Obama Takes Healthcare Overhaul Push to Missouri

The nation's top health official challenged insurers on Wednesday to join President Barack Obama's push to overhaul the medical system, arguing that, if the effort fails, it will hurt them as well as other Americans.

Obama is to speak Wednesday in suburban St. Louis and then travel to northeastern Ohio on Monday, his third healthcare event in a week. His speech comes as congressional Democrats stand on the brink of delivering the president a dramatic success with passage of his massive overhaul legislation — or a colossal failure if they can't get it done.

As part of the administration's campaign, Health and Human Services Secretary Kathleen Sebelius sketched out a stark choice for insurers: oppose reform and eventually lose customers, or work with the White House to improve the legislation.

She told insurers in a speech that, if the overhaul fails, premiums will continue to rise, and employers will cancel coverage. The industry may make money initially, she said, but "this kind of short-term thinking won't work in the long run for the American people or our healthcare system. It won't work for you."

Sebelius called on insurers to take the millions they might spend on attack ads and give Americans relief from rising double-digit premium increases.

Groups that oppose the legislation are stepping up their criticism, with the U.S. Chamber of Commerce announcing a campaign to spend as much as $10 million on ads, starting Wednesday, saying, "Stop this health care bill we can't afford."

Karen Ignagni, the insurance industry's top lobbyist, said the companies don't believe the legislation will reduce costs. The industry is preparing a list of cost-control ideas for Obama.

But Sebelius' speech calmed the war of words between the administration and insurers — at least temporarily.

"I am certainly not here to vilify the hard working employees of insurance companies ... or blame insurance companies for all the problems in our system," she said.

Ignagni, who has accused the White House of waging a "campaign of vilification," told reporters afterward that she appreciated the gesture. "We think now could be the beginning of a change, and we could move from vilification to problem solving," she said.

Leaders in the House and Senate are awaiting a final cost analysis from the Congressional Budget Office in the next day or so that will allow them to start counting votes — and twisting arms — in earnest. In the House, in particular, getting the needed majority will be touch and go.

The two-step congressional approach now being pursued calls for the House to approve a Senate-passed bill from last year, despite House Democrats' opposition to several of its provisions. Both chambers would follow by approving a companion measure to make changes in that first bill.

Republicans are playing on House Democrats' suspicions of their Senate colleagues, arguing that Senate Democrats may not hold up their end of the bargain and the votes will be damaging politically for Democrats in November.

An Associated Press-GfK Poll released Tuesday found a widespread hunger for improvements to the healthcare system, but also found that Americans don't like the way the debate is playing out in Washington.

About four in five Americans say it's important that any healthcare plan have support from both parties. And more than three in five say the president and congressional Democrats should keep trying to cut a deal with Republicans rather than pass a bill with no GOP support.

The poll also found that fewer people approve of Congress than at any previous point in Obama's presidency. Support has dropped to a dismal 22 percent, and the frustration is directed at both Republicans and Democrats. Half of all people say they want to fire their lawmaker. Conversely, Obama's job-performance standing is holding fairly steady at 53 percent.

After a year of off-and-on negotiations, Republicans adamantly oppose Obama's plans. The White House and Democratic leaders say it's now-or-never for the healthcare overhaul, which would cover an additional 30 million Americans, require almost everyone to buy health insurance and impose new restrictions on insurance companies.

Obama's message Wednesday is aimed at the political middle. The plan he's touting would bring in high-tech bounty hunters to help root out healthcare fraud, a populist idea with bipartisan backing.

Waste and fraud are pervasive problems for Medicare and Medicaid, the giant government health insurance programs for seniors and low-income people. Improper payments totaled an estimated $54 billion in 2009. They range from simple errors such as duplicate billing to elaborate schemes operated by fraudsters peddling everything from wheelchairs to hospice care.

The bounty hunters in this case would be private auditors armed with sophisticated computer programs to scan Medicare and Medicaid billing data for patterns of bogus claims. The auditors would get to keep part of any funds they recovered. The White House said a Medicare pilot program recouped $900 million for taxpayers from 2005-08.

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Associated Press writers Ricardo Alonso-Zaldivar, Charles Babington and Donna Cassata contributed to this report.