President Obama's endorsement Wednesday of a risky legislative maneuver to complete health-care legislation sent Democratic leaders scrambling to settle policy disputes and assemble the votes necessary for passage in the coming weeks.
In a speech at the White House, Obama urged Congress to "finish its work" on health care and indicated support for a strategy that includes the budget maneuver known as reconciliation, which would protect the final product from a Republican filibuster in the Senate. Obama told an audience of medical professionals that Congress "owes the American people a final vote on health-care reform."
But completing the job would require weeks of complicated parliamentary tactics that Republicans have pledged to challenge at every turn. Although Obama has reached out to GOP lawmakers in recent days, hosting a bipartisan health summit last week and offering to include conservative proposals in his plan, Republicans remain unified and resolute in their opposition.
GOP opportunities to block reconciliation in the Senate will be numerous. The minority party may offer an unlimited number of amendments and can challenge provisions that don't have a clear impact on the federal budget, restricting the bill's contents. "We're going to scrub the bill thoroughly," said Senate Minority Leader Mitch McConnell (R-Ky).
Even so, House and Senate Democratic leaders pledged to move aggressively. Under the plan taking shape, the House would pass the legislation approved Christmas Eve by the Senate. Both chambers would then pass a reconciliation bill that consists of fixes, being negotiated by Democratic leaders, to address House concerns with the smaller and more moderate-leaning Senate bill.
"The president's announcement is a call to action," said House Speaker Nancy Pelosi (Calif.). "We will now move forward."
Senate Majority Leader Harry Reid (D-Nev.) pledged to use "every option available."
In his remarks, Obama did not mention the reconciliation procedure by name but said the legislation now stalled in Congress "deserves the same kind of up-or-down vote that was cast on welfare reform, the Children's Health Insurance Program, COBRA health coverage for the unemployed and both Bush tax cuts -- all of which had to pass Congress with nothing more than a simple majority."
Those programs were passed under reconciliation rules, which enable the Senate to act with a simple majority rather than a filibuster-proof 60 votes.
In response, Sen. John Cornyn (R-Tex.) said Obama embraced "the hyper-partisan reconciliation tactic," and House Minority Leader John A. Boehner (R-Ohio) said Obama "voiced support for a partisan scheme to jam the bill through Congress."
As the process unfolds, Pelosi faces the challenge of uniting conservatives and progressives in her party behind a Senate bill that both sides find lacking -- on the left because it has no public option, and on the right because its language on abortion coverage is less restrictive.
Because Pelosi is likely to lose at least a handful of Democrats over the abortion issue, she must win conversions among the 39 Democratic lawmakers who voted against the House bill Nov. 7. One target is moderate Rep. Jason Altmire (D-Pa.), who said Wednesday that he was encouraged by the direction of the discussions.
"The bill that appears is going to be brought forward is better than the bill I had to vote on in the House," said Altmire.
The Senate package does not include two key components from the House bill that many conservative Democrats disliked: a surtax on the wealthy that would have paid for the bill, and a mandate that most employers provide coverage for their workers.
Altmire said he still wants to see stronger efforts to control health-care costs, but added, "I'm not saying it has to be 100 percent" to secure his vote.
As Obama spoke, Democrats from both chambers laid the groundwork for defending their use of reconciliation, accusing Republicans of obstructionism for blocking much of Obama's domestic agenda. Rep. Chris Van Hollen (D-Md.), a member of House leadership, cited the five-day blockade of temporary funding for unemployment benefits by Sen. Jim Bunning (R-Ky.), which ended Tuesday night, calling it part of a "calculated and cynical strategy" by the GOP "to bring the work of the American people to a halt."
Sen. Ben Cardin (D-Md.) said Republicans are merely trying to block health-care legislation, not improve it. "It's not that they want us to start over," Cardin said. "They do not want a bill."
Although Democrats agree that reconciliation will be necessary, many questions remain, particularly in the House, about how to proceed. House and Senate leaders have not agreed on the full content of the reconciliation measure, and a final compromise appeared to be at least days away.
Attaching a cost estimate to the fixes -- which under reconciliation rules must cut the deficit by at least $1 billion over the next five years -- would take several days more. House Majority Leader Steny Hoyer (D-Md.) said Democrats were exploring ways to make the Senate bill's passage conditional on passage of the reconciliation bill so that House members could be certain the Senate bill alone would never become law.
Aides said whatever path the House follows, the two bills are likely to move through the House in tandem. Hoyer said Democrats still hope to deal with health "before the Easter break," the timetable Obama is seeking. But given the procedural and political complexity of the task, others called that goal overly ambitious.
Before Obama spoke, senior aides made it clear that the White House would launch a final public push for health-care reform during the next several weeks. That effort is scheduled to begin Monday with a presidential trip to Philadelphia and another on Wednesday to St. Louis.
"Whatever it takes to get health care done," White House press secretary Robert Gibbs said of the president's schedule.