In short, the status quo is broken, and pouring money into a broken system only perpetuates its inefficiencies."

The White House released the letter -- the clearest summary yet of what Obama wants in a healthcare plan -- today (read it here), a day after Obama summoned key senators to the White House to urge them to find common ground.

But an united front might be easier to say than accomplish. Though they insist they will come up with a single compromise bill, Kennedy, chairman of the health committee, and Baucus, chairman of the finance committee, have been squabbling over whether legislation should include a public insurance plan that would directly compete with private insurers.

Obama's letter repeats his goals for healthcare overhaul, and his hope that a bill reaches his desk by October.

He reiterated his support for allowing people to keep the plans they get through their jobs if they want, but also to offer the new public health insurance plan to compete against private insurers. "This will give them a better range of choices, make the health care market more competitive, and keep insurance companies honest," Obama wrote.

He also says he is "open" to proposals on requiring individuals to obtain coverage, but calls for a "hardship waiver" like the one in Massachusetts for those who can't afford it and says more needs to be done to make coverage affordable.

On top of $309 billion he wants to cut from overall healthcare spending over 10 years, he says he wants to cut an additional $200 billion to $300 billion from Medicare and Medicaid over 10 years.

The letter does not address the issue of taxing healthcare benefits to help finance the bill, which he opposed during his campaign but which senators said he suggested he was open to considering in Tuesday's meeting. The White House quickly clarified that it was not his first choice.

By Lisa Wangsness, Globe Staff

WASHINGTON -- Just before leaving for his trip to the Middle East and Europe, President Obama summoned key Senate Democrats to the White House this afternoon to rally the troops for a healthcare overhaul.

Before the meeting, Obama said getting a healthcare bill passed is "not a luxury," and said the period between now and Congress's monthlong recess in August is the "make-or-break period."

He also said a bill must not only cover more people, but also reduce the cost of healthcare, according to the press pool report. "If we don't get control over costs, then it is going to be very difficult for us to expand coverage," he said. "These two things have to go hand in hand."

(His full remarks are below.)

But in the last several days, differences have emerged between the two main architects of the healthcare legislation in the Senate, Edward M. Kennedy of Massachusetts and Max Baucus of Montana.

Kennedy, chairman of the Health, Education, Labor, and Pensions Committee, is leaning toward creating a widely available Medicare-style public insurance option. But Baucus, the Finance Committee chairman, wants a bipartisan solution -- and Republicans consider Kennedy's public plan an intolerable threat to the private insurance industry.

The White House and Baucus also publicly disagreed today over how the bill should be financed, with the administration opposing Baucus's proposal to tax a portion of healthcare benefits provided by employers.

The list of senators expected to attend the White House meeting is below:

The White House, trying to build the case for a healthcare overhaul, released tonight what it calls "the economic case for healthcare reform."

Billed as a "comprehensive analysis" by the president's Council of Economic Advisers, the 56-page report asserts that by slowing the rise of healthcare costs through the overhaul would pay off in a big way for the US economy. Read it here.

Healthcare spending now totals about 18 percent of the country's entire economic output and is projected to reach one third of the gross domestic product by 2040.

The report says that reducing the rise in healthcare costs by 1.5 percentage points a year would increase the real GDP by 2 percent in 2020 and nearly 8 percent in 2030.

That means families would have more disposable income, since less of it would be going to healthcare -- $2,600 more in 2020 and almost $10,000 more by 2030, according to the report.

The analysis also says controlling healthcare spending would lower the unemployment rate by 0.25 percentage points for several years, would help keep the federal budget deficit under control, and help increase the labor supply and level the playing field between small and large businesses.

And the report argued that extending insurance coverage to the uninsured would increase "net economic well-being" by about $100 billion a year, about 0.67 percent of GDP.

Christina Romer, the council's chairwoman, said that lowering health costs would also reduce pressure on government budgets, leaving more room for other priorities such as education.

UPDATE: Senator Edward M. Kennedy of Massachusetts, a key player in drafting a healthcare bill, praised the council's report.

“The council’s report emphasizes the major economic benefit to the nation that will also be achieved if we make health care a basic right for all," he said in a statement. "In the current economic crisis, more and more families are being forced to leave their preferred doctors, forgo medication they need, or are even losing their health insurance entirely because their employer can no longer afford a health plan. We can’t afford to miss this chance to give the American people, at long last, the health care they deserve.”

Republicans and others remain skeptical.

“This report is nothing more than smoke and mirrors. Everyone agrees that reducing the cost of healthcare would benefit our economy, but the administration hasn’t offered a credible plan to do so without raising taxes or rationing care,” House Republican leader John Boehner said in a statement.

Senators Edward M. Kennedy and Max Baucus are trying to rebut several media reports of dissension on a healthcare overhaul.

They and their staffs have been working for months on a healthcare overhaul, but according to the reports, Kennedy is pushing a version that would includes a government-run insurance plan that would compete with private plans, while Baucus is reportedly leaning toward a bipartisan measure without such a public plan.

President Obama also favors a public plan, but the insurance industry vehemently opposes it.

Over the weekend, however, Kennedy, chairman of the Health, Education, Labor, and Pensions committee, and Baucus, chairman of the Finance Committee, issued a joint statement "affirming their commitment to seek common ground on health reform legislation, despite some media reports to the contrary:"

"For both of us, reforming the nation's health care system to cut cost, improve quality and provide affordable coverage remains the top priority on our two committees. We have worked together closely over many months and will continue to do so. We intend to ensure that our committees report similar and complementary legislation that can be quickly merged into one bill for consideration on the Senate floor before the August recess."

UPDATE: Meanwhile, a coalition of liberal and labor groups announced this afternoon that they plan to spend as much as $82 million to lobby for universal healthcare.

The effort includes the AFL-CIO and Change To Win labor federations, MoveOn.org, and more than other 1,000 other groups representing more than 30 million members.

"Over the past few years, we have worked together to build a progressive infrastructure and a movement that helped to elect President Obama and begin to undo the damage of the last eight years. But it was just the beginning," said Howard Dean, the former Vermont governor and chairman of the Democratic National Committee during last year's campaign. "As the health care reform debate makes clear, America needs a strong progressive movement; now is not the time to become complacent."

It's now or never on healthcare, President Obama told his millions of grassroots backers today, urging them to organize and lobby their senators and representatives.

In a call from Air Force One as he returned from a western fund-raising swing, Obama said that if Congress doesn't pass a healthcare overhaul this year, the opportunity will be lost, perhaps forever, the Associated Press reports.

"If we don't get it done this year, we're not going to get it done," Obama told supporters. "The election in November, it didn't bring about change. It gave us an opportunity for change."

Organizing for America, the group housed within the Democratic National Committee that is his presidential campaign from last year and his re-election campaign in waiting, plans a June 6 kickoff on healthcare with house parties across the country.

It has been 16 years since the last sweeping effort, during the Clinton administration, which failed partly due to opposition from the insurance industry. This time, the insurers are offering concessions to head off a public insurance plan that would directly compete.

Obama's remarks on the conference call with supporters is below:

By Peter S. Canellos, Globe Staff

WASHINGTON -- The Supreme Court nomination of Judge Sonia Sotomayor, a candidate more likely than some on President Obama's short list to arouse Republican opposition, could complicate the president's task on another major agenda item -- healthcare.

Over the next two months, while the Senate will be debating Sotomayor's views on affirmative action, the applicability of foreign judicial rulings, and the right to privacy -- all hot-button issues guaranteed to provoke resentment on the ideological edges of both parties -- it will also be trying to come together in a spirit of compromise on healthcare.

"I really think that the stars may be aligned here and we potentially can get it done if everybody comes at it with a spirit not of ideological rigidity," Obama told C-SPAN over the weekend, referring to healthcare. He expressed the hope that "we can really negotiate and compromise and get something done for the American people."

But much of the negotiating on healthcare is slated to take place during the debate over the Sotomayor nomination. The two Senate committees handling the healthcare overhaul expect to have legislation in place well before the August recess; Obama wants his Sotomayor confirmed by then as well so she can prepare for the Supreme Court's next term in October.

That makes for a busy two months on Capitol Hill, and while it's reasonable to expect that the Senate can pursue its dual responsibilities without much procedural interruption, a battle royal over the Supreme Court could consume time and sap the president's political momentum.

"If [Sotomayor's confirmation] takes a month, it does bump things up against the adjournment time," said Dartmouth College political scientist Linda Fowler. "The worry for Obama is less the loss of bipartisan spirit than the time constraints. An acrimonious nomination fight just eats up a lot of time."

Supreme Court appointments have been the main battleground for the two parties' sharply different views on social issues, especially abortion and racial preferences. And while it is unclear whether the Sotomayor nomination will run into strong opposition, early signs are that the GOP is girding for battle.

Many conservative groups released statements expressing concern about her support of "identity politics" -- a line of attack that may succeed in raising questions about both her selection for the high court and her recent ruling against white firefighters who were denied promotions despite scoring higher than minorities on an exam.

Some Republicans consider her more of a liberal activist than federal Judge Diane Wood, former Harvard Law School Dean Elena Kagan, or Homeland Security Secretary Janet Napolitano, who were the other three names on Obama's short list.

But as the first Hispanic nominee to the Supreme Court, Sotomayor also has the pride and support of an increasingly large ethnic group behind her.

Back in 1986, when President Ronald Reagan tapped the conservative Antonin Scalia for the court, many liberals chose not to oppose the nominee because of the deep pride of the Italian-American community, from which he would be the first justice.

"The fact that Obama chose the first Hispanic nominee will be a big hindrance to those who want to oppose her," said Mickey Edwards, former GOP representative from Oklahoma, who noted that the states most important to the Republicans electorally -- Texas, Arizona, and Florida among them -- have large Hispanic populations.

"Pick your fights and this is one you don't want to do," advised Edwards.

As for doing healthcare in the midst of a Supreme Court nomination, he said, "I think the two things can move along on different tracks."

Obama can at least hope so. With Massachusetts Senator Edward M. Kennedy having given up his seat on the Senate Judiciary Committee to concentrate on healthcare, there is relatively little overlap between the senators focused on Sotomayor and those working on healthcare.

The real question is whether Obama comes out of the Sotomayor nomination with enough political capital to wage one more historic battle.

It worked on the $787 billion economic stimulus package.

So President Obama's grassroots group is scheduling house parties on June 6 to help push through a healthcare overhaul. Obama, himself, plans to join in via conference call that Saturday.

"In thousands of homes across the country, we'll gather to launch our grassroots campaign for health care. We'll watch a special message from the President. We'll build the teams and draw up the plans for winning health care reform the same way we won the election: Building support one block, one neighbor, one conversation at a time. And we'll put those plans into action," David Plouffe, Obama's campaign manager last year, wrote to supporters on the email list of Organizing for America.

"These gatherings on June 6th are just the beginning of a battle between those who fought and believe in change and those who would protect a broken status quo. The stakes for our country could not be greater," Plouffe added. "Some call this strategy pie-in-the-sky. They say we'll never have enough volunteers to make a real impact; that you need insiders and Washington lobbyists to make a difference. But you and I know firsthand how wrong they are. Starting June 6th, it's once again time to show this country how bottom-up change is done."

President Obama today sent out a personal appeal -- well, at least as personal as a blast email to millions can be -- to his grassroots supporters to push Congress on healthcare.

The message saying, "I need your voice," was sent through Organizing for America, the group housed in the Democratic National Committee that inherited Obama's campaign apparatus.

"The chance to finally reform our nation's health care system is here. While Congress moves rapidly to produce a detailed plan, I have made it clear that real reform must uphold three core principles -- it must reduce costs, guarantee choice, and ensure quality care for every American," the president writes.

"As we know, challenging the status quo will not be easy. Its defenders will claim our goals are too big, that we should once again settle for half measures and empty talk. Left unanswered, these voices of doubt might yet again derail the comprehensive reform we so badly need. That's where you come in. When our opponents spread fear and confusion about the changes we seek, your support for these core principles will show clarity and resolve. When the lobbyists for the status quo tell Congress to hold back, your personal story will give them the courage to press forward."

Obama promises to read some of the personal stories, then repeats one of his own, seeing his mother die of ovarian cancer while worried about insurance.

"Last November, the American people sent Washington a clear mandate for change. But when the polls close, the true work of citizenship begins," Obama concludes. "That's what Organizing for America is all about. Now, in these crucial moments, your voice once again has extraordinary power. I'm counting on you to use it."

President Obama's grassroots organization is trying to fight back against critics of his healthcare plan, asserting that the same groups that "swift boated" Democratic nominee John F. Kerry in 2004 are trying to pull off a sequel.

Obama's allies point to the fact that Conservatives for Patients' Rights, which has already started to run ads on national cable warning of a government-run healthcare system, hired the same public relations firm that ran the Swift Boat Veterans for Truth campaign questioning Kerry's Vietnam war record.

"We knew healthcare reform would face fierce opposition -- and it's begun. As we speak, the same people behind the notorious "swiftboat" ads of 2004 are already pumping millions of dollars into deceptive television ads. Their plan is simple: torpedo healthcare reform before it sees the light of day by scaring the public and distorting the president's approach," David Plouffe, Obama's former campaign manager and now head of Organizing for America, wrote supporters over the weekend in a fund-raising email.

"We need the resources to take them head on with an urgent, grassroots campaign to pass real healthcare reform in 2009. When the swiftboaters flood the airwaves with distortions, we'll flood the streets with volunteers armed with facts. When they send lobbyists to tell Congress to back down, we'll send millions of calls, letters, and stories from real Americans asking them to stand up."

Conservatives for Patients' Rights was founded by Rick Scott, who also helped finance the Swift Boat campaign and who is the former owner of the Hospital Corporation of America. Obama's allies, including the Service Employees International Union, also highlight HCA's spotty record and the investigations it faced.

Scott has responded to what he calls false personal attacks on the patients' rights group website.

Senator Edward M. Kennedy plans today to introduce another bill that he has long championed, but that languished under a Republican presidency.

The legislation would guarantee paid sick days to workers, as many as seven a year if they, a child, or other close family member falls ill. Supporters say it will help stop the spread of viruses, such as the recent swine flu outbreak.

Though it has the support of President Obama, it is not a slam dunk.

Business groups vow to oppose the bill, saying it would only make times tougher for employers during the economic downturn.

President Obama declares today that, yes, we can all get along.

In his weekly Internet and radio address, he says that advocates for opposing interests are coming to the table and negotiating in good faith on healthcare and energy -- to name two major issues being debated in Washington.

On climate change and clean energy legislation, "utility companies and corporate leaders are joining, not opposing, environmental advocates and labor leaders to create a new system of clean energy initiatives that will help unleash a new era of growth and prosperity."

