WASHINGTON – President Barack Obama stepped up pressure on Congress on Wednesday to pass healthcare reform this year, staging a daylong media blitz that ended with a televised town hall-style meeting at the White House to rally public support.

This is one of those moments where the stars are aligned. We've got insurers who are interested and doctors who are interested, nurses, patients, Obama told an ABC TV audience gathered in the chandelier-lit East Room of the White House.

It's not going to be a completely smooth ride, he said during the question-and-answer session. But if we keep our eye on the prize ... then I'm absolutely convinced that we can get it done this time.

That was a theme he hammered at events throughout the day, including a morning-show interview on ABC and a meeting with state governors who favor an overhaul of the $2.5 trillion U.S. healthcare system.

The United States spends about 16 percent of its gross domestic product annually on healthcare but trails many developed countries on important measures like infant mortality and longevity.

Some 47 million Americans are uninsured and have little access to the healthcare system. Insurance costs have doubled in under a decade, prompting businesses that provide much of the coverage to complain it threatens U.S. global competitiveness.

The president's campaign-style push for reform, including an e-mail plea to supporters in recent days, comes amid signs of strain in the diverse coalition, from doctors to insurance companies, that have so far united behind his push for change.

Insurers and doctors have expressed concern about Obama's call for a public insurance option to compete with private insurers, while others have objected to the cost of the trillion-dollar program and a proposal to pay for it in part by raising taxes on some employer-paid insurance benefits.

Obama says public option, he means government-run health care, Republican National Committee Chairman Michael Steele said in a statement. Without question, the government takeover of healthcare will diminish individual freedom and quality in our health care system.

Some of those who have expressed concern, including the head of the American Medical Association and the chief executive of Aetna insurance company, were part of the audience that questioned Obama on Wednesday night.

The president defended his push for a public health insurance option, saying he believed it was needed to ensure the system is competitive. He renewed his pledge that the overhaul would be paid for and not add to the U.S. deficit.


Obama said most of the cost of reform would be paid for by reallocating money already in the system. He said Congress was debating a host of options for raising the additional funds that would be needed, including a tax on employer-paid insurance benefits above $13,000 or $17,000 annually.

I continue to believe that is not the best way to do it, he said, adding he favored limiting itemized tax deductions for people who earn more than $250,000 per year. But he did not reject a tax on benefits outright.

That's the debate that's taking place in Congress right now, he said. I'm pushing my idea. Other folks are pushing their ideas. There's going to have to be some compromise at the end of the day.

Members of the Senate Finance Committee met behind closed doors to discuss the cost of the bill and possible compromises needed to gain some Republican support.

Committee Chairman Max Baucus said it was long road to reaching agreement because of the complexities of the sweeping legislation. Panel members are trying to bring 10-year cost estimates down to less than $1 trillion from a $1.6 trillion early estimate for the package.

Democratic Senator Kent Conrad, who is a member of the finance panel and also chairman of the Senate Budget Committee, said the package total now stood at about $1.2 trillion.

The cost savings were achieved mostly through reducing proposed subsidies for people who would purchase their insurance through a proposed new insurance exchange, a kind of clearinghouse where people would compare policies and costs.

(Additional reporting by Doug Palmer, Richard Cowan and Andy Sullivan; Editing by Peter Cooney)