No accord on health care; Dems ready to push ahead

WASHINGTON — Giving no ground, President Barack Obama and Republican leaders fought forcefully for their competing visions of historic health care reform Thursday in an exhausting, often-testy live-on-TV debate. Far from any accord, Obama signaled the Democrats were prepared to push ahead for an all-or-nothing congressional vote.

The marathon, seven-hour session did reveal narrow areas of agreement on the topic that has vexed Congress for months and defied U.S. leaders for decades. But larger ideological differences overwhelmed any common ideas, all but cementing the widely held view that a meaningful bipartisan health care bill is not possible as time grows short in this election year.

Obama rejected Republican preferences for starting over, discussing the issue much longer or dealing with it in a limited, step-by-step fashion.

"We cannot have another yearlong debate about this," Obama declared. "I'm not sure we can bridge the gap."

Party officials said March is probably the last chance to act.

It has been more than a year since he proposed his overhaul, which would be important to virtually all Americans in remaking the way they receive and pay for health care. The version he embraces, basically tracking legislation passed by the Senate, would expand health coverage to some 30 million people who lack it and stop insurance companies from dropping people for questionable reasons or denying coverage to people who have certain illnesses.

Obama and the Democrats portray the current situation as a major crisis, with tens of millions of people left with no health insurance at all and health care costs threatening to bankrupt the nation. The Republicans see problems, as well, but seek more modest steps to deal with them and say Obama's plan would run up the federal deficit — despite his claims to the contrary.

Obama strongly suggested that Democrats will try to pass a sweeping overhaul without GOP support, by using controversial Senate budget rules that would disallow filibusters. And then, he said, this fall's elections would write the verdict on who was right.

Democratic leaders tried to portray Republicans as hypocrites for denouncing parliamentary tactics they, too, have used. Democratic leaders hope to embolden colleagues who worry about re-election races in the face of polls showing substantial dislike for the party's approach.

The Democrats-only strategy could face particularly strong resistance in the House, where 39 party members voted against an Obama-backed health care bill last year.