Published: Monday, 10 Aug 2009 | 5:33 PM ET

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August will be a make-or-break month for the drive to revamp health care, as members of Congress use the recess to either sell the need for an overhaul to voters or continue criticism of the insurance industry, the chief of the insurers' main lobbying arm said Monday.

Karen Ignagni, president of America's Health Insurance Plans, told editors and reporters from The Associated Press that if lawmakers use their break to vilify her industry, "members of Congress will come back to Washington without a strong sense that health care reform is doable. And that would be a lost opportunity. We think health care reform is going to be won or lost in August."

Hoping to buttress support for their effort to reshape health care, President Barack Obama and his Democratic allies have targeted the insurance industry with some of their sharpest barbs. Obama has accused insurers of "abuses" and "record profits," House Speaker Nancy Pelosi, D-Calif., has called them "villains," and Obama's campaign organization, Organizing for America, accused them Monday of "stirring up fear with false rumors."

Ignagni said such attacks are designed as a distraction as the health care debate becomes more contentious, saying, "When polls are slipping, people turn to tried-and-true tactics."

Pelosi spokesman Nadeam Elshami said lawmakers were talking to constituents about an overhaul that would let doctors and patients make decisions, not insurance companies.

"Health insurance reform means that never again will Americans be denied coverage because of a pre-existing condition, lose their health coverage if they lose their job, if they become sick or if they file for bankruptcy because of medical bills," he said.

The insurance industry says it favors bipartisan changes in a health system it concedes has become unaffordable for many. But it is battling a proposal at the core of Democrats' blueprints: Creating an optional, government-run health insurance plan. Democrats say public coverage would push costs down by competing with private insurers, and the idea gets strong support in many polls.

Ignagni said a federally run plan would drive insurance companies, hospitals and doctors into bankruptcy, leaving only the government to provide coverage, often called single payer. Obama and other Democrats say they have no intention of setting up such a system.

"It is a very short step to a single payer, and that's what this whole discussion is about," she said. Despite Democrats' claims that private insurers would continue to compete for business, "the reality is it's never going to work that way," she said.

The insurance lobby was a leading force in killing President Bill Clinton's attempt to revamp health care in 1993 and 1994. This year, the momentum has shifted toward overhaul proponents with congressional control of the White House and Congress and many health care providers and businesses agreeing that medical coverage is becoming too costly.

Months ago, the insurance industry proposed easing several of its longtime restrictions, like refusing to issue policies to many sick people or charging them higher rates. In exchange, the industry wants health care legislation to require that nearly all individuals purchase insurance coverage -- a proposal that would bring insurance companies millions of new customers and which Democrats support.

Lawmakers have left Washington until next month with neither chamber having voted on health overhaul legislation, although House and Senate committees have produced initial bills. That has turned August into a public relations battlefield, with groups on both sides spending millions on TV advertising and encouraging supporters to voice their views to legislators.

Most notably, Democratic lawmakers have held numerous town-hall meetings that have been disrupted by unruly opponents. Democrats have said many of the disturbances have been instigated by industry-backed groups, but Ignagni said, "None of those people you've seen on TV are ours."

In May, the insurers joined other health care providers at a White House ceremony and promised to produce a combined $2 trillion in savings over the next decade. So far, the pharmaceutical and hospital industries have agreed to $235 billion in savings, but the insurers have yet to publicly pledge to a specific figure. Ignagni said her group is working with Congress on proposals that will produce "a very high value" of savings.

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