U.S. President Barack Obama will attempt to regain political momentum when he delivers a major address on health care reform to a joint session of Congress on Wednesday.
It may be the most important speech so far in Mr. Obama's young presidency. The political stakes for the president and for congressional Democrats are enormous.
The president will attempt to regain the initiative in the battle for health care reform after losing ground last month in public opinion polls and in some angry town hall forums where his plan was heavily criticized.
"Many may believe that we can't afford to do anything," said presidential spokesman Robert Gibbs. "I think this president believes we can't afford not to."
Hopes for a bipartisan compromise on health care appear to be fading. Senator Mike Enzi of Wyoming is one of a handful of Republicans who has been discussing a bipartisan approach on health care.
But Enzi adopted a negative tone when he gave the Republican response to one of President Obama's recent weekly radio addresses.
"This is big. This is personal. This is one of the most important debates of our lifetime," he said. "If Congress and the administration mess this up each and every one of us will pay for the mistakes, as will generations to come. We need health care reform. But more importantly, we need to get it right,"he said.
Like most members of Congress, Enzi heard from constituents at town hall meetings during the August congressional recess about the health care issue, and he says many of the comments were negative.
Several Democrats have said their town hall meetings were not as raucous, and they insist reform supporters remain adamant that Congress should approve changes to the U.S. health care system.
Some liberal Democrats worry that the president may ask them to give up too much in the health care debate in the hope of salvaging some sort of political compromise by the end of the year.
House Speaker Nancy Pelosi says many Democrats remain committed to a sweeping reform plan that would expand health insurance coverage to millions of Americans who currently do not have it.
"We have a moral imperative to do this. We are the greatest country that ever existed in the history of the world, the great economic leader of the developed world, but the only one that does have access to quality, affordable health care for our people, and we intend to do so," she said.
Republicans and many conservative Democrats are balking on the cost of the reform, which could reach one trillion dollars over the next several years.
Political analysts say Mr. Obama has little choice but to try and restart the debate over health care since his poll ratings have gone down in recent months, both personally and in terms of his handling of the health care issue.
"You do see a lot more worry in the public opinion polls," said John Fortier, an expert at the American Enterprise Institute in Washington. "And the polls differ on how questions are asked, but certainly all the polls have moved to much more skepticism about the cost and about worries about the government role," he said.
A major point of difference between the two main parties is whether the government should offer a health insurance program to compete with private insurance companies in an effort to drive down health care costs.
Republicans argue a government plan, also known as the public option, would undermine the private insurance industry.
Liberal Democrats, including Speaker Pelosi, insist that a public option must be part of any bill eventually passed by Congress.
The president's address will come shortly after Congress reconvenes after its long August recess. Several congressional committees are working on reform proposals, but so far no one plan has emerged for consideration.