Promoting a new initiative to reduce waste in Medicare, Medicaid and other government programs, President Obama traveled to suburban St. Louis on Wednesday to keep up momentum behind his push to complete work on a health overhaul this month.
Obama redoubled his warning that failing to step up regulation of the insurance industry as part of a broader healthcare overhaul would leave more Americans struggling with rising premiums.
And in a campaign-style speech delivered with his shirt sleeves rolled up, Obama called for an end to political gamesmanship in Washington and a swift vote on his healthcare plan.
"The time for talk is over," Obama told a crowd in St. Charles, Mo. "I'm tired of talking about it."
The president's trip -- the second this week -- came as administration officials and senior Democrats on Capitol Hill worked on arranging a series of votes that will be needed to send Obama's healthcare legislation before Congress recesses for spring break.
With Republicans opposed to a sweeping overhaul, Democrats are trying to hold the first vote next week in the House, where party leaders hope to pass the healthcare bill that the Senate passed in December.
They then hope to use a process known as budget reconciliation to push a package of changes through the House and Senate.
Budget reconciliation measures require a simple majority in the Senate, rather than the 60-vote supermajority usually needed to squash a filibuster -- something Democrats could not do now with a 59-41 edge.
But the biggest hurdle confronting Democrats is in the House, where many rank-and-file lawmakers are leery of voting for the Senate bill, which includes unpopular provisions such as a new tax on high-end "Cadillac" health plans that could hit union members and a special provision providing federal aid to Nebraska.
Further complicating the hunt for votes, congressional rules will probably force the president to sign the Senate bill into law before House and Senate lawmakers can vote on the package of changes, another unsavory prospect for House Democrats worried about being on record backing the Senate legislation.
House Speaker Nancy Pelosi (D-Calif.), Senate Majority Leader Harry Reid (D-Nev.) and other senior Democrats were working Wednesday to finalize both the package and the procedure going forward.
Assisted by Obama, they will then begin a final push to persuade wavering Democrats to rally behind the finished package.
Elsewhere Wednesday, the Obama administration kept up its criticism of the insurance industry, which Democrats have used as a foil in their final drive to push through a healthcare overhaul.
Speaking to a group of insurance executives gathered in Washington for an industry conference, Health and Human Services Secretary Kathleen Sebelius warned that insurer opposition to the Democratic healthcare overhaul is shortsighted.
"There's another choice," she said. "Instead of spending energy attacking the parts of the proposal that you don't like, come to the table with (proposals) strengthening the parts that are there. . . . The second choice really may give up some short-term profits, but we also, working together, could create a sustainable health insurance market where Americans will still be able to buy coverage."
After the speech, Karen Ignagni, president of the industry lobbying group America's Health Insurance Plans, promised that insurers would provide specific suggestions to improve the legislation.
Obama's new fraud initiative builds on a proposal he made ahead of his White House summit last month to woo Republicans, who have long complained about waste in government health programs.
Last year, the Medicare and Medicaid programs for seniors and low-income Americans made $54 billion in unwarranted payments to healthcare providers, according to White House.
To combat the problem, Obama has proposed expanding a program to reward private bounty hunters who find waste by auditing government payments through what are called "payment recapture audits."
The White House reported that a pilot program in California, New York and Texas yielded $900 million in Medicare savings between 2005 and 2009.