On a healthcare overhaul, "representatives of insurance and drug companies, doctors and hospitals, and labor unions who are pledging to do their part to reduce health care costs. These are some of the groups who have been among the fiercest critics of past comprehensive health care reform plans."

"I have always believed that it is better to talk than not to talk; that it is far more productive to reach over a divide than to shake your fist across it. This has been an alien notion in Washington for far too long, but we are seeing that the ways of Washington are beginning to change," Obama added.

"This is how progress has always been made. This is how a new foundation will be built. We cannot assume that interests will always align, or that fragile partnerships will not fray. There will be setbacks. There will be difficult days. But we are off to a good start."

His full remarks are below, and the address can be viewed here:

While praising the smooth performance during the swine flu crisis of the agency's acting director, President Obama today formally announced he has appointed someone new to lead the federal Centers for Disease Control and Prevention.

The new chief is Dr. Thomas Frieden, currently commissioner of the New York City Health Department, who will start on the job in early June. (His mini-biography is below.)

“America relies on a strong public health system and the work at the Centers for Disease Control and Prevention is critical to our mission to preserve and protect the health and safety of our citizens," the president said in a statement. "Dr. Frieden is an expert in preparedness and response to health emergencies, and has been at the forefront of the fight against heart disease, cancer and obesity, infectious diseases such as tuberculosis and AIDS, and in the establishment of electronic health records. Dr. Frieden has been a leader in the fight for health care reform, and his experiences confronting public health challenges in our country and abroad will be essential in this new role.”

Obama announced that acting CDC Director Dr. Rich Besser, who became a familiar sight on television, will continue as head of CDC’s Coordinating Office for Terrorism Preparedness and Emergency Response for the past four years.

“Secretary Sebelius and I thank Acting CDC Director Dr. Rich Besser and the women and men throughout the CDC for their superb work, especially over the past weeks," Obama added. "Dr. Besser has led the CDC’s Coordinating Office for Terrorism Preparedness and Emergency Response for the past four years, and those preparations were essential during the recent H1N1 flu detection and response activities. We are very pleased he will continue in that role.”

By James F. Smith, Globe Staff

Dr. Paul Farmer, the global health crusader who has crafted life-saving projects from Haiti to Rwanda, has told colleagues privately that he is mulling a possible appointment by the Obama administration to coordinate growing US overseas health initiatives.

Farmer told faculty members at Harvard Medical School on Monday that he is in discussions with the State Department, which this month proposed a surge in funding over the next six years for global programs to fight AIDS, tuberculosis and tropical disease, and to improve children's health.

It could not be confirmed today exactly what job Farmer is being considered for, but one person who was present at the medical school meeting said Farmer described it as a position overseeing all foreign health aid. Farmer told the gathering that he hadn't decided whether to accept the appointment if it is formally offered but that he was considering it seriously.

Farmer did not respond to email and phone messages seeking comment. Partners in Health also declined to respond, as did Harvard Medical School's Department of Global Health and Social Medicine, where Farmer is vice-chairman.

A State Department spokesman refused any comment on personnel discussions in progress or on potential new positions. It could not be confirmed today whether Farmer is being considered for a full-time policy position or an advisory role, or whether an appointment would be to a new job or an existing one.

The top positions at the US Agency for International Development are vacant, including the administrator and deputy administrator as well as assistant administrator in charge of global health. The top positions are presidential appointments and require Senate confirmation. There could also be health policy roles within the State Department, which this month announced a plan to spend $63 billion over the next six years to fight global diseases including HIV/AIDS, malaria, tuberculosis and other preventable diseases. That would build on an ambitious effort launched by the Bush administration.

Farmer has gained international acclaim for more than two decades of work treating the poorest villagers in the poorest countries, while also carrying out groundbreaking medical research and reshaping health policies in the Third World. When he was still a Harvard medical student he co-founded Partners in Health, the Boston-based nonprofit that supports an array of global health efforts and pushes governments to provide better care.

In 2003, Tracy Kidder published a best-selling book, "Mountains Beyond Mountains," about Farmer.

He remains very active in Partners in Health and its initiatives, including the remaking of Rwanda's health system amid the twin ravages of AIDS and the aftermath of genocide, as well as building programs in other countries -- Russia and Peru among them -- to counter multi-drug-resistant tuberculosis.

One person who was at the Harvard gathering said some colleagues suggested to Farmer that he was being given an opportunity to make a real impact on US policy, and they urged him to take up the challenge.

President Obama held a pep session this morning to rally House Democratic leaders behind his healthcare overhaul plan.

"We've got to get it done this year," he said.

"And we don't have any excuses," he added. "The stars are aligned."

And, Obama said, he is "deeply encouraged" that a bill can emerge before Congress leaves for its August recess, pointing to health industry leaders who opposed sweeping change in the 1990s offering this week to cut costs by $2 trillion over the next decade.

"We're starting to see a shift," Obama said. "They recognize the time is now."

He met in the Oval Office with House Speaker Nancy Pelosi, House Majority Leader Steny Hoyer, House Ways and Means Committee Chairman Charlie Rangel, House Energy and Commerce Committee Chairman Henry Waxman, and House Education and Labor Committee Chairman George Miller.

Obama's full remarks are below:

With momentum appearing to grow for a healthcare overhaul, President Obama is calling once again on his grassroots army to push Congress over the finish line this year.

Obama's backers received an email appeal overnight to sign an online declaration of support for his Obama's core principles: reduce costs, guarantee choice, and ensure all Americans have quality, affordable healthcare.

Mitch Stewart, director of Organizing for America, noted that on Monday healthcare industry leaders offered to cut costs by $2 trillion over 10 years.

"The health care crisis is not new, but it's getting worse," Stewart wrote the 17 million supporters. "For decades, real health care reform has been blocked by special interest lobbying and political point-scoring. We simply cannot go any further down this dangerous road of delay and denial. But we don't have to.

"The most important reason this round of health care reform will be different is you. Last fall millions of regular people came together and did the impossible. Now, we've got to roll up our sleeves, join hands with those new to our movement, and do it again," he added.

"Congress is already hammering out the details of the health care package, and it could still go any number of ways. Our representatives need to understand that when the President lays out these three bedrock principles, Americans of every stripe are standing with him."

Highlighting healthcare for the second day in a row, President Obama is meeting today with business leaders to discuss ways to cut health costs.

"All over the country, innovative ideas are being implemented in the workplace to improve the health of workers and reduce the rising rate of health care spending. Skyrocketing health care costs are crushing families and companies, impeding businesses’ ability to expand and compete, and stunting the country’s economic growth. Some employers and unions – spanning industries, firm size, and workforce demographics – are using creative approaches to reverse that trend in their workplaces," the White House said in a statement.

"Examples of innovative health care programs in the workplace are everywhere. As a result of many successful programs at businesses across the country, workers have become more engaged in their own health care, productivity is increasing, absenteeism is dropping, and employers are passing some of their health care savings to their workers. Employers are discovering that improving quality of care can reduce health care costs. Small actions in the workplace can generate large benefits."

On Monday, Obama huddled with health industry leaders, who pledged to cut the rate of spending increases to the tune of $2 trillion over 10 years.

Obama's remarks after today's session are below, followed by the full White House fact sheet on the meeting:

Harry and Louise helped doom the last major push for a healthcare overhaul in 1993.

This time, not only is the fictional couple supporting the effort, they're putting their money where their mouth is.

The couple's kitchen table conversation about government-run healthcare -- in a TV ad financed by the health insurance industry -- turned the tide against the Clinton administration's healthcare initiative.

Today, insurers and other major industry groups came to the White House to tender an offer that could grease the skids for the ambitious plans of President Obama to vastly expand healthcare coverage.

The industry groups are pledging to control costs to the tune of 1.5 percent a year -- a total of $2 trillion in savings over the next decade -- to help finance the cost of reform.

"The times demand and the nation expects that we, as health care leaders, work with you to reform the health care system," the industry representatives wrote in a letter to Obama.

They note that the annual growth in health spending is to average 6.2 percent a year for the next decade, bringing the share of the nation's total economic output devoted to healthcare from 17.6 percent to 20.3 percent in 2018.

"We are determined to work together to provide quality, affordable coverage and access for every American," the letter continues. "It is critical, however, that health reform also enhance quality, improve the overall health of the population, and reduce cost growth."

The letter is signed by the leaders of the Advanced Medical Technology Association, America's Health Insurance Plans, American Hospital Association, American Medical Association, Pharmaceutical Research and Manufacturers of America, and Service Employees International Union. (Click here to read the letter.)

The president welcomed the industry's promise, saying such a consensus would have unimaginable just a few years ago.

"When it comes to healthcare spending, we're on an unsustainable course" -- for families, businesses, and governments, Obama said at the formal announcement, the industry leaders arrayed behind him.

"We can't continue down the same dangerous road we've been traveling for so many years, with costs out of control, that reform is not a luxury that can be postponed, but a necessity that cannot wait," the president added.

"It is a recognition that the fictional television couple, Harry and Louise, who became the iconic faces of those who opposed healthcare reform in the '90s, desperately need healthcare reform in 2009. And so does America.

"That's why these groups are voluntarily coming together to make an unprecedented commitment. Over the next ten years -- from 2010 to 2019 -- they are pledging to cut the growth rate of national health care spending by 1.5 percentage points each year -- an amount that's equal to over $2 trillion." (His full remarks are below.)

Senator Edward M. Kennedy of Massachusetts, who is helping lead the healthcare effort in Congress, also said the industry move is momentous.

“This is an extraordinary moment of opportunity for real reform in health care," Kenneyd, chairman of the Health, Education, Labor, and Pensions Committee, said in statement. "The President knows it's time to act and is providing impressive leadership. Members of Congress from both parties and leaders of the insurance industry know that the time has come to reduce costs and expand access to quality health care for all. The American people are right to call on Congress and the Administration to delay no longer in easing the heavy burden of ever-increasing health costs that crush the budgets of families and businesses alike.”

Realizing that a healthcare plan is politically likely, insurers and other industry groups have already been offering a series of sweeteners to forestall a public insurance option that they fear would put them out of business.

Groups pushing for the public plan are somewhat skeptical.

"The industry’s proposals could mean real savings for consumers struggling to pay for health care," DeAnn Friedholm, Consumers Union’s campaign director for health reform, said in a statement. "The question is, how do you ensure that the promises are kept and consumers see the benefits of the savings? We maintain that a public health insurance option is still needed to ensure people have real savings and choices.”

Meanwhile, the Democratic Leadership Council and the Center for American Progress Action Fund released a report today that suggests that health system modernization could save the federal government nearly $600 billion in health spending over the next decade, and $9 trillion over the next 25 years.

"Over time, these savings will not only more than offset the cost of covering all Americans, but also will play a critical role in restoring long-term fiscal balance," the groups claim.

Done by David M. Cutler of Harvard University, a leading healthcare economist, the report estimates the savings from enacting measures such as electronic medical records, comparative effectiveness research, and prevention programs.

To read the report's executive summary, click here.

The White House released a "fact sheet" on the pledge (click here to read it) and a list of those attending the session, which is below:

Senator Edward M. Kennedy this afternoon praised President Obama's pick for Food and Drug Administration commissioner, saying that a respected scientist is needed to restore morale at the agency that oversees the nation's food and drug safety.

Dr. Margaret Hamburg, a Harvard Medical School graduate and bioterrorism expert who served as New York City's health commissioner, also told the Senate committee considering her nomination that she wants to restore public confidence in the FDA.

"Dr. Hamburg is widely respected for her expertise in community health, bio-defense, and nuclear, biological, and chemical preparedness," Kennedy said in a statement entered into the record for the Health, Education, Labor, and Pensions Committee hearing. "Her expertise is valuable for problems we now face, such as combating food-borne illness, cooperating with other agencies to address the new flu outbreak and drug-resistant diseases, and protecting our food and drug supplies."

If confirmed by the Senate, one of her first duties will be overseeing development of a vaccine for the new swine flu.

UPDATE: Hamburg breezed through the hearing, with no committee members expressing opposition, the Associated Press reports.

"The agency is facing a range of new and daunting challenges," Hamburg told senators. "These include the globalization of food and drug production, the emergence of new and complex medical technologies, and the risk of adulteration or deliberate terror attacks on our food and drug supplies."

"It’s been clear for some time that the agency has been chronically underfunded," Kennedy said in his statement. "Its budget per American citizen each year amounts to little more than the cost of a fast food meal. The regular intake of fast food is not the well balanced diet we need to be healthy, and it can’t be good for the FDA either.

"The agency needs more than additional funds, however. Morale is low. In recent years, science has often taken a back seat to political pressure. It’s a sad state of affairs when a court rules that the “FDA acted in bad faith and in response to political pressure” and orders the agency to base a decision on science."

A liberal advocacy group goes for some gallows humor in its latest ad support President Obama's healthcare proposals.

The MoveOn.org spot focuses on the push by Obama and many Democrats for a government healthcare plan that would compete with private insurers. The insurance industry is dead set against it, saying it would put insurers out of business and offering a series of concessions to stop the proposal in its tracks.

Tuesday, the industry's main lobbying group told the Senate Finance Committee it would do away with an insurance surcharge that affects 5.7 million women and offered to accept new consumer protections.

In the ad, two men complain about the public plan option.

"It'll be a disaster for us," one says.

"A public healthcare plan means affordable healthcare for everyone," the second says. "You know what that means.

"Healthy people living longer," the first answers.

"This guy's killing us," the second chimes in.

The camera pans out, and it turns out the men aren't insurance lobbyists. Instead, they're funeral directors.

Senator John F. Kerry today introduced a bill that would stop insurers from charging women higher premiums, or denying or limiting coverage based on whether they are pregnant.

Kerry cited a September 2008 report by the National Women’s Law Center that found insurance companies can reject applicants for reasons that affect women; that it is difficult and costly for women to find health insurance that covers maternity care; and that women often face higher premiums than men for identical coverage.

“The disparity between women and men in the individual insurance market is just plain wrong and it has to change,” Kerry said in a statement. “With Mother’s Day around the corner, there’s no better gift to American women than discrimination-free, affordable and accessible insurance that meets their health needs.”

Coincidentally, the main health insurer group said today it would end its practice of charging higher premiums to women if all Americans are required to obtain coverage, the industry's latest concession as it tries to stave off the creation of a government plan that would directly compete with private insurers.

"We don't believe gender should be a subject of rating," Karen Ignagni, president of America's Health Insurance Plans, told the Senate Finance Committee, the Associated Press reports. "We are ready to be accountable to those rules."

