President Barack Obama delivers remarks on health insurance reform at St. Charles High School in St. Louis, Missouri, March 10, 2010. Credit: Reuters/Jim Young

Visiting America's heartland, Obama tried to rally support for his healthcare legislation among wavering Democrats. He urged them to set aside their worries about a political backlash and support the legislation.

Folks in Washington, they like to talk. So Washington is doing right now what Washington does, he told a crowd at a high school in St. Charles, Missouri. They're speculating breathlessly day or night. Every columnist. Every pundit. Every talking head. Is this proposal going to help the Republicans or is this proposal going to help the Democrats?

The time to talk is over. It's time to vote, he said. I don't know about the politics, but I know that it is the right thing to do and that is why I am fighting so hard to get it done.

His campaign-style visit was part of a final push to pass an overhaul of the $2.5 trillion healthcare system.

Whether the bill passes or fails, the healthcare debate is likely to be a major issue in the November elections that could shift the balance of power in Congress now dominated by Democrats.

As Obama's motorcade made its way toward the speech venue, hundreds of protesters from both sides lined the streets waving placards that said, Healthcare for all, Kill the bill, Republicans for healthcare reform and Say no to socialism.

Obama insisted his plan would rein in profit-hungry health companies. Trying to build support for the bill, he and his fellow Democrats have accused the health insurance industry of putting profits before the interests of patients.

In Washington, Health Secretary Kathleen Sebelius told a health insurance industry group that failure to pass health reform would cause costs and premiums would soar and force more Americans and businesses to drop coverage.

We will have a situation where the market is unsustainable, Sebelius said in a speech to a conference sponsored by America's Health Insurance Plans.

Insurers could give up some of their profits to make premiums more affordable and work with Congress to enact the legislation, she said.


AHIP President Karen Ignagni said the industry would accept Sebelius's challenge to offer more proposals for healthcare cost savings but the bill did not go far enough in reining in healthcare costs.

Democrats were still making changes to the overhaul and are awaiting cost estimates from the Congressional Budget Office, a process that could slip into next week.

House Speaker Nancy Pelosi, Senate Democratic leader Harry Reid and other congressional leaders met at the U.S. Capitol for more than two hours with White House Chief of Staff Rahm Emanuel to discuss the next steps.

We had a very good meeting, made a lot of progress, worked through a number of issues. We've resolved a number of issues, Emanuel told reporters afterward. More meetings are planned on Thursday.

In Missouri, Obama pledged to stamp out waste in Medicare and Medicaid, the government-run medical programs for the elderly and needy.

The White House said the new effort to root out improper payments in the two programs could double taxpayer savings to at least $2 billion over the next three years.

Obama accused his critics of using divisive and deceptive rhetoric to try to scare the public by suggesting the bill would result in reduced access to care for older people who rely on Medicare. We're not going to weaken it. We're going to make it stronger, he said.

Republicans have been united in opposing the bill and have criticized a budget process called reconciliation that Democrats plan to use to get a final bill to Obama for his signature.

That process will allow the Democratic majority to pass final legislation by a simple 51-vote majority in the 100-member Senate instead of the 60 votes needed to overcome Republican opposition.

If they ram this bill through the House like this they lose their majority, said Representative Eric Cantor, the No. 2 Republican in the House. They do this at their own peril.

(Additional reporting by Donna Smith, Alister Bull, Steve Holland, Jeff Mason, John Whitesides and Thomas Ferraro; Editing by Eric Walsh and Chris Wilson)