FAIRFAX, Va. — President Barack Obama described the stakes of this weekend's health care vote in stark terms Friday, using words uttered so rarely out of the White House that they seem all but banned: "If this vote fails."
What then? "The insurance industry will continue to run amok," the president declared, pointing to rising rates, denials of coverage and limits on care.
With Sunday's expected vote hanging on the support of just a handful of wavering Democrats, Obama delivered an energetic, 25-minute closing argument for the goal to which he has devoted much of his presidency and on which its future could pivot, at least for a time. Before an amped-up, campaign-style rally of several thousand at George Mason University in suburban Virginia, the president summoned both pragmatism and principle to sway the undecideds to his side.
He emphasized the bill's provisions that would go into effect this year, including those banning insurers from denying coverage to those with pre-existing conditions, dropping coverage when a person becomes ill or imposing annual or lifetime limits on care, requiring free preventive care and allowing children to stay on parents' policies into their 20s.
Obama said the bill, if it becomes law, will deliver "the toughest insurance reforms in history" and "the largest middle class tax cut for health care in history."
"This is a patient's bill of rights on steroids," Obama said. "What we're talking about is commonsense reform. ... You've been hearing a whole bunch of nonsense."
Obama also urged lawmakers to reach beyond today's disputes and grasp the history-making aspect of the effort.
"It's a debate about the character of our country – about whether we can still meet the challenges of our time, whether we still have the guts and the courage to give every citizen, not just some, the chance to reach their dreams," he said.
He pointed to contentious debates decades ago over creating the now-popular Social Security and Medicare programs and enacting civil rights laws. "As messy as this process is, as frustrating as this process is, as ugly as this process can be, when we have faced such decisions in our past, this nation time and time again has chosen to extend its promise to more of its people," Obama said.
It was the fourth outside-the-Beltway event Obama has held on health care in the past two weeks, and his last public push for the legislation that tops his domestic list. He postponed until summer an overseas trip to stay in Washington to help ensure passage and rolled his shirt sleeves up to wade into his delivery. With so much riding on the outcome – from the policy changes he wants to his own political standing – Obama spoke at top decibel levels and, rare for him, ad-libbed considerably from his prepared remarks, filling them in with folksier language and additional dire warnings. Back at the White House, his staff mass e-mailed every positive development in the vote count.
The first-come-first-served crowd of 8,500 responded with vigor, punctuating Obama's speech with loud cheers. A handful of people booed and interrupted, with one yelling "No socialism," but the vast majority appeared supportive of his goal.
The president returned repeatedly to the difficult year of debate over a sweeping remake of health care that has consumed the country, and to the rampant speculation, among lawmakers and in the media, over the political ramifications of a win or loss.
"Is this more of an advantage for Democrats or Republicans? What's it going to mean for Obama? Will his presidency be crippled? ... Or will he be the comeback kid?" he mocked. "A lot of reporting in Washington, it's just like Sports Center. You know, it's considered a sport and who's up and who's down and everybody's keeping score and you got the teams going at it. It's rock 'em sock 'em robots."
Still, Obama acknowledged the difficult decisions facing lawmakers who haven't yet stated their position on the legislation.
"I know this will be a tough vote. I know that everybody is counting votes right now in Washington," he said. "We are going to do something historic this weekend. ... We are going to fix health care in America."