A summary of Kerry's bill is below:

Congress this afternoon handed President Obama another big victory to mark his 100th day in office by passing a spending blueprint that incorporates many of his major policy goals ahead on healthcare, energy, and other issues.

But the votes on the budget outline belied Obama's plea for bipartisanship.

The Senate voted 53-43 for the spending plan, with no Republican support, after the House voted 233-193 earlier today, again without a single Republican vote.

In his prepared opening statement for tonight's press conference, Obama says the budget "builds on the steps we’ve taken over the last one hundred days to move this economy from recession to recovery and ultimately to prosperity."

Newly-turned Democrat Arlen Specter of Pennsylvania voted "no," as he did earlier this month when it initially passed the Senate. Three other Democrats also voted no: Ben Nelson of Nebraska, Robert Byrd of West Virginia, and Evan Bayh of Indiana.

And, still, Obama's allies declared victory.

"America’s workers applaud Congress for passing President Obama’s budget resolution that is a transformational blueprint for growing the middle class and making the economy work for everyone again," John Sweeney, president of the AFL-CIO, said in a statement.

"Now, more than ever, it is crucial that we build an economy that works for working Americans. President Obama’s budget includes a huge down payment on national healthcare reform, investment in growing green jobs and addressing climate change and more funding for education. The budget also moves away from the failed economic policies of the past and includes tax cuts for middle-class working families, rather than for the wealthy and Big Business. "

“Facing the worst economic crisis in decades, President Obama took the oath of office 100 days ago with a bold agenda to turn our economy around, get Americans back to work and lay a solid foundation for future economic growth and prosperity. And he has done just that. The budget passed today by Congress affirms and supports that vision and addresses the President’s fundamental priorities: halving the deficit over the next four years, providing quality, affordable health care to Americans, improving education investing in the clean energy revolution while reducing our dependence on foreign oil,” added Democratic National Committee chairman Tim Kaine.

Tom McMahon, acting executive director, of the labor-liberal coalition Americans United for Change, said in a statement: “While President Obama inherited a crushing recession and the largest deficit in history, 100 days later the nation is on a clear path to economic recovery paved through the transformational budget Congress passed today. In addition to returning fairness to our tax code and beginning to take control of the federal deficit, the President’s budget recognizes that without fixing our broken health care system, without reducing our dependence on foreign oil, and without investing in tomorrow’s educated workforce, America’s struggling middle-class families will never get ahead. The investments called for in this budget for health care reform, education, and clean energy are essential for long-term economic prosperity. It also remains disappointing that many of the same conservatives members of Congress that enabled the very failed economic policies that got us into this mess once again turned their backs on middle-class families and just said ‘no’ today.”

The bill includes a parliamentary maneuver, which if a healthcare plan isn't passed by Oct. 15, would allow Democrats to push through a plan with a simple majority in the Senate, instead of the 60 votes normally required for such major legislation.

A powerful Senate committee held a hearing today on the swine flu epidemic.

The Senate Health, Education, Labor, and Pensions Committee will hear from Richard E. Besser, acting director of the Centers for Disease Control and Prevention, and Anthony Fauci, director of the National Institute for Allergy and Infectious Diseases.

The commitee's chairman is Senator Edward M. Kennedy of Massachusetts, whose remarks entered into the record are below.

The US Senate this afternoon confirmed Kathleen Sebelius as health and human services secretary, completing President Obama's cabinet, after Democrats pointed to the swine flu crisis as showing the need for action.

She flew immediately to Washington and was quickly sworn in. Obama's remarks are below.

The 65-31 vote followed hours of debate on the Kansas governor's nomination, which had been held up by Republicans over concerns by her record on abortion, her views on a healthcare overhaul, and unpaid taxes.

Nine Republicans joined the Democratic majority in pushing Sebelius over the 60 votes she needed. They included Susan Collins and Olympia Snowe of Maine and Judd Gregg of New Hampshire.

Her backers said that her confirmation was essential now to help coordinate the government's response to the swine flu outbreak, which has been led so far by Homeland Security chief Janet Napolitano.

Senator Edward M. Kennedy of Massachusetts, who is helping lead the charge for a healthcare overhaul, said Sebelius's confirmation would jump-start the work. She is expected to play a key role, though not as extensive as Obama's first nominee for the job, former Senate Majority Leader Tom Daschle, who was also supposed to be head of the White House office of healthcare reform before he withdrew over unpaid taxes.

“With the confirmation of Governor Sebelius, the commitment of the Administration and Congress to passing health care reform this year now moves into high gear," Kennedy said in a statement.

“In his first 100 days in office, President Obama has taken large steps toward putting America back on track. His leadership has produced a strong new investment in education, established the principles needed to guide the United States into a more energy efficient world, and made opportunities for national and community service far more available to all Americans. In the next 100 days, I’m confident that President Obama will have us well on the way to the landmark enactment of quality, affordable health care as a right for all Americans.”

Billy Tauzin, president and CEO of the Pharmaceutical Research and Manufacturers of America, added his plaudits.

“Gov. Kathleen Sebelius is a wise choice to guide the President on shaping healthcare reform," he said in a statement. "Sebelius combines the vital combination of skills that it will take to accomplish this challenging job: Toughness and an intimate understanding of the healthcare challenges that face our nation during these tough economic times.

“We applaud the Finance committee’s endorsement of Sebelius and are pleased that the Senate as a whole quickly followed its lead. Clearly, achieving meaningful healthcare reform will be difficult, making it imperative for Sebelius to be confirmed in a timely manner," Tauzin added. "“It’s equally important for Congress to act rapidly to put a full-time Commissioner in place to head the Food and Drug Administration (FDA). Consumers count on the FDA to help assure the safety of a myriad of products – including the life-saving anti-virals contained within the Strategic National Stockpile, which could be deployed in the event of an influenza pandemic."

"Today's confirmation of Gov. Kathleen Sebelius is a tremendous step forward in the effort to address comprehensive health care reform and in turn put our economy back on track," John Sweeney, president of the AFL-CIO, said in a statement.

"Gov. Sebelius is highly qualified and throughout her career, she has shown a unique ability to work with members of both parties to find solutions to pressing problems. As Governor and former health insurance commissioner of Kansas, she is a proven fighter for the rights of patients and consumers. We look forward to working with Secretary Sebelius for real solutions to the problems of working families who deserve quality and affordable health care."

Marcia Greenberger, co-president of the National Women's Law Center, applauded the Sebelius's confirmation.

“Governor Sebelius has a strong record on protecting women’s legal rights, child care and early education, and healthcare," Greenberger said in a statement. "Her stellar career and track record provide reassurance to the American public that she is highly qualified to lead HHS, and that she will make meeting the needs of women and children a priority of the Department. As health care reform moves forward, the country now has a strong HHS Secretary who understands the needs of women and their families, and can bring the particular barriers faced by women to the table."

Anti-abortion groups had marshalled their resources to oppose Sebelius, a Catholic who personally opposes abortion but who vetoed a series of abortion restrictions as governor.

Nancy Keenan, president of NARAL Pro-Choice America, commended the Senate vote.

“We applaud the Senate’s vote to confirm the eminently-qualified Gov. Kathleen Sebelius to serve in this critical position,” Keenan said in a statement. “Anti-choice advocates tried every desperate trick in the book to derail her confirmation, but this vote shows that a majority of senators understand that Americans are tired of the antagonistic politics of the past. As our country faces challenges on a number of fronts, especially on the issue of affordable health care, we look forward to ensuring that women’s health and sound science are a priority, rather than the failed political maneuvering that damaged this agency during the previous Bush administration.”

Cecile Richards, president of the Planned Parenthood Federation of America, added in a statement:

“We applaud Gov. Kathleen Sebelius’ confirmation as secretary of health and human services. She is an excellent choice to lead HHS and has a proven track record of increasing access to affordable care. As countless women and their families struggle to afford quality health care during these difficult economic times, the need for health care reform that improves health outcomes is immediate. Her ability to work in a bipartisan fashion will serve her well as the Obama administration and Congress tackle the critical issue of health care reform for American families. We look forward to working with her and the administration to expand access to care and lower health care costs.”

While they lost this fight, anti-abortion activists said it had energized their supporters.

“Despite the results of tonight’s vote, we’re finding that more and more Americans are waking up to the danger of President Obama’s nominations of extreme abortion advocates to serve in his administration,” Marjorie Dannenfelser, president of th Susan B. Anthony List, said in a statement.

“The high profile Sebelius confirmation battle has generated new interest and brought thousands of new activists on board for the pro-life cause. This grassroots energy will only increase our momentum as we confront the next round of President Obama’s extreme pro-abortion nominees, beginning with former NARAL Legal Director Dawn Johnsen. We expect all pro-life Senators will oppose Dawn Johnsen’s nomination for Office of Legal Counsel, and their support will be critical to keeping her extreme abortion views out of the White House.”

As congressional negotiators resume today putting the final touches on a spending blueprint, the biggest bone of contention is Democrats' intent to include a fast track for a healthcare overhaul.

Republicans are incensed by the maneuver, known as reconciliation, that would allow Democrats to push through a healthcare bill with a simple majority vote in the Senate, rather than the 60 votes typically required for such major legislation.

Senator Judd Gregg of New Hampshire, who was President Obama's pick for commerce secretary until his last-minute withdrawal, compared Obama to Venezuelan leader Hugo Chavez in accusing him of strong-arming the Congress.

“I can understand shaking Hugo Chavez’s hand, but I can’t understand embracing his politics,” Gregg, the senior Republican on the Senate Budget Committee, said today, according to the New York Times.

NBC, meanwhile, reports that the top Senate Democrat, Harry Reid, is trying to calm Republicans. Under the Democrats' plan, they would only use the fast-track tactic if a bill isn't passed by Oct. 15.

"Make no mistake -- we are determined to reform health care this year." Reid said in a letter today to Republican Leader Mitch McConnell. "Our strong preference is to do so by working alongside you and your caucus." 

President Obama declared this morning that "science is more essential....than ever before" for the nation's security, health, and economy.

And the proof, he said, is the swine flu outbreak that has killed more than 100 in Mexico and shown up in the United States, though with no fatalities yet.

Obama told the National Academy of Sciences that he is closely monitoring the outbreak, which he called a "cause for concern, but not a cause for alarm." The public health emergency was declared Sunday as a precaution, he said, to make sure officials have everything they need to contain the illness.

The president's speech was a follow-up to his decision last month to reverse President Bush's limits on federal funding for embryonic stem cell research -- and an accompanying pledge to take the politics out of science.

He repeated that promise this morning -- and also announced a pledge to increase research and scientific funding to a level equal to that during the space race to the moon, amounting to 3 percent of the gross domestic product.

In his speech, Obama also announced a new President’s Council of Advisors on Science and Technology, which will help "formulate policy in the many areas where understanding of science, technology, and innovation is key to strengthening our economy and forming policy that works for the American people," the White House said.

“This council represents leaders from many scientific disciplines who will bring a diversity of experience and views. I will charge PCAST with advising me about national strategies to nurture and sustain a culture of scientific innovation,” Obama said.

The advisory council will be headed by John Holdren, whom Obama appointed as director of the Office of Science and Technology Policy.

“This PCAST is a group of exceptional caliber as well as diversity, covering a wide range of expertise and backgrounds across the relevant science, engineering and innovation fields and sectors. The President and I expect to make major use of this extraordinary group as we work to strengthen our country’s capabilities in science and technology and bring them more effectively to bear on the national challenges we face,” Holdren, who had been director of the Program on Science, Technology, and Public Policy at Harvard University’s Kennedy School of Government, said in a statement.

The co-chairman of the council will be Eric Lander, director of the Broad Institute of MIT and Harvard and Professor of Biology at MIT, Professor of Systems Biology at Harvard Medical School, and member of the Whitehead Institute for Biomedical Research.

Obama's full prepared remarks are below, followed by the White House summary of his proposals:

Opponents of Democrats' healthcare proposals today launched a $1 million TV ad that asserts that President Obama and his allies are on the path to more government control and less patient choice.

The ad from the Conservatives for Patients' Rights Action Fund says that a provision in the $787 billion economic stimulus package to measure the effectiveness of care and treatment would copy national health plans in Canada and Britain.

The spot then features opponents of the government health plans in those countries warning of patients losing their choice of doctors, and some actually dying as they wait for care.

The ad ends with the announcer urging viewers to call Congress "you won't trade your doctor for a national board of bureaucrats."

In the budget outline they plan to pass this week, Obama's Democratic allies in Congress plan a parliamentary maneuver that would make it easier to pass a healthcare overhaul by requiring only a simple majority vote.

Also, the Senate Health, Education, Labor, and Pensions Committee announced this afternoon that a working group will hold a hearing on Tuesday about the lessons learned in the states, specifically on covering residents.

Those scheduled to testify include Jon Kingsdale, executive director of the Massachusetts Health Insurance Connector; Eileen McAnneny, senior vice-president of Associated Industries of Massachusetts; Susan Besio, director of the state Office of Vermont Health Access; and Barry Chen, board member of the Vermont Program for Quality in Health Care.

Republican opposition is holding up Kathleen Sebelius taking office as health and human services secretary and completing President Obama's cabinet.

And her supporters are none too happy.

The Senate Finance Committee on Tuesday sent the Kansas governor's nomination to the full Senate, but when the top Senate Democrat, Harry Reid, tried to bring up the nomination today, Republican leader Mitch McConnell objected, pushing the vote into at least next week.

Republicans have criticized Sebelius's ties to a Kansas abortion doctor and her views on healthcare reform. Anti-abortion groups have lobbied against Sebelius, a Catholic who personally opposes abortion, for her actions as governor on the issue.

NARAL Pro-Choice America today sent out an email alert to supporters urging them to contact their senators.

"Just a couple of hours ago, Gov. Kathleen Sebelius’ nomination to lead the Department of Health and Human Services hit a serious road block," the email says.

"Anti-choice senators blocked a vote today in response to pressure from the big 10 of the anti-choice movement. James Dobson of Focus on the Family, Tony Perkins of the Family Research Council, Wendy Wright of Concerned Women for America, and seven other anti-choice groups sent a letter yesterday calling on the Senate to block Gov. Sebelius’ nomination. There’s no way we can allow far-right radicals like James Dobson or Wendy Wright to obstruct this critical nomination."

John Sweeney, president of the AFL-CIO, also criticized the delay.

"Senate Republicans are obstructing the confirmation of Gov. Kathleen Sebelius and ignoring the American voters' mandate for new leadership and an end to the status quo, especially when it comes to our nation's broken healthcare system," he said in a statement. "Gov. Sebelius is part of that new leadership, and she will bring to the position of Secretary of the Department of Health and Human Services new vision rooted in experience.

