WASHINGTON - President Barack Obama prepared a high-stakes plea for healthcare reform on Wednesday as a key Senate Democrat said he was ready to end bipartisan negotiations and move ahead without Republican support.

Obama hopes a nationally televised speech to the U.S. Congress at 8 p.m. EDT (0000 GMT) will rejuvenate his flagging push for an overhaul of the $2.5 trillion healthcare system, which has bogged down in Congress amid a flood of criticism.

Obama and his aides said the address would lay out concrete proposals and guidelines for lawmakers who have struggled to find common ground on a handful of proposals circulating in Congress.

In the Senate, months of bipartisan Finance Committee talks by the so-called Gang of Six negotiators moved into the final stages as panel Chairman Max Baucus said it was time to proceed with or without Republicans.

Baucus told reporters he would push ahead with a bill next week modeled after proposals he distributed recently to members. That plan would levy a fee on insurers to help pay for coverage but would not include a government-run health insurance option, which he said cannot pass the Senate.

The time has come for action and we will act, Baucus said, adding that he hoped and expected some Republicans would back the proposal, expected to cost nearly $900 billion over 10 years. I am going to move forward anyway.

Three committees in the House of Representatives and one other Senate panel have completed work on a healthcare bill, leaving the Senate Finance Committee as the final hurdle before each chamber can take up the issue.


Baucus's plan includes sweeping insurance market changes. It would tax insurance companies on their most expensive healthcare policies and offer tax credits to individuals and families to help offset the cost of premiums.

Obama has sought a comprehensive healthcare overhaul that would cut costs, improve care, regulate insurers and expand coverage to more than 46 million uninsured Americans.

But Republicans have balked at the total cost, questioned Obama's pledge that the plan would not increase government debt and called some of the proposals a first step to a government takeover of healthcare.

Moderate and liberal Democrats, meanwhile, have clashed over the government-run public option backed by Obama.

Critics say the option would hurt insurance companies and give the government too broad a role in the industry. But liberal Democrats say it is crucial to fostering increased competition and they will not support a plan without it.

Obama has signaled he supports the government-run option but it is not essential to a final bill, and a senior administration official told reporters he would repeat that stance during his speech.

The public choice is a means to an end. It's not an end in and of itself. So he will make that clear, the official said.

In a bid to win Republican support, White House spokesman Robert Gibbs said Obama would address reform of medical malpractice lawsuits, which Republicans blame for raising medical costs.
The president will talk about meaningful malpractice reform tonight. What I hope that does is cause Republicans to understand that we're close to getting something truly significant done for the American people, Gibbs said on Fox Morning News.

Obama hopes the speech can help him reclaim control of the debate on his top domestic priority after critics used a month-long August break for Congress to launch a wave of attacks on the healthcare plans.

The failure of the healthcare initiative could sharply weaken Obama less than a year into his presidency, endangering the remainder of his agenda from climate change to immigration reform and putting Democrats at risk in congressional elections next year.

Democratic President Bill Clinton's dramatic blowout on healthcare reform in 1994 led Democrats to lose power in both chambers of Congress in a landslide defeat later that year.

Shares of top health insurers, volatile as the healthcare debate gathers steam, were slightly higher in afternoon trade ahead of Obama's speech. Shares of the S&P Managed Health Care stock index were up about 1.8 percent while the Morgan Stanley Healthcare Payor stock index was up about 2 percent.

(Additional reporting by Patricia Zengerle, Steve Holland, Susan Cornwell, Donna Smith, Ross Colvin; editing by Chris Wilson)