Obama promises health care overhaul

updated 3:39 p.m. ET Aug. 5, 2009

WAKARUSA, Ind. - President Barack Obama said Wednesday he's determined to get an overhaul of the health care system before the end of the year and, if necessary, without bipartisan support.

His comments reflected a growing sense among Democrats that they may have to carry the legislation to expand coverage and try to control medical costs with votes from lawmakers of their own party — or at best a handful of Republicans.

Visiting economically stressed Indiana to announce $2.4 billion in taxpayer grants for electric cars and tens of thousands of jobs, Obama pledged successful conclusion of the health care overhaul that he argues would stabilize the nation's fiscal health.

"I promise you, we will pass reform by the end of this year because the American people need it," the president said.

That will take some doing, since action on legislation in the House and Senate has been slowed by divisive policy arguments. Republican leaders oppose the Democrats' approach, and they're saying Congress should start over. But in an interview after his speech, Obama said he is not wedded to a bill with Republican as well as Democratic support.

He said he is encouraged that a small group of three Democratic and three Republican senators on the Finance Committee continue to negotiate, but signaled impatience with protracted talks that haven't yet produced legislation.

"Sometime in September we're going to have to make an assessment" about whether to keep trying to negotiate with Republicans, he told MSNBC.

Obama said he "would prefer Republicans working with us" but that getting his main priorities for a health care overhaul are more important. It represents a marked change from the emphasis Obama placed on bipartisanship when he launched his campaign for a health care overhaul at a White House summit in March.

The president's shift is being echoed by Democratic senators.

"The time is closing in," said Sen. Jay Rockefeller, D-W.Va. "We cannot finish this year without passing major health care reform. It's our sacred duty to the American people."

Rockefeller said negotiations with Republicans have only resulted in a bill that "gets weaker, and weaker, and weaker."

Obama's health care summit: Just for show? In a story with more twists than a soap opera, Obama's invitation to congressional leaders of both parties to attend a Feb. 25 meeting can't be dismissed as a mere diversion. GOP cool to Obama call for health talks NYT: Obama, GOP set for TV health showdown What’s the big deal with insuring across states? Sen. Landrieu defends Medicaid deal for La.

"Everything is being focused on will three Republicans cooperate, or will they not?" Rockefeller said.

Democrats will need 60 votes to overcome parliamentary delaying tactics and pass a bill in the Senate. While there are 60 Democratic senators, two have been absent because of illness, and not all Democrats support the legislation that has emerged thus far from committee.

Democratic leaders could resort to a maneuver that lets them pass a budgetary bill with a 51-vote majority, but it comes with a risk: large parts of the health care legislation could be stripped away on the Senate floor if they don't directly relate to spending or revenues. Among the provisions likely to be targeted are consumer protections such as prohibitions to keep insurance companies from discriminating against patients in poor health.

Rockefeller said Democrats "coming together will be the requirement we go through to get a good bill."

Sen. Sherrod Brown, D-Ohio, suggested that fellow Democrats would be taking a risk if they defy their party leadership on procedural votes that could snarl the health care bill.

"I don't think there's any Democrat, on a procedural vote, who wants to be on the wrong side of history," he said. "I think, in the end, there will also be a handful of Republicans who don't want to be on the wrong side of history."

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