Obama's $900 Billion Volley

President Obama speaks to a joint session of Congress of the need to find common ground on health care.

Image: Jason Reed-Pool/Getty Images

Liberal Democrats, deficit hawks, the elderly, moderates, big and small business.

About the only folks President Obama didn't reach out to Wednesday night in his big health care speech were insurance company executives and Sarah Palin. He even promised to study the cost of malpractice lawsuits and gave a shout out to John McCain.

The president sought to find a middle for his health reform to garner much-needed support. He moved a step closer, delivering an inclusive speech aimed at some of the undecided members of Congress. Speaking to American taxpayers and businesses as well, the president trimmed his package to about $900 billion over 10 years. That cost is less than the wars in Iraq or Afghanistan or George W. Bush's tax cuts for the wealthy, Obama said.

"He positioned himself in the center," says Dan Mendelson, CEO of Washington research group Avalere Health and a former Clinton health care policy coordinator. "It will be difficult for Republicans to reject his overtures completely. He gave them enough that they have to at least start to work with him. He took the ball and he's walking down field. Whether he runs down the field we'll see." (For a transcript, click here.)

The details largely mirrored a proposal being considered in the Senate Finance Committee but bended in a number of areas, most notably the public option for health insurance. While the president said there needs to be an alternative for people who can't get insurance through private companies, he left the door open to what the option will be.

Obama made it clear that he didn't intend to dismantle the current health insurance system but rather to build on it. Throughout the speech, he showed his hand, willing to deal on some of the more controversial aspects of the plan, namely the public option.

"To my progressive friends, I would remind you that for decades, the driving idea behind reform has been to end insurance company abuses and make coverage affordable for those without it," Obama said. "The public option is only a means to that end - and we should remain open to other ideas that accomplish our ultimate goal. And to my Republican friends, I say that rather than making wild claims about a government takeover of health care, we should work together to address any legitimate concerns you may have."

Laurel Pickering, executive director of the New York Business Group on Health, says Obama didn't go far enough to meet GOP concerns and that will make it difficult to reach a consensus.

"Where I think he fell down, is crossing that bridge with Republicans and seeking bipartisan support," says Pickering, whose group includes 170 large employers.

While he began with a conciliatory note Obama warned Republicans and "special interests" that he will push forward, leaving them behind. At one point, he threatened: "If you misrepresent what’s in the plan, we will call you out."

"I will not waste time with those who have made the calculation that it’s better politics to kill this plan than improve it," Obama said.

The president spent plenty of time slapping insurance companies around but then spent several minutes lecturing individuals that they have to buy insurance.

The president drew laughter when he said there are "some significant details to be ironed out." And he drew boos at other points. House Republicans stood up holding copies of their bill when Obama said he wanted to work with the GOP. The president said lies and distortion clouded the debate. But when he said reform won't cover illegal immigrants, Republican Rep. Joe Wilson of South Carolina yelled "you lie."

"It's a highly emotional debate," Mendelson says.