"Throughout her career and as health insurance commissioner of Kansas, Sebelius has shown a commitment to fighting for consumers' and patients' rights. As governor of Kansas, Sebelius has a proven record of working with leaders on both sides of the aisle to solve problems."

UPDATE: Late today, Republican National Committee Chairman Michael Steele called on Obama to withdraw Sebelius's nomination unless she answers more questions on abortion, saying that she has not been forthcoming about her ties to a Kansas abortion doctor, George Tiller.

"Significant questions remain about Gov. Kathleen Sebelius' evolving relationship with a late-term abortion doctor as well as about her position on the practice of late-term abortions," Steele said in a statement, the Associated Press reports. "If Gov. Sebelius and the Obama administration are unwilling to answer these questions, President Obama should withdraw her nomination."

The White House declined to comment. A spokesman for Senate Majority Leader Harry Reid dismissed Steele's complaints.

"This is nothing more than a baseless attack from someone desperate to stake a claim as the leader of the leaderless Republicans and get right with the right-wing of his party," said Reid spokesman Jim Manley.

By Bryan Bender, Globe Staff

WASHINGTON -- A high-level commission will develop a blueprint this year for how to get the most out of record levels of global health aid, enlisting lawmakers, pharmaceutical executives, and a wide array of specialists to recommend ways the US government can better coordinate what organizers say is now a fragmented approach to helping the world's most vulnerable people.

The bipartisan Commission on Smart Global Health Policy, whose members include Senators Jeanne Shaheen of New Hampshire and Olympia Snowe of Maine, was given a mandate today to identify a more comprehensive strategy for spending the estimated $10 billion dedicated each year to assisting the world's most disease-plagued nations.

"How does the US capitalize on current investments? What should we be doing more of? What should we be doing differently?" Helene D. Gayle, president of the humanitarian organization CARE and a former assistant US surgeon general, said in outlining the objectives of the study she will help lead.

Perhaps a more important challenge, she added, is, "How do we better measure our impacts?"

The commission, which plans to issue its recommendations to the Obama administration early next year, has also enlisted an unlikely figure to spearhead the effort: retired Navy Admiral William J. Fallon, who was commander US military forces in the Middle East and Asia and is now a professor at MIT's Center for International Studies.

Fallon told reporters at a kickoff breakfast that he hopes to bring to the effort 40 years of experience witnessing first-hand the haphazard, short-term course the United States often takes in helping meet the basic needs of at-risk populations in what are often already unstable parts of the world.

Fallon, who oversaw the US military response to the Asian tsunami in 2004, said that in relative terms the amount the United States spends on global health each year is significant but could be far better utilized over the long term -- including for what he called "preventative maintenance" in Muslim countries where a deep distrust of American motives breeds extremism.

"If we could ever get our act together and come up with a comprehensive plan to pool resources...we can probably get some stuff done," Fallon said. "When you start slicing and dicing this thing to see where the money is actually going, it's a thousand places. And what's the effect?"

The commission is sponsored by the nonpartisan Center for Strategic and International Studies in Washington. Organizers say it is prepared to take on some controversial subjects, including whether there is too much focus on Africa and whether the major emphasis on treating HIV should be balanced with greater efforts to meet basic needs such as clean drinking water that could prevent diseases such as malaria that affect far larger numbers of people than HIV.

J. Stephen Morrison, who runs CSIS' Global Health Policy Center, and Jen Kates of the Kaiser Family Foundation, wrote in a paper released today that one "delicate task" of the commission will be to "decide on the correct balance between HIV and other areas."

"That will involve complex choices, potentially involving winners and losers or at least the perception of such," they wrote.

The commission's 26 members include several members of Congress; former top diplomats and intelligence officials such as John Negroponte; leaders of nonprofits such as the Bill and Melinda Gates Foundation; former Health and Human Services Secretary Donna Shalala; the president of Barnard College; and executives from major corporations such as Exxon Mobil, Coca Cola, and drug giant Merck and Co.

"We have an unprecedented opportunity," Gale said, "to think about this issue in a way that I think has not been done before."

Shaheen told the Globe in a statement that the commission's work is critically important, not just for the foreign nations most in need.

“Creating a long-term, strategic policy to address global health care challenges will strengthen our national security, our economy, and our standing as a moral leader in the world," she said.

President Obama's cabinet is nearly complete after the Senate Finance Committee voted this morning to send to the full Senate the nomination of Kansas Governor Kathleen Sebelius as health and human services secretary.

The vote was 15-8, a division caused in part by displeasure among some GOP senators about Sebelius' inaccurate response to the committee about how much campaign cash she received from George Tiller, a Wichita abortion doctor who is under investigation by Kansas' medical board over late-term procedures he performed.

According to the Associated Press, Sebelius told the committee that Tiller, who was acquitted of criminal charges involving the late-term abortions, had given her $12,450 between 1994 and 2001. But the AP found that Tiller and his abortion clinic donated an additional $23,000 between 2000 and 2002 to a political action committee Sebelius established to raise money for fellow Democrats. Sebelius apologized and called it an oversight.

Only two of 10 Republicans on the committee supported Sebelius. They were Pat Roberts from her home state of Kansas, and Olympia Snowe of Maine.

Obama's initial pick for the post, former Senate Majority Leader Tom Daschle, withdrew after tax discrepancies arose that forced him to pay more than $100,000 in back taxes and penalties. Sebelius had her own tax problems, acknowledging mistakes in three years of tax returns and paying more than $7,000 in back taxes to fix improper deductions.

The president wanted Daschle to lead a healthcare overhaul by also leading a new White House office of healthcare reform, but after his nomination foundered, Obama split the two jobs. Still, Sebelius will play a key role in remaking the health system

As Congress returns today from a two-week recess, Senators Edward M. Kennedy and Max Baucus reaffirmed their intention to push through a healthcare overhaul this year.

Baucus, a Montana Democrat who is chairman of the Senate Finance Committee, and Kennedy, a Massachusetts Democrat who leads the Senate Health, Education, Labor, and Pensions Committee, have been leading the charge so far. In a letter to President Obama, they announced what they called an "aggressive" schedule for their committees to draft comprehensive healthcare legislation in early June.

"We must act swiftly, because the cost of inaction is too high for individuals, families, businesses, state and federal governments," the senators wrote. "Comprehensive health care reform legislation will responsibly contain costs, improve quality, enhance disease prevention, and provide coverage to all Americans. We are committed to working with you, and with our colleagues in Congress, to enact legislation to achieve these long-overdue reforms without delay."

Obama has convened a White House summit on healthcare, where Kennedy, who is battling brain cancer, made an emotional appearance. He has also set aside a "downpayment" on healthcare in his $3.6 trillion proposed budget.

The full text of the letter is below:

So far, abortion has not emerged as a huge issue in the confirmation of Kathleen Sebelius for health and human services secretary.

But as she goes today before the Senate Finance Committee, which will vote whether to forward her nomination to the full Senate, conservatives are trying to put abortion front and center, while also highlighting her tax trouble -- she acknowledged paying about $7,000 in back taxes after "unintentional" errors in three years of returns.

UPDATE: Senators decided to wait to vote on Sebelius's nomination until they return from a two-week recess that starts Saturday, so that lawmakers have more time to review her responses on tax and other issues.

"Gov. Sebelius may not pay her own taxes, but has no qualms about using tax dollars to pay for others’ abortions. Even before she reported her tax issues Gov. Sebelius was manifestly unqualified to run America's health care system, as illustrated by her coddling of the abortion industry at the expense of Kansas women's safety. With her background, Gov. Sebelius can only be expected to politicize the office of HHS. Gov. Sebelius's difficulties illuminate an emerging pattern: that Obama nominates non-experts who cannot be relied upon to solve their own tax problems, let alone govern effectively," said a statement issued today by a who's who of anti-abortion conservatives.

They include Tony Perkins, president of the Family Research Council; Wendy Wright, president of Concerned Women for America; David Keene, chairman of the American Conservative Union; Marjorie Dannenfelser, president, Susan B. Anthony List; Grover Norquist, president of Americans for Tax Reform; Tom Minnery, vice president of government and public policy, Focus on the Family; and Don Wildmon, president, American Family Association.

"More acute than her tax problems, Gov. Sebelius is not to be trusted with any aspect of citizens' healthcare. As a member of the Kansas House of Representatives in the 1980s and 1990s Gov. Sebelius voted to weaken or eliminate even such modest measures as parental notification, waiting periods and informed consent. As governor, she twice has vetoed bills attempting to protect the health and safety of women by more tightly regulating abortion clinics. Gov. Sebelius has been endorsed by Planned Parenthood and they have conducted fundraising activity on her behalf. Clearly, Gov. Sebelius has a track record of politicizing common-sense health issues," they added.

Sebelius, a Catholic who personally opposes abortion, has not gone along with further limits as Kansas governor, though she did sign a bill on Friday requiring doctors to allow women to see ultrasound images of their fetuses before performing abortions.

In her prepared testimony, Sebelius said she wants to focus on prevention and primary care to help slow the rising costs of Medicare and Medicaid. On Tuesday, she told another Senate panel that she would make healthcare overhaul her mission.

The US House approved a bill today that would let the federal government regulate -- but not ban -- cigarettes and other tobacco products for the first time.

Senator Edward M. Kennedy, who is expected to introduce his version of the legislation later this month, immediately applauded the House passage,

“I am extremely pleased that a strong bipartisan majority of the House of Representatives has passed legislation empowering the Food & Drug Administration to regulate tobacco products. FDA regulation of cigarettes – the most lethal of all consumer products – is long overdue. I am confident that the Senate will approve it expeditiously, and send it to President Obama for his signature,” Kennedy said in a statement.

The Massachusetts Democrat and Representative Henry Waxman of California have pushed the legislation since the US Supreme Court ruled in 2000 that the agency did not have that authority.

The vote was 298-112, the Associated Press reports, overcoming years of opposition from tobacco-state lawmakers and other critics. President Obama supports the bill, which Bush administration threatened to veto.

All 10 Massachusetts Democrats in the House voted for the bill.

House Speaker Nancy Pelosi also called for full approval by Congress.

"Every day, Americans benefit from the oversight the FDA provides on the foods we eat and the medicines we take. Despite the fact that tobacco is one of the deadliest products in America, the FDA has no authority to regulate it. That is just not right," she said in a statement.

"Incredibly, tobacco is exempt from standards that apply to a can of soda or a box of pasta. Tobacco makers are exempt from critical and basic consumer protections, such as ingredient disclosure, product testing, and restrictions on marketing their dangerous and addictive product to children. By granting the FDA the authority to regulate tobacco products, we will protect public health, prevent disease, and stop tobacco companies from hooking America's children on their deadly product. This legislation also requires detailed disclosure of tobacco product ingredients, and restricts tobacco marketing and sales to youth, among other things. And this legislation does all of this in a fiscally responsible way -- funding FDA tobacco activity through a user fee on tobacco manufacturers."

Senator Richard Burr, R-N.C., is expected to lead the opposition, but supporters are confident they can clear the 60-vote threshold needed to break a filibuster.

"This vote brings us closer to putting a deceitful and dangerous industry under the watchful eyes of government regulators," American Heart Association CEO Nancy Brown said in a statement.

Opponents from tobacco-growing states such as top-producing North Carolina argued that the FDA had proven through food safety failures that it's not up to the job. They also said that instead of unrealistically trying to get smokers to quit or prevent them from starting, lawmakers should ensure they have other options, like smokeless tobacco.

That was the aim of an alternate bill offered by Rep. Steve Buyer, R-Ind., who would leave the FDA out and create a different agency within the Health and Human Services Department. His proposal failed on a 284-142 vote.

"Effectively giving FDA stamp of approval on cigarettes will improperly lead people to believe that these products are safe, and they really aren't," Buyer said. "We want to move people from smoking down the continuum of risk to eventually quitting."

Major public health groups, including the American Lung Association and the American Medical Association, wrote to lawmakers asking them to oppose Buyer's bill, contending it would leave tobacco companies without meaningful regulation and able to make untested claims about the health effects of their products.

Rep. Mike Rogers, R-Mich., also was unsuccessful in changing a provision that allows the FDA to tap its general fund for about six months to get the new program started. He argued that money would be diverted from the agency's already overstretched food inspection and disease research budgets. Waxman countered that the user fees from the tobacco industry would pay for the new FDA office and that any money borrowed from the general fund would be paid back without affecting other programs.

Buyer pointed out that Waxman's bill is supported by the nation's largest tobacco company, Marlboro maker Philip Morris USA. Officials at rival tobacco companies contend the Waxman bill could lock in Philip Morris' market share.

Material from the Associated Press was used in this report.

Senator Edward M. Kennedy, citing his own battle with brain cancer, came out forcefully this morning for Kathleen Sebelius's nomination as health and human services secretary.

"Few debates in Congress touch our lives as profoundly and personally as health care. Over the past ten months, I’ve seen our health care system up close," he said at the confirmation hearing for Sebelius.

"I’ve benefitted from the best of medicine. But we have too many uninsured Americans. We have sickness care and not health care. We have too much paperwork and bureaucracy. Costs are out of control. But today we have an opportunity like never before to reform healthcare."

His full prepared statement is below.

In her prepared testimony, Sebelius vowed to make healthcare reform her "mission.

"Inaction is not an option. The status quo is unacceptable, and unsustainable," the Kansas governor said in her testimony.

UPDATE: Sebelius was Obama's second choice for the job, after former Senator Tom Daschle was derailed by tax issues.

Now, the Associated Press reports that Sebelius has corrected three years worth of tax returns after finding "unintentional errors" involving charitable contributions, the sale of a home, and business expenses.

Sebelius alerted senators in a letter dated Tuesday that was obtained by The AP. She says she and her husband paid a total of $7,040 in back taxes and $878 in interest for 2005 to 2007.

The Senate Health, Education, Labor, and Pensions Committee announced this afternoon that it will hold the confirmation hearing on Tuesday for Kathleen Sebelius as secretary of health and human services.

Sebelius, the Democratic governor of Kansas, was President Obama's second pick for the post after tax troubles derailed former Senator Tom Daschle.

Obama also wanted Daschle to double as the health reform czar, but after his withdrawal separated the two jobs. Sebelius, however, will stay play a key role in the president's effort to pass a healthcare overhaul this year.

Calling for a renewed war on cancer, Senators Edward M. Kennedy of Massachusetts and Kay Bailey Hutchison of Texas introduced legislation today designed to improve research and treatment.

In a joint article, the two senators point out that since the United States declared the original war on cancer in 1971, the mortality rate has decreased by only 6 percent, far less than for heart disease and stroke.

