The U.S. Congress appears headed for a final battle over health-care reform legislation in the next several days, and the political stakes for President Barack Obama, his Democratic allies and opposition Republicans are enormous.
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Health-care reform has been President Barack Obama's top domestic priority, and the president is making an energetic final push for support, including a recent visit to Ohio.
"I do not know about the politics, but I know what is the right thing to do," Obama said. "And so I am calling on Congress to pass these reforms and I am going to sign them into law. I want some courage! I want us to do the right thing, Ohio, and with your help we are going to make it happen!"
Public support for the Democratic health-care plan has eroded during the past several months, and Mr. Obama must now rely on Democrats alone to get the legislation through Congress.
Political experts see passage of health care as a crucial political test for Mr. Obama in advance of congressional midterm elections in November.
Tom DeFrank is a veteran journalist and political analyst with the New York Daily News and a regular guest on VOA's 'Issues in the News' program.
"He has some sort of health care bill close to having enough Democratic votes to sign on, and he also understands that he has to show that he can lead, that he can govern, that he can get something done," DeFrank noted. "He needs a new accomplishment and he needs to be able to say, I got health care. So once again, he is raising the stakes."
Congressional Democrats also have a lot riding on passage of a health care bill. Many liberal Democratic voters have become disillusioned with the compromises made in Congress, and they will be sorely disappointed if the health care effort fails.
House Speaker Nancy Pelosi continues to rally liberal and moderate Democrats in Congress to support this final attempt at passing health care.
"This legislation not only makes history, but it will make progress for America's working families," she said.
The stakes are also enormous for congressional Republicans. Republicans were in disarray following the 2008 elections that produced a Democrat in the White House and a strengthening of Democratic control of both houses of Congress.
Republicans oppose the health care effort on principle, arguing that it represents too much government intervention in the health care system and will bankrupt the country with its high cost.
Republicans have seen their standing in the polls improve as their opposition to health care has intensified.
Indiana Republican Congressman Mike Pence spoke to a crowd outside the U.S. Capitol that had gathered to rally against the Democratic health-care bill.
"I say, Mr. President, Madame Speaker, the American people know what is in the bill. We just do not want it!", he said.
Pence was cheered on not only by Republicans, but by grassroots conservatives and Libertarians who are supporters of the so-called Tea Party movement.
The anti-tax, anti-big government Tea Party movement takes inspiration from the anti-tax protesters just before the American Revolution who threw tea into Boston Harbor to protest British taxes.
Tea Party sympathizers oppose government interference in health care and in other areas of the economy, and they fear the Democratic-led Congress is spending too much and increasing the national debt.
Julie Heckman is a Tea Party supporter from Maryland who attended the rally against the Democrat's health-care bill.
"I feel so strongly that this country is headed, fiscally, in a horrible direction, and for the first time in my adult life, we have a Congress that will not listen to the people, and we are fed up and we want them to listen to us," she said.
The Tea Party movement is also drawing support from some political independents who say they are disappointed that President Obama has not pursued the kind of moderate, bipartisan agenda he talked about during the presidential campaign.
The combination of energized Republicans and Tea Party activists, plus disappointed independent voters spells big political trouble for Democrats trying to hold control of Congress in the November elections.
Larry Sabato directs the Center for Politics at the University of Virginia.
"In the House of Representatives, it is really a question of whether Obama's Democrats are going to lose 15 seats or 25 seats or the 40 seats necessary for the Republicans to take over," noted Sabato.
Republicans are hoping for a replay of the 1994 midterm elections, when they won control of both the House and Senate in large part because of public opposition to the health-care-reform plan put forward by another Democrat in the White House, Bill Clinton.