WASHINGTON — President Barack Obama, facing a revolt by centrist Democrats in Congress over the cost of overhauling the health care system, warned Friday that "now is not the time to slow down."
He also sought to reassure doubters that he'll make sure that the plan, which could cost roughly $1 trillion over a decade, won't add to the federal deficit, saying twice, "I mean it."
Obama's hastily scheduled remarks in an afternoon White House appearance came after a bipartisan group of six centrist senators wrote to Senate leaders asking that they "resist timelines which prevent us from achieving the best result."
In addition, 22 mostly freshman Democrats in the House of Representatives wrote to Speaker Nancy Pelosi voicing concerns about the House plan to raise taxes on the wealthy and some small businesses to help pay for more health care coverage.
Perhaps anticipating growing resistance, the president also scheduled a prime-time news conference for Wednesday night.
Obama has been pushing for House and Senate votes on a health care overhaul before Congress's August recess. The strategy aims to enter the August recess with a burst of momentum behind the legislation, then to thrash out the final details in a House-Senate conference this fall. House or Senate failure to pass initial versions of the measure before the recess could sap momentum from the effort and leave it more vulnerable to opposition.
The Democrats' twin goals — to expand health care coverage to nearly 50 million uninsured Americans and to restructure the system to contain long-term costs — could cost roughly $1 trillion over a decade, the nonpartisan Congressional Budget Office estimates.
CBO Director Douglas Elmendorf told lawmakers Thursday that the overhaul plans before Congress lack cost controls and would drive up federal health care spending.
The centrist senators' letter reflected those concerns.
"While we are committed to providing relief for American families as quickly as possible, we believe taking additional time to achieve a bipartisan result is critical for legislation that affects 17 percent of our economy and every individual in the U.S.," said the letter, signed by Democrats Ben Nelson of Nebraska, Mary Landrieu of Louisiana and Ron Wyden of Oregon, as well as independent Joe Lieberman of Connecticut and Republicans Olympia Snowe and Susan Collins of Maine.
Obama countered Friday that "if we step back from this challenge at this moment, we are consigning our children to a future of skyrocketing premiums and crushing deficits. If we don't achieve health care reform, we cannot control the costs of Medicare and Medicaid, and we cannot control our long-term debt and our long-term deficits."
He also warned: "If we don't get health care reform done now, then no one's health insurance is going to be secure, because you're going to continue to see premiums going up at astronomical rates, out-of-pocket costs going up at astronomical rates, and people who lose their jobs or have a pre-existing medical condition or changing their jobs finding themselves in a situation where they cannot get health care."
Senate Republican Leader Mitch McConnell of Kentucky said that "the CBO testimony yesterday should be setting off alarm bells. Instead of rushing through one expensive proposal after another, we should take the time we need to get things right."
On Friday, the House Ways and Means Committee approved the House Democrats' overhaul by 23-18, and the House Education and Labor Committee did too, by 26-22. In each panel, three conservative Democrats joined Republicans in opposition.
Still, House Democratic leaders hailed the committee votes as milestones and said the House is on track to vote on the measure by month's end.
"Congress has made historic progress on health insurance reform that will put patients and doctors back in charge," Pelosi said.
Still, more changes will be made before any overhaul is enacted.
"There's no doubt the bill will have changes as it moves through the process," said House Majority Leader Steny Hoyer, D-Md. "I would be shocked as a legislator if that were not the case."
Earlier, White House economic adviser Larry Summers defended the congressional Democrats' approach in remarks at the Peterson Institute for International Economics, a policy research organization in Washington.
David Walker, a former head of the Government Accountability Office, noted the CBO analysis and asked Summers: "What would you say about the fact that we're in danger of creating a huge expectation gap for the American people on health care, because we can't reduce costs by expanding coverage?"
Summers said that while long-term economic effects can't be predicted with enough accuracy to satisfy auditors, covering the uninsured should translate over time to disease prevention, better care and fewer costs passed on to the insured.
"We don't know just when those lower health care costs will result," Summers said. "We don't know enough for an auditor."
Trying to cut costs alone, however, without expanding coverage, could trigger "a more energetic game of hot-potato" where health care providers simply try to avoid dealing with the poor, Summers said.
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