WASHINGTON — With Republicans apparently unmoved by a daylong face-off on live TV, President Obama and Democrats in Congress now face the test of whether they can overhaul the nation's health care system by themselves.
Obama conceded after seven hours of sometimes testy talks with Republicans on Thursday that the two major parties may be too far apart on the biggest health care issue — whether the federal government should pay for insurance for tens of millions of people who don't now have coverage.
He urged Republicans one last time to consider any hope of agreement. Barring that, however, he signaled that Democrats will press ahead, perhaps using a controversial rule to get legislation through the Senate with a simple majority rather than the usual 60-vote supermajority that they can't assemble without at least one Republican.
Even then, however, he and Democrats face significant challenges in mustering enough Democratic votes in the House of Representatives. Democrats suggested that they have just a few more weeks to get health care legislation passed before they take a spring recess and then turn to other issues.
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"I'd like the Republicans to do a little soul-searching and find out are there some things that you'd be willing to embrace that get to this core problem of 30 million people without health insurance," Obama said at the conclusion of the daylong session at Blair House, across from the White House.
"I don't know, frankly, whether we can close that gap," he added. "If we can't, then I think we've got to go ahead and some make decisions, and then that's what elections are for."
With his quest for universal health care stalled in Congress, Obama had convened the extraordinary, televised session with top aides and 38 members of Congress from both parties.
The president and his team made their case anew for a nearly $1 trillion, 10-year plan to expand health insurance to millions of the uninsured, improve coverage for those who do have insurance and control costs for everyone who pays insurance premiums.
Republicans countered with a scaled-down plan, arguing for a slower, step-by-step approach.
"We believe that our views represent the views of a great number of the American people, who have tried to say in every way they know how — through town meetings, through surveys, through elections in Virginia and New Jersey and Massachusetts — that they oppose the health care bill that passed the Senate on Christmas Eve," said Sen. Lamar Alexander, R-Tenn.
"We want you to succeed, because if you succeed our country succeeds. But we would like, respectfully, to change the direction you're going on health care costs," Alexander said. "We believe we have a better idea."
If Obama failed to move conservatives, he also failed to impress at least one moderate Republican, retiring Sen. George Voinovich of Ohio.
"There are two types of leadership, consensus leadership, where you bring people together and find common ground, and sales leadership, where you try to convince others your idea is better. So far this has been all sales leadership," Voinovich said.
"It reminds me of what the president did to sell the stimulus, when he came to see us and said, 'I'm interested in your ideas, but I've really gone as far as I can go.' "
Some liberal Democrats said, however, that the televised session would help Obama portray the Republicans as obstructionist and win public support.
The country "will understand the president has done everything humanly possible to work this out," said Rep. Neil Abercrombie, D-Hawaii. "What the president has done is put himself in a position where even his harshest critics will say he's reached out to find cooperation."
Obama and Democratic lawmakers also signaled that they're preparing to play hardball in the Senate. They refused to rule out using the Senate's "reconciliation" rules to push their plan through the Senate with a simple majority, although they were challenged to do so.
"Mr. President, renounce this idea of going back to the Congress and jamming through on a . . . partisan vote through a little-used process we call reconciliation, your version of the bill," Alexander told Obama.
"If we don't, then the rest of what we do today will not be relevant. The only thing bipartisan will be the opposition to the bill."
Obama didn't renounce it, however, and Senate Majority Leader Harry Reid, D-Nev., reacted angrily to the suggestion that he might use it — while not ruling it out.
"No one has talked about reconciliation, but that's what you folks have talked about ever since that came out, as if it's something that has never been done before," Reid said.
"But remember, since 1981, reconciliation has been used 21 times. Most of it has been used by Republicans, for major things, like much of the Contract for America, Medicare reform, the tax cuts for rich people in America. So reconciliation isn't something that's never been done before."
Said Obama: "Most Americans think that a majority vote makes sense."