President Barack Obama accused insurance companies of placing profits over people and said Republicans ignored long-festering problems when they held power as he sought to build support Monday for swift passage of legislation stalled in Congress.
"How much higher do premiums have to rise before we do something about it?" said Obama, making the first in an expected string of out-of-town trips to pitch his plan to remake the health care system.
The president said dismissively that Republican critics in Congress say they want to do something about rising health care costs, but said they did not when they held power. "You had 10 years. What happened. What were you doing?" he said to applause from an audience at Arcadia University, near Philadelphia, Pennsylvania.
Obama made his appeal as Democratic leaders in Congress worked on a rescue plan for sweeping changes in health care that seemed earlier in the year to be on the brink of passage. The two-step approach calls for the House to approve a Senate-passed bill despite opposition to several of its provisions, and both houses to follow immediately with a companion measure that makes a series of changes.
The White House has said it wants the legislation wrapped up by March 18, but that seems unlikely. The companion bill has not yet been made public, and a protracted debate is expected in the Senate, where Republicans vow to resist even though they will not be able to block passage by mere talk.
Obama's stated goals across more than a year of struggle has been to extend coverage to millions who lack it, ban insurance industry practices such as denying coverage on the basis of pre-existing conditions and cut costs.
Republicans dismissed Obama's argument instantly.
"The American people have heard all this rhetoric from the president before, and they continue to say loudly and clearly they do not want a massive government takeover of health care," said House Republican Leader John Boehner of Ohio.
Obama has long identified the insurance industry as an obstacle to changes along the lines he seeks, but the administration's actions and rhetoric seem to have escalated in recent days.
The president's proposal would give the government the right to rein in excessive premiums increases — a provision included after one firm announced a 39 percent increase in the price of individual policies sold in California.
Separately, Kathleen Sebelius, the secretary of health and Human Services, convened a White House meeting with insurance executives last week, and followed up with a letter released in advance of Obama's speech.
It asked companies to "post on your Web sites the justification for any individual or small group rate increases you have implemented or proposed in 2010."