"The solution isn’t easy, but there are steps we should take now if we hope to see the diagnosis rate decline substantially and the survival rate increase," they write.

That includes earlier screening and diagnosis when cancer is more curable, a more coordinated approach to research, raising awareness of clinical trials, and more comprehensive care during remission, they say.

Kennedy, who is battling brain cancer himself, has championed healthcare during his long Senate career and authored the 1971 bill to fight cancer.

A summary of the bill is below.

Dr. Edward J. Benz, Jr., president of Dana-Farber Cancer Institute in Boston and president of the Association of American Cancer Institutes, issued a statement praising the bill:

"We are extremely grateful for the leadership of Senators Kennedy and Hutchison in bringing this important legislation forward. Despite the great progress that has been made against cancer in the past quarter century, the burden of the disease on patients and their families around the world remains unacceptably high.

"This legislation holds significant promise. It stands to improve access to latest advances in cancer care. It places much needed focus on national initiatives in cancer prevention. It outlines a strong set of priorities to improve patient participation in clinical trials. It acknowledges that more people are surviving cancer and addresses the need for greater cancer survivorship care and services. It calls for reducing disparities in cancer mortality. It provides the resources for workforce development to help ensure that we have the highly skilled caregivers needed to expertly and compassionately care for patients. It also recognizes that current research has immense potential to lessen that burden for future generations and provides a powerful impetus for continued progress. We will be working closely with Senators Kennedy and Hutchison and their staffs to refine the bill and work for its passage."

Following is the full article from the senators:

Renewing the War on Cancer
By Edward M. Kennedy and Kay Bailey Hutchison

Cancer is a relentless disease. It doesn’t discriminate between men and women, wealthy or poor, the elderly or the young. In 2008, over 1.4 million Americans were diagnosed with some form of the disease. If it wasn’t you, it may have been a spouse or sibling, a parent or a child, a friend or a coworker. We, too, have known the challenges of cancer diagnoses for ourselves or our family members or friends. And while there are many stories of survival, this disease still takes far too many lives. More than half a million Americans lost their battle with cancer last year.

Since the War on Cancer was declared in 1971, we have amassed a wealth of knowledge about the disease. Advances in basic and clinical research have improved treatments significantly. Some of the most important progress has been made in prevention and early detection, particularly screening, including mammography and colonoscopy. Behavior modifications, such as smoking cessation, better eating habits, regular exercise, and sunscreen have been found to prevent many cancers. Continued focus must be placed on prevention, which will always be the best cure.

Though heightened awareness and prevention should be emphasized, alone they don’t translate into adequate progress for those with cancer. Since 1971, the cancer mortality rate has decreased by only 6 percent. In the same period, by contrast, mortality rates have dramatically declined for heart disease (by 56 percent) and stroke (by 66 percent). Today, cancer is the second leading cause of death in the United States, exceeded only by heart disease. If the current trend continues, the National Cancer Institute predicts that one in every two men and one in every three women will be diagnosed with cancer in their lifetimes, and that cancer will become the leading killer of Americans.

The solution isn’t easy, but there are steps we should take now if we hope to see the diagnosis rate decline substantially and the survival rate increase. To do so, we must identify and remove the numerous barriers that obstruct our progress in cancer research and treatment.

First, it is essential that cancer be diagnosed at an initial, curable stage. One of the most promising breakthroughs is the monitoring of biomarkers, which leave evidence within the body that alerts clinicians to hidden activity indicating that cancer may be developing. Identification of such biomarkers can lead to the earliest possible detection of cancer in patients.

Second, even if we significantly improve early detection, lack of health insurance and other impediments to care will preclude many Americans from undergoing routine screening. With early screening, the disease may be detected at a treatable stage and dramatically increase the rate of survival. Greater outreach is clearly needed to make screening more available to all, and especially to underserved populations.

Third, we must adopt a more coordinated approach to cancer research. Establishing an interconnected network of biorepositories with broadly accessible sources of tissue collection and storage will enable investigators to share information and samples much more effectively. Integrated research will help accelerate the progress of lifesaving research. The search for cures should also be a cooperative goal. The current culture of isolated career research must yield to more cooperative arrangements to expedite breakthroughs. Our national policy should encourage all stakeholders in the War on Cancer to become allies and work in concert toward cures.

Fourth, as our nation’s best and brightest researchers seek new ways to eradicate cancer, we must improve treatment for those who have it today. Raising awareness of clinical trials would result in more patients and their doctors knowing what promising trials are available. Doing so will expand treatment options for patients, and enable researchers to develop better methods for prevention, diagnosis, and therapy. Today, less than five percent of the 10 million adults with cancer in the United States participate in clinical trials. Disincentives by the health insurance market, preventing patients from enrolling in clinical trials, must be eliminated.

Finally, as our knowledge of cancer advances and patients live longer, we need a process that will improve patient survivorship through comprehensive care planning services. There is great value in equipping patients with a treatment plan and summary of their care when they first enter remission, in order to achieve continuity of therapy and preventing costly, duplicative, or unnecessary services.

We have introduced bipartisan legislation to bring about these necessary changes, and we hope to see the bill enacted in the coming weeks and months. These policy initiatives cannot be fully implemented without broad support and sufficient resources, and we are committed to leading this effort to completion.

It’s time to reinvigorate the War on Cancer, and more effective coordination of policy and science is indispensable for rapid progress.

By Stephen Smith, Globe Staff

President Obama this evening nominated Dr. Howard Koh, an associate dean at the Harvard School of Public Health and former Massachusetts public health commissioner, to a top health position in his administration.

If confirmed by the Senate as an assistant secretary of health, Koh would be responsible for establishing the nation's public health agenda.

He is the second member of his family to be nominated to a top Obama administration post this week: On Monday, his brother, Yale Law School Dean Harold Koh, was picked to be the State Department's legal adviser, a post that also requires Senate approval.

Howard Koh served as the public health commissioner in Massachusetts from 1997 to 2003, first being appointed by Governor William Weld and continuing in the office through the Paul Cellucci and Jane Swift administrations before resigning in the early days of the Mitt Romney administration.

As public health commissioner, Koh spread a gospel of prevention across the state that was both personal and passionate. He'd established his bona fides in the world of disease prevention as a young physician at the hospital that was the forerunner of Boston Medical Center. From that base, he helped direct the successful 1992 campaign to raise the state tobacco tax, with the money spent on launching Massachusetts' widely emulated tobacco control program.

In the waning days of his tenure as public health commissioner, swooning budget conditions forced Koh to largely dismantle the Tobacco Control Program.

After leaving the state post, Koh joined the Harvard School of Public Health as an associate dean, with his work focusing on cancer prevention, health disparities, tobacco control, and emergency preparations. He is one of the few doctors with certifications from four specialty boards of medicine: internal medicine, hematology, medical oncology, and dermatology.

Senator Edward M. Kennedy, back on Capitol Hill to pursue his political dream of universal healthcare, is declaring in a hearing today that the insurance market is broken and must be fixed.

"As the economic crisis worsens and the unemployment rate rises, the number of uninsured citizens will grow. In February 2009, more than eight percent of Americans were unemployed and 1.1 million of them will become uninsured with each one percent increase in unemployment. To guarantee that all Americans have access to quality medical services, we clearly must reform the current health insurance market," Kennedy said in a statement entered into the record before the Senate Health, Education, Labor, and Pensions Committee.

Kennedy says that Congress should look at the healthcare overhaul in Massachusetts for "sensible reform." The Bay State plan includes an individual mandate -- something that President Obama opposes.

"A key component is the requirement that all individuals must have health insurance and that insurance must meet a minimum standard of coverage," Kennedy says in his statement. "To assist those who have difficulty finding affordable health insurance, a state-wide “Insurance Connector” was created to pool individuals together. The plan assists low-income residents with a sliding-scale subsidy to ensure affordability. Although the nation has many diverse health insurance markets, Massachusetts’ reform shows that insurance market reforms can make a large difference – insurance coverage has risen from 94% percent to when the plan took effect in 2006 to over 97% percent today."

His full statement, provided by his Senate office, is below:

WASHINGTON -- Senator Edward M. Kennedy is back in Washington this week to shepherd a bipartisan bill to greatly expand funding for national service and to hold a series of meetings on healthcare as part of a broader effort to draft a massive overhaul plan this summer.

It would be the longest stint on Capitol Hill of the Obama administration for the veteran Massachusetts lawmaker, who has been in Florida recuperating and undergoing treatment for brain cancer. He returned to Washington earlier this month for a White House healthcare forum, and before that returned briefly to cast a key vote last month on the economic stimulus package. On inauguration day, he suffered a seizure at a congressional luncheon and was held overnight for what doctors said was fatigue.

Kennedy has been a passionate advocate of the national service legislation, which build on initiatives to boost public service that began during his brother's presidency. The measure was the first major piece of legislation the ailing Massachusetts lawmaker brought forward after being diagnosed with a brain tumor last May.

Written with Utah Republican Orrin Hatch, the plan would provide $5 billion over five years to fund 250,000 volunteers in energy, environmental, healthcare, and education programs. A similar measure passed overwhelmingly last week in the House, 321-105, with 70 Republican votes, and President Obama highlighted the effort in his first joint address to Congress.

Kennedy was part of a 74-14 vote this evening to bring the bill to the Senate floor. A final vote is likely this week.

Kennedy will also hold meetings on healthcare, according to a spokesman.

He and his staff have been working closely with Max Baucus, a Montana Democrat and chairman of the Senate Finance Committee, who laid out a breakneck schedule for a healthcare overhaul, including a review of healthcare delivery in April, an examination of ways to expand coverage in May, and an examination financing options before drafting the proposed legislation by June.

"Sen. Edward Kennedy (D-Mass.) and I have set up regular meetings with those Senators who will play a role in health reform, to inform and oversee the process as our staffs work closely together to craft a bill," Baucus wrote today in Roll Call, a Capitol Hill newspaper. "In the coming weeks and months, the Senate Finance Committee and the entire Congress will try, try again to pass comprehensive health reform. And this time, there is a better chance than ever to succeed."

When Senator Judd Gregg stunningly withdrew as President Obama's choice for commerce secretary, the New Hampshire Republican blamed "irresolvable conflicts" on policy.

He wasn't kidding.

Since giving Obama the heave-ho last month, Gregg has been one of the Democratic president's harshest critics. In recent days, he has been blasting Obama's proposed $3.6 trillion budget, saying it would bankrupt the country. Gregg, the ranking Republican on the Senate Budget Committee, got some more ammunition on Friday, when the nonpartisan Congressional Budget Office projected that Obama's game plan would generate unsustainable deficits averaging almost $1 trillion a year for the next decade.

In an interview on MSNBC this afternoon, Gregg said if he were in charge, he would excise from Obama's budget the healthcare expansion ($634 billion over 10 years) and the government takeover of student loans, would freeze discretionary domestic spending, and would tackle entitlement programs such as Medicare and Social Security.

He also stood by his eye-opening remarks about the moves by some Democrats to limit debate -- and require only a bare majority for passage -- on major tax proposals in Obama's budget plan, including carbon and healthcare taxes.

While Democrats say that Republicans did the same when they were in control, Gregg and other Republicans say that puts a lie to Obama's pledge of bipartisanship and changing how Washington does business.

"That would be the Chicago approach to governing: Strong-arm it through," Gregg said last week. "You're talking about the exact opposite of bipartisan. You're talking about running over the minority, putting them in cement, and throwing them in the Chicago River."

The Obama administration today is announcing that David Blumenthal, a Harvard Medical professor who is director of the Institute for Health Policy at Massachusetts General Hospital, will be national coordinator for health information technology.

In his new post, he will be in charge of nearly $20 billion in the economic stimulus package to build health IT, including encouraging more doctors and hospitals to use computers.

“President Obama believes we must take serious steps to modernize our healthcare system in order to improve the health of all Americans, bring down costs, and ensure sustained long-term economic growth. Health information technology is a critical part of the President’s strategy to reform our health care system and as one of the nation’s leading health information technology experts, Dr. Blumenthal has the experience and the vision to help make this effort a reality,” Jenny Backus, a spokeswoman for the Department of Health and Human Services, said in a statement.

“As a practicing physician and a leading scholar on health information technology, Dr. Blumenthal is uniquely qualified to help America’s doctors, nurses, hospitals, and patients reap the benefits of a modernized health system. Dr. Blumenthal shares President Obama’s commitment to investing in a health IT infrastructure that will protect patient privacy, and improve both quality and efficiency in our nation’s health system.”

Senator Edward M. Kennedy applauded the choice of Blumenthal, who was on Kennedy’s health staff from 1977 to 1980.

"President Obama has made an inspired choice in selecting David Blumenthal to lead the Administration’s effort to bring health care into the digital age. David is the right person to oversee this major initiative to reduce costs, avoid errors, improve care, and save lives,” Kennedy said in a statement.

MoveOn.org is moving on from the Iraq war to healthcare.

The powerful grassroots group, which was a key early supporter of Barack Obama, got its start in 1998 when it pushed for a censure of President Clinton and end to impeachment proceedings over the Monica Lewinsky scandal, and made a name with its vehement opposition to the Iraq war.

But now that Obama is president and has announced a withdrawal plan from Iraq, the group is expanding into other legislative priorities.

Starting Thursday, MSNBC reports, it plans to run a national cable TV ad on Obama's healthcare overhaul plan.

The spot takes on insurance companies, which MoveOn says will oppose a public insurance plan because it would cost them money. Obama has not committed to such an option, though it is under consideration in Congress.

"You know what the insurance companies see when they look at you?" the announcer asks. "Money -- which is why they're against the president's healthcare reform."

"Don't let the insurance companies get away with it," the announcer says, urging viewers to call their members of Congress to "put people before profits."

President Obama, lifting an eight-year limit on federal funding of stem cell research, today portrayed his decision as part of a broader move to focus on science instead of politics.

Besides signing an executive order (read it here) reversing the Bush administration restrictions, Obama is also issuing a presidential memorandum (read it here) directing the head of the White House Office of Science and Technology Policy to develop a strategy for restoring scientific integrity to government decision making.

The goal, the president said: "To ensure that in this new administration, we base our public policies on the soundest science; that we appoint scientific advisers based on their credentials and experience, not their politics or ideology; and that we are open and honest with the American people about the science behind our decisions."

On embryonic stem cell research in particular, Obama acknowledged the religious-based opposition. But he said there is an ethical way to do such research.

