Democrats pushed healthcare reform legislation forward in a key congressional panel on Friday but the battle over President Barack Obama's top policy goal looked ready to move outside Washington as lawmakers prepared for a monthlong break, Reuters reported.
With polls showing the public wary of the cost and scope of the healthcare reforms, Democrats said they needed Obama to keep up the pressure as they lobby their constituents to support legislation to rein in costs, improve care and cover most of the 46 million uninsured Americans.
"We need to go out and make an impressive case over August," White House political adviser David Axelrod told reporters after meeting with House Democrats just before the third and last panel in the House of Representatives, Energy and Commerce, was to act on its healthcare legislation.
The district-to-district battle is expected to be intense, with Republicans gearing up to stop Obama's reform plan.
The Republican National Committee is spending nearly $1 million on television and radio ads in 33 states targeting Senate leaders and fiscal conservatives of the House of Representatives.
Many of these conservative Democrats could be vulnerable in the 2010 midterm election -- one reason Obama and his fellow Democrats who control Congress are eager to put healthcare behind them by the end of this year.
As for Democrats, House Speaker Nancy Pelosi has zeroed in on the insurance industry, which, unlike hospitals and drug companies, has not found ways to help pay for health reform.
Healthcare overhaul proposals would include either a government-run or non-profit cooperative to compete with private insurers, and Democrats see insurance companies as an easy target for populist criticism.
"The glory days are coming to an end for the health insurance industry in our country," Pelosi said, adding that Democrats would counter the industry's "shock and awe carpet-bombing campaign" to keep the status quo.
Many industry and consumer groups backing healthcare reform also plan to speak out, including the AARP seniors' group and the American Medical Association.
Obama has staked much of his political fortune on winning overhaul of the $2.5 trillion healthcare system this year to expand insurance coverage to most Americans and hold down skyrocketing growth in medical costs, which he has described as central to long-term economic recovery.
While Obama has set the overall goal, he left the tough details to lawmakers in the House and Senate, which are both now working on specific reform legislation.
That effort was dealt a major setback on Thursday when Senate Democrats said they had not made sufficient progress in their effort to reach a bipartisan bill to permit a vote in the Finance Committee before they leave next week.
In the House, Democratic leaders agreed to a package of changes including savings in drug costs and expanded subsidies for the poor to appease liberals upset with an earlier deal made with fiscal conservatives in their party.
"We've agreed that we need to pull together," House Energy and Commerce Committee Chairman Henry Waxman told reporters, adding that he expected the full committee to approve the draft bill later on Friday.
Democrats said one proposed change in the House bill would require the government to negotiate with drugmakers over medicine prices under Medicare, the insurance program for the elderly and disabled.
Waxman's panel is the last of three House committees to vote on reform plans, and the deal pushed off until September the intra-party arguments over the shape of the final bill the full House expects to vote on in September.
But as discussions drag on, more Americans are voicing doubt over the reform plan, with many worried that a costly overhaul could reduce the quality of their care and limit choices of doctors.
California Governor Arnold Schwarzenegger, a Republican, cautioned that Washington was pushing more of the cost of care for the poor onto states that can ill afford it. Although he told congressional leaders he supported expanded coverage, he said the plan underway in the Senate would cost California $8 billion more a year.
"I cannot and will not support federal healthcare reform proposals that impose billions of dollars in new costs on California each year," he wrote in a letter to congressional leaders.
The White House and leaders of the Democratic-controlled Congress had hoped the final committees mulling the measure -- the House Energy and Senate Finance panels -- could end deliberations before the August recess.
While the Senate Finance Committee will not have a final plan to vote on before the recess next week, its chairman said they will work during the month to craft a plan that will garner some Republican support when Congress returns in September.
Their negotiations have focused on a plan that would insure people through non-profit cooperatives.
The House is going in a different direction, with a government-run insurance plan, but with the right for each state to supplement this with cooperatives.