Democratic leaders from Congress to the White House vowed Friday to resurrect their long-stalled health care legislation, with or without Republican suggestions or votes.
"We know what happens if we do nothing: more and more people pay more," White House press secretary Robert Gibbs said. "The president believes we still have to act."
Nearly a year after President Barack Obama set the overhaul effort in motion, Gibbs said the president would make an announcement, probably on Wednesday, about "where he sees a path moving forward."
Gibbs said the next few days would be a "fairly dynamic process" as the administration and Democratic congressional leaders decide how best to proceed. The White House believes the most likely route to passage by Congress is a controversial one known as "reconciliation," which involves special budget rules allowing majority Democrats to avoid any Republican filibuster, said a senior administration official.
But there are other options for a Democratic-only solution, said the official, who spoke on condition of anonymity because of the political sensitivity of the issue. Less likely, at this point, is settling for a more modest fallback bill.
One day after an unprecedented health care summit that brought together Obama and lawmakers of both parties, House Speaker Nancy Pelosi said the nationally televised event showed GOP lawmakers are "accepting of the status quo" in which insurance companies mistreat consumers.
She told reporters at a news conference there are "good prospects for passing" health care legislation along the lines Obama has outlined, even if Republicans refuse their support.
The Senate's second-ranking Democrat, Richard Durbin of Illinois, seconded the determination to move ahead. "We are not going to wait," he said.
Both Pelosi, D-Calif., and Durbin said Democrats would consider Republican suggestions for changes. They aren't likely to get much. Spokesmen for the House and Senate Republican leaders said Friday their party does not plan a formal response to Obama, having made clear a belief that Democrats should scrap their bills.
The House and Senate both passed sweeping bills late last year, and had appeared on the cusp of reaching agreement on a final compromise that could remake the nation's health care system early last month. In general, the bills would have expanded coverage to tens of millions who lack it, while curbing insurance industry abuses such as banning the denial of coverage on the basis of pre-existing medical conditions.
Those efforts buckled when Republicans won a special election for a Senate seat in Massachusetts, depriving Democrats of the 60 votes they need to block GOP filibusters.
Now Democratic leaders are attempting a complicated rescue mission that could involve having the House pass the bill the Senate has already cleared — on the condition that a second measure would remove or alter provisions that are objectionable to numerous House Democrats.
Sen. John McCain, R-Ariz., said Republicans are still willing to negotiate changes in the health care system with Obama, but only on a "step-by-step" basis.
McCain said on ABC's "Good Morning America" he believes the White House summit on the medical care system was beneficial and many people learned a lot from it.
But he also said it is time "to start over. What we're saying is, let's start out on the areas we agree upon." The Arizona Republican said the GOP would be "seriously interested" in negotiating a less complex, less sweeping health care bill with the Obama administration.
In their remarks, Durbin and Pelosi echoed Obama's closing statement on Thursday that Democrats will move forward on a health care overhaul with or without Republicans, preparing his party for a fierce fight whose political outcome will rest with voters in November.
Policy marathon
Delivering his closing argument at a 7-1/2-hour televised policy marathon, Obama told Republicans he welcomes their ideas — even ones Democrats don't like — but they must fit into his framework for a broad health care remake that would cover tens of millions of uninsured.
It's a gamble for Obama and his party, and it's far from certain that Democratic congressional leaders can rally their members to muscle a bill through on their own. At stake are Democrats' political fortunes in the midterm elections and the fate of Obama's domestic agenda pitted against emboldened Republicans.
"The truth of the matter is that politically speaking, there may not be any reason for Republicans to want to do anything," Obama said, summing up. "I don't need a poll to know that most Republican voters are opposed to this bill and might be opposed to the kind of compromise we could craft.
"And if we can't," he added, "I think we've got to go ahead and make some decisions, and then that's what elections are for."
To the nearly 40 lawmakers in the room with him, the message was unmistakable.
"Frankly, I was discouraged by the outcome," said Senate Republican Leader Mitch McConnell of Kentucky. "I do not believe there will be any Republican support for this 2,700-page bill."
Obama's plan would require most Americans to get health insurance, while providing subsidies for many in the form of a new tax credit. It would set up a competitive insurance market for small businesses and people buying coverage on their own. Other changes include addressing a coverage gap in the Medicare prescription benefit and setting up a new long-term-care insurance program. The plan would be funded through Medicare cuts and tax increases.
At the summit, there were some areas of agreement, including barring insurers from dropping policyholders who become sick, ending annual and lifetime monetary limits on health insurance benefits and letting young adults stay on their parents' health policies into their mid-20s or so.
Yet on the core issues of how to expand coverage and pay for it, the divide was as wide as ever. Democrats argue a stronger government role is essential, and with it higher taxes and new rules for private companies.
"We have a very difficult gap to bridge here," said Rep. Eric Cantor of Virginia, the No. 2 House Republican. "We just can't afford this. That's the ultimate problem."