"Rather than furthering discovery, our government has forced what I believe is a false choice between sound science and moral values," he said in the East Room of the White House, filled with advocates of stem cell research who cheered and applauded his annoucement. "In this case, I believe the two are not inconsistent. As a person of faith, I believe we are called to care for each other and work to ease human suffering. I believe we have been given a capacity and will to pursue this research -- and the humanity and conscience to do so responsibly."

Under Bush's order, taxpayer money could only be used for research on a small number of stem cell lines created before Aug. 9, 2001. Since, hundreds more stem cell lines have been created, but off-limits to federal funding.

While urging Congress to give more money to stem cell research, Obama is leaving to Congress the particularly controversial issue of whether taxpayer money should be used to experiment on embryos themselves. A congressional ban has been in place since 1996. He also made clear he opposes cloning for human reproduction.

The president also said that while stem cell research holds much promise in the treatment of spinal cord injuries, diabetes, and Parkinson’s disease, there is no certainty.

"But that potential will not reveal itself on its own," Obama said. "Medical miracles do not happen simply by accident. They result from painstaking and costly research from years of lonely trial and error, much of which never bears fruit, and from a government willing to support that work.

"Ultimately, I cannot guarantee that we will find the treatments and cures we seek," he added. "No president can promise that. But I can promise that we will seek them -- actively, responsibly, and with the urgency required to make up for lost ground. Not just by opening up this new frontier of research today, but by supporting promising research of all kinds, including groundbreaking work to convert ordinary human cells into ones that resemble embryonic stem cells.

"I can also promise that we will never undertake this research lightly. We will support it only when it is both scientifically worthy and responsibly conducted."

Some patients, who could be helped by such research, attended the ceremony.

One was former Communications Workers of American vice president Pete Catucci, who was diagnosed with ALS, known as Lou Gehrig’s disease, in early 2007.

“Stem cell therapy is real. It’s time the United States caught up with the rest of the world and moved forward on this critical research," Catucci said in a statement. "I am grateful to President Obama for reversing the ban on federal funding for embryonic stem cell research that’s blocked so much important research over the past eight years.”

But one vocal advocate was not. Actor Christopher Reeve, who was paralyzed in a horse-riding mishap and whose crusade Obama noted.

"Christopher once told a reporter who was interviewing him: 'If you came back here in ten years, I expect that I’d walk to the door to greet you,' the president said.

"Christopher did not get that chance. But if we pursue this research, maybe one day – maybe not in our lifetime, or even in our children’s lifetime – but maybe one day, others like him might."

Senator Edward M. Kennedy of Massachusetts issued a statement praising Obama's move.

"Sometimes medicine advances through inspired discoveries in the laboratory, and sometimes through brilliant insights at the patient’s bedside. But today, an extraordinary medical breakthrough was achieved with the stroke of a pen. With today’s executive order, President Obama has righted an immense wrong done to the hopes of millions of patients.  The President’s action today unlocks the enormous potential of life-sustaining medical progress against a wide range of serious illnesses and injuries, all within strong ethical guidelines.”

So did Kennedy's Bay State colleague in the Senate.

“Today’s announcement is a long time in coming,” Senator John F. Kerry said in a statement. “Finally an American President has reaffirmed our country’s commitment to potentially lifesaving, ethical stem cell research. For the past eight years, not only has scientific progress been restricted, but the best hopes for a dialogue that finds common ground have been diminished. I commend President Obama for no longer allowing politics to get in the way of promising work on spinal cord injuries, Alzheimer’s, Parkinson’s, diabetes, heart disease, cancer and other diseases affecting millions of Americans, and for an approach that restores the promise of ethically-guided research in the best American tradition.”

Obama also won plaudits from an interesting quarter, former first lady Nancy Reagan. "I’m very grateful that President Obama has lifted the restrictions on federal funding for embryonic stem cell research,” she said in a statement. “These new rules will now make it possible for scientists to move forward. I urge researchers to make use of the opportunities that are available to them, and to do all they can to fulfill the promise that stem cell research offers."

UPDATE: Republicans in Congress, however, objected vociferously to Obama's decision.

"This decision runs counter to President Obama's promise to be a president for all Americans," Representative John Boehner of Ohio, the top Republican in the House, said in a statement. "For a third time in his young presidency, the president has rolled back important protections for innocent life, further dividing our nation at a time when we need greater unity to tackle the challenges before us.

"I fully support stem cell research, but I draw the line at taxpayer-funded research that requires the destruction of human embryos, and millions of Americans feel similarly," Boehner said.

Representative Chris Smith, co-chairman of the House Congressional Pro-Life Caucus, told reporters at a Capitol Hill news conference that scientific advances had already been happening under the Bush administration rules.

"At a time when highly significant, even historic breakthroughs in adult stem cell research have become almost daily occurrences and almost to the point of being mundane, President Obama has chosen to turn back the clock and starting today will force taxpayers to subsidize the unethical over the ethical, the unworkable over what works, and hype and hyperbole over hope," Smith said.

"Human-embryo-destroying stem cell research is not only unethical, unworkable and unreliable, it is now demonstrably unnecessary. Assertions that leftover embryos are better off dead so that their stem cells can be derived is dehumanizing and cheapens human life."

Obama's full remarks (transcript from the White House) are below:

A liberal-labor advocacy group has jumped on Rush Limbaugh's latest eyebrow-raising remark --about Senator Edward M. Kennedy's health -- as part of its crusade to tie the conservative radio show host around the neck of the Republican Party.

On his show Friday, Limbaugh talked about President Obama trying to shift attention to healthcare because he is failing to turn around the economy -- then suggested that Kennedy would be dead before a healthcare overhaul gets done.

"Before it's all over, it'll be called the Ted Kennedy Memorial Healthcare Bill," Limbaugh said.

Americans United for Change, calling the remark "disgusting," has joined the Democratic Party in demanding an apology.

"That's really clever, Rush -- picking on the senator with a brain tumor," the group told its supporters. "We can't let the Republican Party stay silent about Rush's wildly offensive remark. Demand an apology now."

"Senator Kennedy has spent his entire life fighting for policies to put America back on track -- policies like ending the war in Iraq, raising the minimum wage, and ensuring every American has access to quality, affordable healthcare," the group's missive continued. "The only thing Rush Limbaugh has fought for is himself. Now that Rush Limbaugh is the undisputed leader of the Republican Party, we want to know: will Congressional Republicans defend or demonize their leader's latest antics against their friend Senator Kennedy?"

No word from Limbaugh as yet, though he could address the controversy on his show today.

Americans United for Change, meanwhile, launches its latest cable TV ad asserting the Limbaugh is now the GOP's titular leader. The Republican Party, it says, has adopted Limbaugh's “I Hope he Fails” strategy towards Obama and has become the “Party of No:” "No to the jobs package, no to the Obama budget, no to healthcare reform and no to bipartisanship."

Senator Edward M. Kennedy drew a standing ovation when he appeared at the White House healthcare summit on Thursday.

But radio show host Rush Limbaugh gave him another kind of greeting today, suggesting that the healthcare bill will be named in memory of Kennedy, who is battling brain cancer.

Continuing his criticism of President Obama, Limbaugh said Obama is failing to fix the economy "so he's moved on to healthcare. This is highly visible, it's news-leading, gets a great focus, plus it has the great liberal lion, Teddy Kennedy, pushing it."

"Before it's all over, it'll be called the Ted Kennedy Memorial Healthcare bill," Limbaugh said on his show.

Neither Kennedy nor Limbaugh have responded to the situation.

The Democratic Congressional Campaign Committee quickly launched a petition drive urging Republican National Committee Chairman Michael Steele to denounce Limbaugh. The committee's executive director, Brian Wolff, called the remark "reprehensible" and "truly outrageous."

"Leader Limbaugh minimizes the struggle of hardworking Americans without access to affordable health care and demonizes a patriotic Senator who has spent his life fighting so that every person has the opportunity to live the American dream," Wolff said in a statement, calling the radio host by the moniker Democrats are using to suggest that Limbaugh is the leader of the GOP.

"Leader Limbaugh crossed the line.  National Republicans must stand up to their leader, Rush Limbaugh, and tell him that enough is enough." 

Americans United for Change, a liberal-labor coalition, added its outrage.

Jeremy Funk, a spokesman, said in a statement: “Even for someone with a long, sordid history of spewing sexist, racist, and disgusting rhetoric, Rush Limbaugh has really outdone himself this time with this wildly uncalled for and tasteless remark about ailing Senator Ted Kennedy. But as the undisputed leader of the Republican Party, the question is: will Congressional Republicans defend or admonish their leader’s latest antics? No one is holding their breathe for the latter.”

Following up Thursday's summit at the White House, the Obama administration announced today a series of regional events to continue gathering ideas on a healthcare overhaul.

They will be later this month and early next month and be hosted by the governors of California, Iowa, Michigan, North Carolina, and Vermont..

“Health care reform is a fiscal imperative,” Obama said in a statement. “Skyrocketing health care costs are draining our federal budget, undermining our long-term economic prosperity and devastating American families. The time for reform is now and these regional forums are some of the key first steps toward breaking the stalemate we have been stuck in for far too long. The forums will bring together diverse groups of people all over the country who have a stake in reforming our health care system and ask them to put forward their best ideas about how we bring down costs and expand coverage for American families.”

Like the White House version, the regional forums will include doctors, patients, providers, policy analysts, and others. The events will begin with a video from Obama, a summary of the findings from community gatherings in December, and an overview of Thursday's summit.

Senator Edward M. Kennedy, who has declared healthcare as his final mission, appeared at the close of today's White House summit.

Kennedy drew a lengthy standing ovation and cheers.

"To Sir Edward Kennedy. That's the kind of greeting a knight deserves," President Obama said, noting that British Prime Minister Gordon Brown announced Wednesday that the Massachusetts lawmaker is receiving an honorary knighthood.

"It is thrilling to see you here, Teddy," the president added. "We are so grateful for you taking the time to be here and the extraordinary work that your committee has already started to do."

Obama also gave Kennedy the first question. Taking the microphone, Kennedy called the summit a "very special gathering."

"I join with all of those that feel that this is the time, now is the time, for action," Kennedy said. "I think most of us who have been in this room before have seen other times when the House and the Senate have made efforts, but they haven't been the kind of serious effort that I think that we're seeing right now.

"If you look over this gathering here today, you see the representatives of all the different groups that we have met with over the period of years," he added. "I mean, you have the insurance companies, you have the medical professions -- all represented in one form or another. That has not been the case over the history of the past, going all the way back to Harry Truman's time. But it is the case now. And it is, I think, a tribute to your leadership in bringing all these people together and really a leadership of so many that are gathered here today.

"What it does is basically challenges all of us to really do the best we can.....I just want to say that I'm looking forward to being a foot soldier in this undertaking. And this time, we will not fail."

Obama also made sure to shake hands with Kennedy first after his concluding remarks and wrapping up the summit.

It was the veteran Massachusetts lawmaker's first return to the nation's capital since casting a key vote on the economic stimulus package last month. Kennedy, who is battling brain cancer, has been recuperating in Florida since suffering a seizure on Inauguration Day.

Kennedy and his staff have been working closely with Senator Max Baucus, chairman of the Finance Committee, on legislation for a healthcare overhaul.

Cancel that page: The White House is not calling Dr. Sanjay Gupta to be the nation's surgeon general.

CNN is reporting this afternoon that its well-known medical correspondent has withdrawn from consideration, and will talk more about it tonight on "Larry King Live."

Gupta would have been one of the most visible personalities in that job, but critics questioned whether he could have been an independent voice on public health matters.

Senator Sheldon Whitehouse of Rhode Island fired off one of the best lines at today's White House healthcare summit.

As relayed by President Obama at the wrap-up session, Whitehouse argued during a small group session that it's time for an overhaul by saying it's not a "Harry and Louise" moment -- referring to the couple in the insurance company TV ads that helped scuttle health reform during the Clinton administration -- but a "Thelma and Louise" moment, alluding to the 1991 movie starring Susan Sarandon and Geena Davis whose characters drive off a cliff at the end.

"We're in the car headed toward the cliff and we must act," Obama quoted Whitehouse, before adding that while Thelma and Louise did go over the cliff, "that's not our intention here."

Opening his healthcare summit, President Obama vowed this afternoon to try to enact comprehensive reform by the end of the year, saying that Washington has ignored the problem for far too long.

Declaring that the "exploding cost" of healthcare is one of the greatest threats to the "very foundation of our economy," he said that sweeping change is a "fiscal imperative" as well as a moral one, noting that the ranks of the uninsured has grown by 8 million to about 46 million.

The president directly addressed skeptics who say, as he put it, "that at a time of economic crisis, we simply can't afford to fix our healthcare system as well."

Obama asserted that the country can't afford not to take on healthcare. "The same soaring costs that are straining our families' budgets are sinking our businesses and eating up our government's budget too," he said. "Too many small businesses can't insure their employees. Major American corporations are struggling to compete with their foreign counterparts. And companies of all sizes are shipping their jobs overseas or shutting their doors for good."

He added: "If we want to create jobs and rebuild our economy, and get our federal budget under control, then we have to address the crushing cost of health care in this year in this administration."

And to the doubters who point out that the Clinton administration utterly failed 16 years ago, Obama argued that many of those who bitterly opposed major changes in healthcare then are now on board.

"Our inability to reform healthcare in the past is just one example of how special interests have had their way, and the public interest has fallen by the wayside. And I know people are afraid we'll draw the same old lines in the sand, and give in to the same entrenched interests, and arrive back at the same stalemate that we've been stuck in for decades," he said.

"But I am here today -- and I believe you are here today -- because I believe that this time is different. This time, the call for reform is coming from the bottom up, from all across the spectrum – from doctors, nurses and patients; unions and businesses; from hospitals, health care providers and community groups. It’s coming from mayors, governors and legislatures, Democrats, Republicans who are racing ahead of Washington to pass bold health care initiatives on their own. This time, there is no debate about whether all Americans should have quality, affordable healthcare the only question is, how?"

Obama promised openness in the process, a reminder that the Clinton effort was assailed for being conducted mostly behind closed doors.

Ad libbing, he called an invitation to the summit "the hottest ticket in town."

"In this effort, every voice must be heard," the president said. "Every idea must be considered. Every option must be on the table. There should be no sacred cows. Each of us must accept that none of us will get everything we want, and that no proposal for reform will be perfect.... But when it comes to addressing our healthcare challenge, we can no longer let the perfect be the enemy of the essential.

"Finally, I want to be very clear at the outset that while everyone has a right to take part in this discussion, nobody has the right to take it over and dominate. The status quo is the one option that is not on the table. And those who seek to block any reform at all -- any reforms at any cost -- will not prevail this time around."

Obama said during the campaign and after, he received letters from people seeking help because they have put off going to the doctor or filling prescriptions, and have to go to the emergency room for care.

