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Obama Calls for ‘Up or Down Vote’ on Health Care Bill

President Obama called on Wednesday for an “up or down vote” on health care overhaul.Credit...Shawn Thew/European Pressphoto Agency

WASHINGTON — President Obama, beginning his final push for a health care overhaul, called Wednesday for Congress to allow an “up or down vote” on the measure, and sketched out an ambitious — and, some Democrats said, unrealistic — timetable for his party to pass a bill on its own within weeks.

“I believe the United States Congress owes the American people a final vote on health care reform,” Mr. Obama said during a 20-minute speech in the East Room of the White House. He said there was no point in starting over, as Republicans are demanding, and called on nervous Democrats to stick with him, declaring there was no reason “for those of us who were sent here to lead to just walk away.”

The speech, less than a week after Mr. Obama held a high-profile televised health care forum, will usher in what White House officials say will be their last campaign to bring Washington’s long and contentious health care debate to a close — with a bill-signing ceremony at the end.

On Thursday, Health and Human Services Secretary Kathleen Sebelius will meet at the White House with insurance industry executives to spotlight unpopular rate increases; next week, Mr. Obama will travel to Missouri and Pennsylvania to stump for the health care bill.

In his remarks, the president refrained from using the word “reconciliation,” the parliamentary tactic that Democrats are expected to employ to avoid a Republican filibuster and win passage with a simple majority. But he made clear that was his intent, and reminded Americans that despite current Republican objections, other major bills had been passed using the same tactic.

“Reform has already passed the House with a majority. It has already passed the Senate with a supermajority of 60 votes,” Mr. Obama said. “And now it deserves the same kind of up or down vote that was cast on welfare reform, that was cast on the Children’s Health Insurance Program, that was used for Cobra health coverage for the unemployed and, by the way, for both Bush tax cuts — all of which had to pass Congress with nothing more than a simple majority.”

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Senator Mitch McConnell criticized Mr. Obama's request.Credit...Stephen Crowley/The New York Times

Republicans were furious.

“They’re making a vigorous effort to try to jam this down the throats of the American people, who don’t want it,” the Senate Republican leader, Mitch McConnell of Kentucky, told reporters after Mr. Obama’s remarks. “We think that’s a policy mistake, and we think resorting to these kind of tactics, to thumb your noses at the American people, is something that ought to be resisted.”

On Capitol Hill, the strategy could prove a heavy lift for the House speaker, Nancy Pelosi, and the Senate majority leader, Harry Reid, who are now under intense pressure from the White House to translate Mr. Obama’s wishes for a final bill into legislative language. Both leaders issued statements Wednesday praising Mr. Obama and vowing to press ahead. But, noticeably, neither publicly committed to Mr. Obama’s timetable.

Privately, Senate leadership aides said Mr. Obama’s deadline could be difficult to meet. The tentative plan is for the House to adopt the bill passed by the Senate, and for both chambers to use reconciliation to pass a package of changes that would bridge gaps between the initial House and Senate versions.

But the final language must still be sent to the nonpartisan Congressional Budget Office for evaluation, a process that takes time. Many aspects of the legislation remain unresolved, and rank-and-file Democrats in the House remain deeply uneasy over both the substance of the bill and the process by which it would be adopted.

Ms. Pelosi does not yet have the votes she needs to pass the legislation. She faces complex negotiations with both the moderate and liberal wings of her party to come up with a package that can pass the House without deviating so much from the existing Senate version that Mr. Reid would have trouble assembling a majority for the final vote in the Senate.

“I am not inclined to support the Senate version,” said Representative Shelley Berkley, Democrat of Nevada, who voted for the House bill in November. “I would like something more concrete than a promise. The Senate cannot promise its way out of a brown paper bag.”

As Democrats prepared for a final showdown with Republicans, other potential stumbling blocks emerged. House Democrats from New York met Wednesday with Ms. Pelosi to discuss their concern that the emerging bill would shortchange their state on Medicaid and other issues.

“I am very, very disappointed and unhappy,” said Representative Eliot L. Engel, Democrat of New York. “The White House is taking us for granted, and they shouldn’t.”

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CNBC coverage of President Obama on Wednesday calling for Congress to allow an “up or down vote” on health care legislation.

Supporters of abortion rights, in and out of Congress, said Wednesday that they were alarmed at the prospect that lawmakers might impose new restrictions on insurance coverage of abortion in the push to enact sweeping health legislation. Representative Jan Schakowsky, Democrat of Illinois, said language restricting insurers’ ability to cover abortions “remains in the president’s proposal, and we are very concerned about that.”

Friday will mark one year since Mr. Obama laid out his plans for a health care overhaul with a high-profile forum at the White House, where he engaged in a lively debate with lawmakers of both parties and executives from the insurance, hospital and pharmaceutical industries. On Wednesday, the scene at the White House was far different.

Mr. Obama spoke, without taking questions, to a group of sympathetic medical professionals, many of them clad in white lab coats to provide a TV-friendly image. After 12 months of legislative hearings, town hall meetings, speeches, polls and debates, Mr. Obama was in the position of selling not only the public, but his own party, on his top domestic priority.

“The American people want to know if it’s still possible for Washington to look out for their interests and their future,” Mr. Obama said. “They are waiting for us to act. They are waiting for us to lead. And as long as I hold this office, I intend to provide that leadership. I don’t know how this plays politically, but I know it’s right.”

Seeking to reassure wavering Democrats that he would back them up, he pledged to do “everything in my power to make the case for reform.”

Moments after he finished speaking, the White House announced plans for him to visit Pennsylvania and Missouri — states that are home to vulnerable Democrats like Representative Jason Altmire of Pennsylvania and Representative Ike Skelton of Missouri, who were among 39 Democrats to vote against the health measure when it passed the House last year. If Mr. Obama is to sign his legislation into law, he is going to have to convert some of those no votes into yeses; traveling to a lawmaker’s home state could be one way to do that.

Senior advisers to Mr. Obama are betting that the politics of health care will eventually turn in the party’s favor, if the president can actually sign a bill into law. The legislation includes popular restrictions on the insurance industry; some, like a provision barring insurers from discriminating against children on the basis of pre-existing conditions, would take effect quickly — a point noted by Mr. Obama’s press secretary, Robert Gibbs.

“The president has always subscribed to the notion that the politics will catch up,” Mr. Gibbs said.

A version of this article appears in print on  , Section A, Page 1 of the New York edition with the headline: PRESIDENT CALLS FOR FINAL VOTE ON HEALTH BILL. Order Reprints | Today’s Paper | Subscribe

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