The president faces a number of hurdles in his push for health care changes, as the effort has gone from platitudes and rhetoric to cold, hard legislation, with tough choices on how the program will be paid for, or whether it will include a public, government-run health insurance plan.
Obama wants to see health care legislation pass through both the House and Senate before the August recess, but Republicans, and even some Democrats, say that is unlikely.
The president today had stern words for those critics.
"It's the same Washington thinking that has ignored big challenges and put off tough decisions for decades. And it is precisely that kind of small thinking that has led us into the current predicament," Obama said while announcing Dr. Regina Benjamin as his pick for U.S. Surgeon General. "So make no mistake. The status quo on health care is no longer an option for the United States of America."
"We are going to get this done. Inaction is not an option. And for those naysayers and cynics who think that this is not going to happen, don't bet against us," he said. "I understand people are a little nervous and a little scared about making change. ... The muscles in this town to bring about big changes are a little atrophied, but we're whipping folks back into shape."
"Republicans very much want reform but not on the backs of the American people with the kind of taxes and potential rationing of care that would result," said Sen. Jon Kyl, R-Ariz, on "This Week With George Stephanopoulos." "There is no chance that it's going to be done by August. President Obama was right about one thing. He said if it's not done quickly, it won't be done at all. Why did he say that? Because the longer it hangs out there, the more the American people are skeptical, anxious, and even in opposition to it."
But administration officials say the president is hopeful and sees the finish line in a chance to revamp health care for the first time in modern history. At a news conference marking the end of the G-8 Summit in Italy, the president resonated that optimism.
"We're closer to that significant reform than at any time in recent history," he said when asked to refocus on his domestic agenda at the speech in L'Aquila, Italy. "That doesn't make it easy. It's hard. But I'm confident that we're going to get it done."
When questioned whether it is a do-or-die before Congress breaks in August, Obama said, "I never believe anything is do-or-die. But I really want to get it done by the August recess."
The bill faces resistance even from some conservative Democrats in Congress on who would pay for it.
Today, the president argued that his plan would not add to the deficit over the next decade, though Congressional Budget Office estimates of different congressional proposals have put the various price tags at close to a trillion dollars or more. Obama also repeated the promise that those making $250,000 a year or less would not pay more in taxes.