The political battle over health care reform in the United States will intensify in the coming weeks. Health care reform remains President Barack Obama's top domestic priority, but recent polls indicate that public support for the reform effort has slipped. The president has tried to re-energize Democrats in recent days to support the reform effort, but Republicans appear to be unmoved and have vowed to continue their efforts to defeat Mr. Obama's plan.
In the most important speech so far in his presidency, Mr. Obama sought to regain the political momentum on health care in front of a joint session of Congress and a national television audience.
"I understand that the politically safe move would be to kick the can further down the road, to defer reform one more year, one more election, or one more term. But that is not what this moment calls for. That is not what we came here to do. We did not come to fear the future. We came here to shape it. I still believe we can act even when it is hard."
Initial reviews of the president's effort to revive the reform effort have been generally positive.
"He allayed the concerns of some voters in the middle who have been uneasy about whether this would be good or bad for them," said Norman Ornstein, a political analyst at the American Enterprise Institute in Washington. "The second thing the president's speech did was to energize his own Democrats who have been divided on this issue and uncertain about where to go."
The president and his Democratic supporters in Congress want to offer health insurance to tens of millions of Americans who currently do not have it. They also want to rein in the skyrocketing cost of health care, which consumes an increasingly large portion of the U.S. government budget.
But the reform effort faltered during August when lawmakers faced intense anger and criticism at sometimes chaotic town hall meetings around the country.
Republicans oppose the president's effort as too costly and too much government involvement in the economy. And they say the president's recent speech did little to alter the political atmosphere.
This is the House Republican leader, John Boehner.
"Americans are frustrated, they are angry, and most importantly, they are scared to death," he said. "They are scared to death that the country they grew up in is not going to be the country that their kids and grandkids grow up in."
Despite the opposition, reform supporters continue to mobilize.
Gordon Duvall is a community activist from Colorado who recently battled prostate cancer. Duvall came to Washington to urge Congress to help those who cannot afford health insurance.
"This is our government. It is a government of the people, for the people, by the people, and the by the people piece needs to get back into it, because this is our's. We can't say government is corrupt. We're government," Duvall said.
Analyst Norman Ornstein says the political stakes in the health care debate are enormous.
"Obama defined health reform as his number one domestic priority after economic recovery," Ornstein noted. "A failure to act on health reform sends the signal that this majority that we brought into act can't do it, and the victims are going to be his own Democrats in Congress."
Another expert, Larry Sabato of the University of Virginia, says it was clear from the president's recent speech that he has all but given up on winning over Republicans to support his health care initiative.
"I think that Obama has recognized that his only chance of getting any kind of substantial health care reform is negotiate almost exclusively with Democrats, and that is what is going to happen," Sabato said.
Analyst Norman Ornstein still believes some version of reform is likely by the end of the year.
"It will be not a full health care plan. It will be more like a third of what supporters of dramatic change would like," Ornstein said. "But it will make a very real difference in the lives of a lot of people."
Ornstein says a failure to act could lead to big Democratic losses in next year's midterm congressional elections.