"There's a lot of desperation out there," he said. "Today, I want them, and people like them across this country, to know that I have not forgotten them. They are why we are here today – to start delivering the change they demanded at the polls in November.

Obama concluded, "It will not be easy. There will be false starts and set-backs and mistakes along the way. But I am confident that if we come together, and work together, we will finally achieve what generations of Americans have fought for and fulfill the promise of healthcare in our time. And what a remarkable achievement that would be."

UPDATE: At the close of the summit, Obama played moderator, summarizing the high points of what was discussed during small breakout sessions.

Obama warned both liberal groups that want universal coverage that it won't work without cutting costs, and fiscal conservatives that want to cut costs that reform won't work without expanding coverage.

He addressed the skepticism again that with the deepening recession, there are too many other priorities and healthcare reform should wait for another day.

Obama argued that the nation "didn't get it done" during good times, mild recessions, and war. "There is always a reason not to do it," he concluded.

His full opening remarks are below, followed by his closing remarks and the question-and-answer session at the close of the summit:

Healthcare is the message of the day at the White House -- and if President Obama succeeds in an overhaul that helps many of the 47 million Americans without insurance -- could be one of his signature achievements.

Obama is convening a summit this afternoon with about 150 elected officials and representatives of groups that have much at stake in the outcome -- and that helped kill the last attempt at an overhaul during the Clinton administration 16 years ago.

"The Forum will bring together the people who have a stake in our health care system and the people who have the ability to change it; those who worked to pass health care reform a decade ago and those who worked to defeat it," the White House says in a background paper.

"Learning the lessons of past efforts, the President is starting by bringing diverse and bipartisan stakeholders together for a substantive and transparent discussion consistent with the principles he has laid out," the background paper says. "Participants will be asked to work together and offer up ideas to bring down costs and increase coverage for all Americans. The President will ask for the best ideas and the best ways to make reform happen. While the people around the table – Republicans, Democrats, insurance companies, labor, doctors and patient advocates – may not agree on everything, having them around the table is a critical, but first step in this process."

While some skeptics say healthcare is too heavy a lift during a deepening recession, Obama argues that the skyrocketing medical costs make reform essential to the recovery. In his proposed budget, he set aside $634 billion over 10 years for an initiative that many analysts say will cost more than $1 trillion.

The president plans to make opening remarks at about 1 p.m. Then, the participants will break into small groups for discussion. Obama plans to make closing remarks about 4 p.m.

UPDATE: The White House released a list of attendees, which is below. It includes several "everyday" Americans who took part in house meetings and other gatherings to discuss healthcar.

By Lisa Wangsness, Globe Staff

WASHINGTON -- Senator Max Baucus said this morning he plans to have lunch with Senator Edward M. Kennedy this week to discuss a major healthcare overhaul, the top priority for both senators, who chair the Finance Committee and the Committee on Health, Education, Labor and Pensions, respectively.

The news is significant because Kennedy, who is suffering from brain cancer, has mostly been in Florida since Inauguration Day, when he experienced a seizure during a Senate luncheon. He returned to Capitol Hill briefly to cast a key vote on the economic stimulus package.

Baucus, speaking to reporters at a Kaiser Family Foundation breakfast, said he has been speaking frequently with Kennedy about healthcare, which is the subject of a summit President Obama is convening on Thursday. He did not say whether Kennedy would attend the summit, but he said the two are working together closely. They recently co-authored a Wall Street Journal opinion piece about the need for a health overhaul.

Obama, making healthcare a priority, put $634 billion in his 10-year budget plan as a downpayment and on Monday named two key aides to push an overhaul: Kansas Governor Kathleen Sebelius as health and human services secretary, and former Clinton administration official Nancy DeParle as director of the White House Office of Health Reform.

Kathleen Sebelius apparently doesn't have a tax problem, but she might have an abortion hurdle to confirmation.

This afternoon, President Obama plans to introduce the Kansas governor as his backup pick for health and human services secretary after his first choice, former Senate Majority Leader Tom Daschle, withdrew amid a firestorm over taxes he didn't pay on a private driver.

Sebelius comes with bipartisan credentials, but the most vocal opposition to her nomination could come from abortion foes. A Catholic who personally opposes abortion, she has refused to go along with restrictions in Kansas, where the anti-abortion movement is strong.

Opponents are pointing to a meeting that Sebelius had in the governor's mansion with a Wichita abortion provider, who is about to go on trial for violating state restrictions on certain late-term abortion procedures.

"Governor Sebelius's record as Governor, a state representative, and a close ally of abortionists like the notorious George Tiller (whom she threw a party for in the Governor's mansion) leaves no doubt she will be a strong advocate for abortion disguised as 'health care,' " Tom McClusky, senior vice president of the Family Research Council, said in a statement.

Bill Donahue, president of The Catholic League, added in a statement: "Catholics do not expect that abortion-rights presidents will go out of their way to choose pro-life Catholics to be in their administration. But they also don’t expect them to go out of their way to offend them. Obama has done just that."

Dr. Charmaine Yoest, president & CEO of Americans United for Life Action, issued a statement as well: “As a member of the Kansas House and later as Governor, Gov. Sebelius has a long history of opposing and even vetoing measures such as parental involvement for a daughter's abortion; informed consent; medically-supported health and safety standards for abortion clinics; and reasonable limits on late-term abortions. Nominating someone with an extremist record on abortion who is also associated with the most notorious abortionist in America to be Secretary of Health and Human Services is offensive. This is a politically divisive move. The Senate should reject this polarizing nomination."

Catholics United, a liberal group, is coming to Sebelius's defense, issuing a list today of 25 Catholic leaders supporting her nomination. It also accuses anti-abortion groups of trying to smear the governor.

"Gov. Sebelius is a proven and tireless advocate for children's health care, education, adoption, and support for pregnant women, all components of a public policy agenda intended to benefit the common good. Under her leadership, the state of Kansas has witnessed sharp declines in both abortions and teen pregnancy,” Chris Korzen, executive director of Catholics United, said in a statement, “Because of her success in expanding health care coverage and reducing abortions, we feel that Gov. Sebelius is an excellent choice to lead our nation's Department of Health and Human Services.”

The group says that as governor, Sebelius, supported Pregnancy Maintenance Initiatives, which are programs run through agencies such as Catholic Charities that provide pregnant women with alternatives to abortion; signed Alexa’s Law to deal with certain crimes against fetuses, including in the slaying of a pregnant woman, murder charges in the death of the unborn child as well; signed a law doubling the adoption tax credit and oversaw an expansion of adoption support spending; and oversaw a decline in teen pregnancies between 2002 and 2007.

“Our nation desperately needs leaders who can bring Americans together behind common ground, common good solutions to the problems of our day,” said Korzen. “Kathleen Sebelius’ ability to lead as a popular Democrat in a very conservative state proves she is the right woman for the job. We call on all people of good will to support her nomination and we look forward to her service in this important position.”

UPDATE: Boston-based Catholic Democrats also came to Sebelius's defense today.

"Governor Sebelius's legislative record, experience as a governor, and Catholic sensibilities, particularly regarding preferential treatment for the poor, will be of tremendous value in addressing health care reform, the projected Medicare insolvency crisis as soon as 2016, and aiding the millions of people who are being pushed into poverty as a result of the economic crisis," Steve Krueger, the group's national director, said in a statement.

President Barack Obama officially nominated Kansas Governor Kathleen Sebelius as secretary of health and human Services, and also tapped Nancy-Ann DeParle as his healthcare czar.

Obama initially planned for former Senator Tom Daschle to fill both roles, but his nomination was scuttled after questions about unpaid taxes.

Sebelius, an early Obama backer during the campaign, will also play a key role in Obama's planned healthcare overhaul -- he asked for $634 billion over 10 years as a downpayment.

DeParle, another former Clinton administration official who handled budget matters for federal healthcare programs and managed Medicare and Medicaid, will be counselor to the president and director of the White House Office for Health Reform.

“If we are going to help families, save businesses, and improve the long-term economic health of our nation, we must realize that fixing what’s wrong with our health care system is no longer just a moral imperative, but a fiscal imperative. Health care reform that reduces costs while expanding coverage is no longer just a dream we hope to achieve – it’s a necessity we have to achieve," Obama said in a statement.

"There's no easy formula for fixing our healthcare system," Obama said at a news conference, flanked by Sebelius and DeParle.

Healthcare costs are rising at a pace threatening the federal budget, he said. In recent years, he noted, a million Americans have joined the ranks of the uninsured, which now totals more than 47 million.

He said he is committed to a healthcare overhaul and is trying to bring Republicans as well as fellow Democrats together -- a task that he said Sebelius will make easier.

"She has forged a reputation for bipartisan problem-solving," Obama said, noting that former GOP presidential candidate and Senator Bob Dole was on the stage as well.

Sebelius also has a deep knowledge of healthcare and has been on the front lines of the issue, the president said.

Obama called DeParle one of the nation's leading experts on healthcare finances. "I have absolute confidence in her ability to lead the public and legislative effort," he said.

The president acknowledged that a healthcare overhaul will be difficult, and many interests would prefer the status quo.

"I didn't come to Washington to take the easy route," he declared. "I came here to deliver the sweeping change they voted for in November."

Sebelius expressed confidence that healthcare reform can happen. "The work won't be easy, but bringing about real change rarely is," she said.

(Click here for the full remarks of Obama and Sebelius.)

Before naming his picks, Obama also announced the release of $155 million from the $787 billion economic stimulus package to support 126 new health centers designed to provide comprehensive primary and preventive healthcare services to 750,000 Americans and create 5,500 jobs.

“We have acted quickly to put Recovery Act dollars to good use in communities across America,” Obama said in a statement. “The construction and expansion of health centers will create thousands of new jobs, help provide health care to an estimated 750,000 Americans across the country who wouldn’t have access to care without these centers, and take another step toward an affordable, accessible health care system.”

According to the White House, Massachusetts will get $1.3 million, enough for 7,060 patients and 50 jobs.

Senator John F. Kerry of Massachusetts said the Bay State money will go to the North Shore Community Health Center which has locations in Salem and Peabody, as well as a planned location in Gloucester.

“President Obama committed to invest recovery dollars in efforts that save jobs and help those who are struggling, and Massachusetts can attest that today’s announcement is proof that he’s keeping his word. This funding is a lifeline for the seniors, new and expectant parents and families who depend on North Shore Community Health Center for their medical care,” Kerry said in a statement. “The skyrocketing price of health care forces working people to make agonizing choices- between heating their homes or refilling their prescriptions, buying groceries or taking their children for an annual check-up. Were it not for North Shore Community Health Center too many people would be forced to gamble with their health, and the health of their children. I applaud President Obama and his Administration for recognizing the essential role North Shore Community Health Center plays in the lives of thousands and supporting their vital efforts.”

The other New England totals: Connecticut, $1.3 million, 5,240 patients, 40 jobs; Maine, $2.6 million, 11,170 patients, 85 jobs; New Hampshire, $930,000, 2,100 patients, 15 jobs; Rhode Island, $2.4 million, 7,380 patients, 55 jobs; and Vermont, $1.3 million, 4,170 patients, 30 jobs.

Reaction is pouring into the nomination of Sebelius, who is being praised by civil rights and women's groups.

“I know from personal experience as a Kansas native, and from my work at the University of Kansas, that Governor Sebelius is the right person to work with President Obama and Congress to reform our nation’s health care system and efficiently administer critical human services for Americans, both young and old,” Janet Murguía, President and CEO of the National Council of La Raza, the nation's largest national Hispanic civil rights advocacy group, said in a statement. “She has demonstrated compassion and courage in helping her state address difficult issues. She worked to reduce barriers to health care for low-income families by eliminating burdensome Medicaid paperwork requirements that disproportionately impact racial and ethnic minorities. As the insurance commissioner, she actively reached out to the public to ensure that a potential insurance company merger had the interests of patients in mind.”

Murguía continued, “At a time when 46 million Americans, including a full one-third of Latinos, go without health insurance, and millions more struggle to hang on to the little coverage they have, the challenges facing our health care system require immediate solutions. Governor Sebelius has exactly the right combination of skills to lead this effort. She is a proven executive and knows how to work across party lines, as well as with diverse interests, to achieve results.”

Ellen R. Malcolm, president of EMILY's List, said in a statement: "I am so pleased to congratulate Governor Kathleen Sebelius on her nomination as the next Secretary of Health and Human Services. With over 48 million Americans still uninsured and millions more scraping by, this nation needs a strong, innovative leader to reach across the aisle and fix our broken health care system. In her years as governor and insurance commissioner, Secretary-designate Sebelius proved her effectiveness by helping to modernize Kansas's health care system and extend health care to those who need it most. She will bring the same determination to our country's health care crisis and work with President Obama as he strives to make quality, affordable health care a reality for every American."

John Sweeney, president of the AFL-CIO, also praised the pick in a statement.

"We congratulate President Obama on his choice of Gov. Kathleen Sebelius as our next Secretary of Health and Human Services. The nomination of Gov. Sebelius will provide a great boost to the effort to enact sweeping health care reform. Her experience as Kansas insurance commissioner and her outstanding record as governor uniquely qualify Gov. Sebelius for this demanding position. Time's selection of her in 2005 as one of the country's five best governors speaks to the critically important leadership and managerial abilities needed for this job.
Gov. Sebelius brings a track record of bipartisanship and the ability to work well with all the players in health care. We look forward to work with her to enact affordable, comprehensive health care for all."

Kerry added his praise in a statement.

“Governor Sebelius more than earned her spurs on reform in Kansas, reaching across the aisle, building consensus, and standing firm at the right moments on some of the thorniest issues of the health care system. As Kansas’ insurance commissioner, she took a gutsy stand against the big insurance giants in the name of preventing them from raising premiums on those already struggling to pay for health care. As Governor, she reached across the aisle in a red state to deliver health care coverage to tens of thousands of low-income children. That combination of toughness and bipartisan leadership will be critical to the success of health care reform on a national basis.”

President Obama today named the person who will coordinate federal efforts on HIV/AIDS.

Jeffrey S. Crowley, MPH, Senior Research Scholar at Georgetown University’s Health Policy Institute, will be director of the Office of National AIDS Policy.

“Jeffrey Crowley brings the experience and expertise that will help our nation address the ongoing HIV/AIDS crisis and help my administration develop policies that will serve Americans with disabilities,” Obama said in a statement. “In both of these key areas, we continue to face serious challenges and we must take bold steps to meet them. I look forward to Jeffrey’s leadership on these critical issues.”

