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Obama slams insurers, demands health care reform

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'Not the America I believe in'
  • NEW: Rep. James Clyburn says he believes there will be enough votes to pass bill
  • Obama delivers campaign-style speech to boost support
  • House Democrats working to find votes needed to pass legislation
  • Republicans cry foul over plan to use budget reconciliation to pass bill

Strongsville, Ohio (CNN) -- The yearlong fight over health care reached a fever pitch Monday as President Obama took his call for change to the political swing state of Ohio, slamming insurance companies and repeating his call for a final congressional vote on his sweeping reform plan.

The president's push came as the House of Representatives prepared for an expected vote this week on the roughly $875 billion bill passed by the Senate in December. Rep. James Clyburn, the Democrat and House majority whip from South Carolina, told CNN Monday he was "very comfortable" that the votes to pass the Senate bill in the House were there.

"I think we have reached a significant consensus in our caucus. The will is there to get this done," Clyburn said on CNN's "Campbell Brown."

"They're, as the leaders of the party, going to find a way to do it. I think come the weekend, we'll be where we need to be in order to get the 216 votes that are required," he said.

Under the strategy adopted by congressional leaders, if the House passes the Senate bill, both chambers of Congress would pass a series of changes designed in part to make the legislation more acceptable to House Democrats.

If enacted, the reform proposal would be the biggest expansion of federal health care guarantees since the enactment of Medicare and Medicaid more than four decades ago. The plan is expected to extend insurance coverage to more than 30 million Americans.

The Senate bill would reduce federal deficits by about $118 billion over 10 years, according to the nonpartisan Congressional Budget Office.

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Republicans, meanwhile, have repeatedly promised to fight what they say amounts to an ill-conceived government takeover of the country's health care system.

GOP leaders have said the plan will do little to slow spiraling medical costs. They also say it will lead to higher premiums and taxes for middle-class families while resulting in deep Medicare cuts.

"We need health insurance reform right now," the president said at a campaign-style rally outside Cleveland. And "this is like a patients' bill of rights on steroids."

In the end, the president said, "this debate is about far more than politics. ... It comes down to what kind of country we want to be."

Obama brought up the story of a self-employed Ohio woman named Natoma Canfield who, according to the president, was repeatedly hit with large premium increases after being diagnosed with cancer.

Canfield eventually was forced to drop her coverage. She was recently diagnosed with leukemia.

"When you hear people say 'start over,' I want you to think about Natoma," Obama said. "When you hear people saying that this isn't the 'right time,' you think about what she's going through. ... There but for the grace of God go any one of us."

The president said the "status quo on health care is simply unsustainable. We cannot have a system that works better for the insurance companies than it does for the American people."

Obama's trip to Ohio was the latest in a series of speeches designed to bolster sagging public support for his health care proposal. The president delivered similar remarks in Pennsylvania and Missouri last week. On Friday, he agreed to delay an upcoming trip to Indonesia and Australia to help make a final pitch to wavering rank-and-file Democrats.

"I think people have come to the realization that this is the moment," senior White House adviser David Axelrod said Sunday on CNN's "State of the Union."

The House Budget Committee officially put the legislative wheels in motion Monday on final passage of the reform plan. The committee approved a legislative maneuver known as reconciliation, a procedure that would allow key changes to the bill to pass the Senate with a simple majority of 51 votes. Senate Democrats lost their filibuster-proof, 60-seat supermajority with the January election of GOP Sen. Scott Brown of Massachusetts to the seat formerly held by the late Democratic Sen. Ted Kennedy.

Republicans are livid about the Democrats' decision to use reconciliation. They say the procedure, which is limited to provisions pertaining to the budget, was never meant to facilitate passage of a sweeping reform measure such as the health care bill.

"In its desperation to force this bill through, the White House is reverting to the anything-goes approach," Senate Minority Leader Mitch McConnell, R-Kentucky, said after Obama's speech. "And the results are predictable: Americans won't like this bill any more than they liked the last one."

Democrats have pointed out that reconciliation was used to pass several major bills in recent years, including President George W. Bush's 2001 and 2003 tax cuts.

Unanimous GOP opposition to the reform plan has left House Speaker Nancy Pelosi, D-California, struggling to find the 216 votes necessary to pass the Senate version of the bill.

Clyburn was cautiously optimistic, although he said he didn't expect Democrats to make a final commitment until they had seen the results from the Congressional Budget Office.

"I am very comfortable that we'll be where we need to be before the vote is cast," he said, adding that Democrats want "to get rid of discrimination against people because of pre-existing conditions."

"We want to get rid of revisions because of catastrophic illnesses," he said. "We want to make sure that kids can stay on their parents' insurance until they're 27 so they can go to professional schools."

Among other things, some House members have expressed concern that the Senate bill does not include an adequate level of subsidies to help middle- and lower-income families purchase coverage. They also object to the Senate's proposed tax on expensive insurance plans.

At the same time, a handful of socially conservative House Democrats say the Senate plan doesn't do enough to ensure taxpayer funds are not used to fund abortions. Several political observers have said deep divisions over abortion may be the toughest hurdle for Democratic leaders to overcome.

Partly to help sweeten the deal for House liberals, multiple Democratic sources have said a large student loan reform measure probably will be rolled into the health care reconciliation package.

The measure, which is a priority for Obama, would end the practice of having private banks offer student loans while expanding direct lending from the government.

The list of proposed changes also includes closure of the Medicare prescription drug "doughnut hole" by 2020. Under current law, Medicare stops covering drug costs after a plan and beneficiary have spent more than $2,830 on prescription drugs. It starts paying again after an individual's out-of-pocket expenses exceed $4,550.

In addition, the effect of the so-called "Cadillac" tax on high-end plans may be reduced by delaying its implementation until 2018 while raising the income threshold at which the tax is imposed.

Adding to the political complications, a separate legislative maneuver being advocated by some Democrats would allow the House to avoid a direct up-or-down vote on the Senate bill. Under the proposal, the full House would only have to vote on a rule declaring the Senate bill to be passed.

"If Speaker Pelosi believed there was ample support for the Senate legislation, then she would bring it to the floor of the House for a 'yea' or 'nay' vote," House Minority Whip Eric Cantor, R-Virginia, said Monday.

"Instead, Americans are watching what happens when it becomes necessary to push political kickbacks and bend the rules so perversely to give members of the majority party who wouldn't otherwise support this legislation political cover."

Public opinion polls show that a majority of Americans have turned against the administration's health care reform plan, though individual elements of the proposal remain widely popular.

"I don't know about the politics, but I know what's the right thing to do," Obama said at the conclusion of his remarks Monday.

CNN's Lisa Desjardins, Alan Silverleib and Deirdre Walsh contributed to this report.