Obama's Next Big Battle: Affordable Health Care

March 1, 2009— -- President Obama plans to move ahead this week with an ambitious plan to overhaul the country's health care system.

It is likely to be a messy and costly political battle.

The latest ABC News poll shows that 53 percent of Americans are concerned about being able to afford necessary health care, and 33 percent are "very concerned."

During the presidential campaign, both sides called for repairs to the ailing system. Now the question is: how?

Franklin Roosevelt couldn't do it; nor could Truman, Kennedy, Johnson or Clinton. Both Clintons, in fact.

But President Obama will try again.

There are 46 million Americans without insurance and that number is quickly growing, as the ranks of the unemployed balloon in this economy.

"The cost of our health care has weighed down our economy and the conscience of our nation long enough. So let there be no doubt: health care reform cannot wait, it must not wait, and it will not wait another year," Obama told Congress Feb. 24.

Obama is asking for $634 billion in his new budget to be put aside over the next 10 years as a sort of health care fund. He says some of the money will come from taxing the wealthy and through trimming the fat in current government programs like Medicare and Medicaid.

The budget calls for also taking, over 10 years, $175 billion in fees that the government now pays insurance companies to cover more than 10 million people in private Medicare. The administration has said that that such private plans cost 14 percent more than traditional Medicare.

In his weekly video address Saturday, Obama acknowledged that "the insurance industry won't like the idea that they'll have to bid competitively to continue offering Medicare coverage, but that's how we'll help preserve and protect Medicare and lower health care costs for American families."

Others that might suffer under his budget include hospitals, drug makers and home health services. All have powerful lobbying groups.

The ambitious plan comes during the worst economic crisis this country has seen in a generation. Health care reform wasn't achievable in even the best of times. Now, it could be that much harder.

Just today, the White House again offered an ambitious timeline.

"Look, we want to get health care reform done this year, and we want to do it in a way that doesn't add to the deficit and that also helps bend the curve over the long term," said Peter R. Orszag, Obama's Director of the Office of Management and Budget, said this morning on "This Week."

Orszag said that heath care "is the key to our fiscal future."

The health care debate is likely to pick up steam as the week moves on. Tomorrow, Obama is expected to nominate Kansas Governor Kathleen Sebelius as Secretary of Health and Human Services and Thursday, he'll host a nonpartisan health care summit at the White House.