Crowley's biography, provided by the White House, is below:

President Obama told Congress and the nation that a healthcare overhaul can't wait -- and backed up his words by calling today for a $634 billion reserve fund as a down payment on the changes.

The two key US senators working on healthcare have Obama's back as well, jointly penning an op-ed piece in today's Wall Street Journal.

"Some argue that repairing the health-care system now is impossible, given the urgency and high cost of ending the financial crisis. The claim is that we can fix one problem or the other -- but not both. In truth, the two are inextricably intertwined: Solving the nation's health-care crisis is a fundamental part of healing our economy," write Senator Edward M. Kennedy, chairman of the Health, Education, Labor and Pensions, and Senator Max Baucus, chairman of the Finance Committee.

The two Democrats add that "there is also a moral imperative to follow economic recovery efforts with health reform. If Congress can bail out the nation's banks, surely we can help families get the quality, affordable health care they deserve."

They conclude, "Health is a public good worthy of major, long-term investment. Our starting point will be the down payment of more than $600 billion that the president included in the budget released today. The challenge of crafting this public policy is certainly large. But just as Congress and the president met the first challenges of restoring our nation's economy, we must also keep our commitment to reforming health care -- now."

With Tom Daschle's tax flame-out, President Obama does not have someone to shepherd a healthcare overhaul yet.

But today, he did name someone to focus on getting care to the uninsured and underserved.

Mary Wakefield, director of the Center for Rural Health at the University of North Dakota and described by the White House as one of the nation’s top rural healthcare professionals, will be administrator of the Health Resources and Services Administration.

“As a nurse, a Ph.D., and a leading rural healthcare advocate, Mary Wakefield brings expertise that will be instrumental in expanding and improving services for those who are currently uninsured or underserved,” Obama said in a statement. “Under her leadership we will be able to expand and improve the care provided at the Community Health Centers which serve millions of uninsured Americans and address severe provider shortages across the country.”

The agency oversees community health centers across the country and programs that send doctors and nurses to underserved areas and will administer $2.5 billion in the stimulus package to improve healthcare infrastructure and train health care professionals.

Wakefield's biography, provided by the White House, is below:

By Lisa Wangsness
Globe staff

WASHINGTON -- A trio of Boston doctors says the 2006 Massachusetts healthcare law is a poor model for a national system because it leaves too many people without affordable care.

In an analysis issued earlier today and an accompanying letter signed by nearly 500 Bay State physicians, they urged Senator Edward M. Kennedy to push for a Medicare-for-all style national healthcare system, something Congressional leaders and the White House have rejected as politically unworkable as they consider a major overhaul to the healthcare system this year.

"Any plan that retains private insurers will add layers of bureaucracy and fail to control costs, dooming the noble effort to assure good care for all," the letter said.

The Massachusetts healthcare law essentially builds on the existing health insurance system, where most people obtain coverage through their employers. It requires virtually all people to buy insurance and provides limited assistance to those who cannot afford it. President Obama and Senate Finance Committee Chairman Max Baucus have endorsed aspects of the plan, making it likely to influence any effort to overhaul the national system.

The doctors' analysis -- written by Rachel Nardin, a neurologist and an assistant professor at Harvard Medical School, and Steffie Woolhandler and David Himmelstein, both primary care doctors and associate professors at Harvard Medical School -- questions the quality of data showing that all but 2.6 percent of Massachusetts residents have insurance, arguing the number is probably 5 percent or more.

The doctors also say that the new insurance available to lower middle class people imposes unaffordale out-of-pocket costs, particularly on the chronically ill. And they argue that because the new law is more expensive than anticipated, the state has prematurely cut funding for "safety net" providers who help the poor free of charge, leaving them without a last resort.

"Despite having health insurance, many Massachusetts residents cannot afford care," Nardin said at a press conference in Washington earlier today. She cited the example of a young diabetic from the Boston area whose costs went from nothing under the old "free care" system to $340 per month under the new law, consuming one-quarter of her take-home pay.

Asked how Congress and the White House might avoid Massachusetts' mistakes to create a better national system, Woolhandler and Nardin said the main lesson was that a Medicare-for-all style system is the only way to achieve universal health reform.

Supporters of the Massachusetts system dismissed the doctors' analysis as driven by ideology more than by facts.

"They let the perfect be the enemy of the good," said MIT economist Jonathan Gruber, a board member of the Commonwealth Health Insurance Connector Authority, which administers the Massachusetts law.

Gruber noted that the Connector has capped out-of-pocket costs and premiums for low-income people, ensuring that someone making less than three times the poverty level -- about $32,000 for a single person -- will pay no more than around 10 percent of their income each year. He acknowledged, however, that those who earn between three and five times the poverty level may have a harder time finding affordable insurance.

Jon Kingsdale, executive director of the Connector, added that out-of-pocket costs for people who earn two to three times the poverty rate are similar to what most people in that income range pay for insurance through their employer.

"Their criticism that we substantially raised cost-sharing for most of the people we've helped... is absolutely untrue," Kingsdale said.

He also noted that while some low-income Boston and Cambridge residents could obtain comprehensive care free of charge before the law passed, most people living outside the metropolitan area then lacked access to drug benefits and broad range of specialist care. Insurance provides access to comprehensive care, he said.

Data on uninsurance is not perfect, he added, but that surveyors went to great lengths to be accurate.

Kingsdale also said the doctors' analysis did not accurately portray the cost of subsidized insurance for low-income people; Kingsdale said the cost in the 2008 fiscal year was $800 million, not more than $1 billion.

By Jillian Jorgensen, Globe Correspondent

WASHINGTON -- More than $4 million in federal grants for medical research have been awarded to Massachusetts institutions, Senator Edward M. Kennedy's office announced today.

The 16 grants from the National Institutes of Health totaling $4,634,625 will fund research at 12 hospitals, universities, and other institutions into medical technologies and diseases, including neurological disorders, cancer, and HIV/AIDS.

Boston University was awarded $1,162,282, coming from five different grants spread between their main campus and medical campus, which operates Boston Medical Center.

Massachusetts General Hospital will receive two grants totaling $755,730 for the hospital, and Brigham and Women's Hospital was awarded $370,289 to study development, regeneration, and cancer growth in the liver.

Fenway Community Health Center in Boston received $189,483 from the National Institute for Drug Abuse to study the effectiveness of pharmacy-based HIV intervention for intravenous drug users.

“Senator Kennedy commends these institutions on their outstanding achievements in the field of health research,” Keith Maley, a Kennedy spokesman, said in a statement. “Their cutting-edge research is producing vital advances in our understanding and improvement of health care.”

Other institutions receiving grants include Beth Israel Deaconess Medical Center, Children's Hospital Boston, Innovative Chemical/Environmental Tech in Norwood, Massachusetts Institute of Technology, the University of Massachusetts at Amherst, and the University of Massachusetts at Worcester.

WASHINGTON -- Senators Edward M. Kennedy and Max Baucus, in a public letter to President Obama this afternoon, affirmed their commitment to passing a major health care bill this year and urged the new president to move with dispatch to find a replacement for Tom Daschle, who would have been the White House's point-person on that issue.

Daschle, Obama's nominee for Health and Human Services, withdrew his name this week after acknowledging he had failed to pay $128,000 in taxes on a private car and driver lent to him by a Democratic donor. Since he lost his reelection bid in 2004, he had also earned large speaking fees from health care interests whose activities are regulated by HHS.

"We have a moral duty to ensure that every American can get quality health care," the senators' letter said. "Incremental efforts will no longer suffice and we cannot afford to wait any longer. With your continued leadership and commitment, we remain certain that our goal of enacting comprehensive health care reform can be accomplished this year.

Daschle's departure devastated health advocates, who viewed him as uniquely qualified to guide the White House reform effort. A veteran former senator with a low-key demeanor who had won respect on both sides of the aisle, Dashle had recently authored a book on health reform and had the full confidence of the president.

Baucus, the chairman of the Senate Finance Committee, and Kennedy, the chairman of the Committee on Health, Education, Labor and Pensions, have been working steadily since last summer to prepare the way for a bill they hoped to send to the floor in the first 100 days of the new administration.

In their letter, they expressed disappointment about the Daschle situation but said the circumstances demanded immediate bold action.

"As you have emphasized we must act now," the letter said. "The ranks of the uninsured grow larger each day. The cost of health care to families, businesses and government are crippling and, although we spend more on health care than any other country, the quality of care provided by America's health care system is often uneven compared to other industrialized nations."

Health care advocates do not agree on who would the best person to replace Daschle, or whether Obama should have two people take his place -- one to head the department and one to work on the health bill.

A day after he had to jettison the person he hoped would be the architect of a healthcare overhaul, President Obama this afternoon will get to claim a smaller victory.

He signed into law a bill, given final approval by the House today, to extend subsidized coverage to 4 million more children across the country. The bill on the State Children's Health Insurance Program costs nearly $33 billion and covers children whose parents earn too much to qualify for Medicaid, but find it expensive to buy private insurance.

"This is good, this is good," Obama began, as supporters applauded and cheered.

With the bill, "We fulfill one of the highest responsibilities that we have -- to ensure the health and well-being of the nation's children," he said, First Lady Michelle Obama by his side.

But Obama also noted the reality that 8 million children lack health insurance, among an estimated 47 million Americans without health insurance, according to the Census Bureau, about 16 percent of the population..

"This is only the first step," he said, calling it a downpayment on his commitment for universal healthcare coverage.

And, like an event during his campaign, he introduced a "real family" to illustrate the issue, vowing that he will refuse to accept" that some children do not get the basic help they need to reach their full potential.

He also noted that the legislation lifts the ban on states allowing the children of immigrants to enroll in the program, eliciting another big cheer from the invited audience.

Tom Daschle, who was nominated for health and human services secretary and for a new White House office of healthcare reform, withdrew his nomination on Tuesday over tax troubles.

Senator John F. Kerry praised the final passage of the bill, noting that the program covers nearly 100,000 children in Massachusetts.

“It’s about time we take care of our most vulnerable children. We’ve waited far too long for this day,” Kerry said in a statement. “America’s kids should be guaranteed comprehensive care whether they need dental care, mental health, medical or surgical treatment.”

The legislation also includes parity for mental health services under the program. “It’s about time we take care of our most vulnerable children. We’ve waited far too long for this day,” Kerry added. “America’s kids should be guaranteed comprehensive care whether they need dental care, mental health, medical or surgical treatment.”

An anti-tax group, however, argued that by signing the bill, Obama had violated a core campaign promise -- not to raise taxes on those earning less than $250,000 a year.

Americans for Tax Reform said that the tobacco tax hike that funds the expansion -- "a 156 percent increase in the federal excise tax on tobacco, a hike of 61 cents per pack" -- disproportionately hits lower income people.

Obama's full prepared remarks are below:

Tom Daschle has withdrawn as President Obama's nominee for health and human services secretary because of his failure to pay his taxes on time.

Daschle, the former top Democrat in the Senate, apologized publicly and privately on Monday. Senators and Obama had stood by him, but Daschle withdrew today, saying he did not want to be a distraction.

Obama said he accepted the decision with sadness and regret, the White House said.

"Now we must move forward," added Obama, who on Monday said he "absolutely" stood behind Daschle.

Besides overseeing a huge agency, Daschle was also supposed to be the point person for Obama on healthcare reform.

In his withdrawal letter, Daschle said he would have not been able to operate "with the full faith of Congress and the American people."

Asked about the stunning reversal, White House spokesman Robert Gibbs said Daschle made the decision because he did not want to be a distraction to Obama's agenda.

"We're at a critical juncture in our nation's history... and the president has a robust agenda to deal with those problems," Gibbs said.

Gibbs also told reporters at his daily briefing that Daschle, and deputy budget director-designate Nancy Killefer, who also withdrew over tax problems today, recognized that they could not follow a different standard of ethics and accountability than Obama is calling for.

"That agenda and the president's call for change was more important," he said.

Asked whether Daschle's withdrawal will delay the healthcare reform effort, Gibbs said others in the administration will carry the ball.

"I don't think the effort for healthcare slows down," he said. "This is bigger than any one group or individual."

Senator Max Baucus of Montana, chairman of the Senate Finance Committee, had backed Daschle's nomination on Monday and is helping lead the charge for healthcare reform, along with Senator Edward M. Kennedy of Massachusetts.

“It was with regret but with respect for his decision that I learned of Senator Daschle’s request to withdraw his name from consideration for Secretary of Health and Human Services," Baucus said in a statement. "Tom would have been, as I said, a terrific partner at HHS on health reform, and I hope and fully expect that he will continue to play a leading and valuable role in health policy for this country.”

Senator Edward M. Kennedy of Massachusetts, who had already been working with Daschle on healthcare, issued this statement:

“Tom Daschle is a public servant of high character and deep devotion to this country. He is strongly committed to health care reform and would have been an outstanding Secretary of Health and Human Services. Even though he has withdrawn his name, I know that Tom remains dedicated, as am I, to achieving quality, affordable health care for all Americans. Tom will remain a respected voice in this important debate, and I look forward to continuing to work with him.”

Senator John F. Kerry of Massachusetts added his statement:

“I wish Tom Daschle had not decided to withdraw his nomination for Secretary of Health and Human Services. While Tom’s decision is a reminder of his loyalty to President Obama and his determination not to be a distraction, this was no ordinary appointment and today is not a good day for the cause of health care reform. Tom brought a unique level of legislative skill and experience to this position in addition to his passion to achieve affordable health care for every American. Tom made it very clear he’d made a mistake and he took responsibility for it. I believe that when the smoke clears and the frenzy has ended, no one will believe that this unwitting mistake should have erased thirty years of selfless public service and remarkable legislative skill and expertise on health care. I know Tom Daschle well. I know his integrity and I respect his heart for this cause, and I know Tom will find other ways to contribute to this central mission.”

Harry Reid, the top Democrat in the Senate, said while Daschle was "ideally suited" for the job, the healthcare reform effort can move forward.

Reid told reporters on Capitol Hill that he was "terribly disappointed" by what happened to Daschle, whom he called "like a brother to me."

"I support his decision," Reid added.

Daschle was being criticized for not paying until last month $128,203 in back taxes and $11,964 in interest, mostly for the use of a private car and driver. He was also being questioned about speaking fees he accepted from healthcare interests.

Senator John Ensign of Nevada told reporters on Capitol Hill that there were "serious problems" with Daschle's activities.

While Daschle wasn't a registered lobbyist, he seemed to be in conflict with Obama's pledge to end the revolving door between lobbyists and government, Ensign said.

Daschle would have been grilled before the Senate Finance Committee next week, Ensign said. "He saved the president from being embarrassed next week in a public hearing," he said.

The statements from Daschle and the president are below: