At a campaign-like rally in Pennsylvania today, a combative President Obama criticized insurance companies, pushed members of his own party, and called for the public's support in a final push for health care reform legislation before Congress. The White House has said it hopes to have a health care bill signed into law by March 18, but even with the president's full support, passage of the bill is far from certain.
Before an enthusiastic crowd at Arcadia University outside Philadelphia, Obama called on Democratic lawmakers to pass the legislation and not worry about political consequences in the upcoming mid-term elections.
"My question to them is, 'When's the right time? If not now, when? If not us, who? Is it a year from now or two years from now or five years from now or 10 years from now?' I think it's right now, and that's why you're here today," he said.
The bill's passage depends on a two-step legislative maneuver -- the House must approve the Senate's health care bill, and then both chambers would pass a follow-up bill. The companion bill hasn't been released publicly, but it is intended to satisfy House critics who don't agree with all the provisions of the Senate bill.
Tough Tone Toward Insurance Companies
Obama has grown increasingly critical of insurance companies in recent days, and today he suggested that insurers do not put consumers first and have little incentive to control costs due to lack of competition.
"They will keep on doing this for as long as they can get away with it. This is no secret," he said. "They're telling their investors this: 'We are in the money. We are going to keep on making big profits even though a lot of folks are going to be put under hardship.'"
To support his case, the president referred to a recent conference call organized by the investment bank Goldman Sachs. During the call, he said, an insurance broker said insurance companies were better off raising rates on existing customers and losing customers than expanding their business with new customers. Insurers argue that ever-higher insurance rates are a product of rising medical costs for things like prescription drugs and hospital procedures.
Republicans See Opportunity in President Obama's Health Care Push
While the president has hardened his tone on insurance companies, he's done little to soften public opinion toward his health care reform plan, and some Republicans see the legislation as a political opportunity.
According to an ABC News/Washington Post poll, 43 percent approve of the president's handling of health care, down from 57 percent in April 2009.
"If the bill passes, I think that's surely one of the things that they should and will run on," said Cornyn, the chairman of the National Republican Senatorial Committee, charged with supporting Republican candidates. "This whole idea of rubbing the nose of the voter in a bill that they find unpopular and thinking it won't be bad for them is just, to me, a conscious suspension of your power of disbelief."
The White House believes that once a bill is passed, its immediate changes -- such as protection of people who risk losing insurance because of pre-existing medical conditions -- would be politically popular and would help Democrats in November's mid-term elections. But moderate Democrats in the House remain wary of the Senate bill, particularly its $1 trillion price tag and some of the language regarding abortion. Some lawmakers are also concerned that once the Senate bill passes, the promised follow-up bill may never come through.
Calling on the Public for Support
For his part, Obama remains committed to the plan and is calling on his supporters to help turn the tide of public opinion with a campaign-like message.
"I need you to knock on doors, talk to your neighbors, pick up the phone," he said. "When you hear an argument by the water cooler and somebody's saying this or that about it, say, 'No, no, no, no. Hold on a second.'"
The president will continue his final health care push this week with a trip to St. Louis Wednesday.
ABC's Rick Klein and The Associated Press contributed to this report.