President Barack Obama, conceding that ordinary Americans are skeptical of his plan to overhaul the nation's health care system, sought Wednesday to convince the public that the changes would benefit them and strengthen the economy.

"Reform is about every American who has ever feared that they may lose their coverage if they become too sick or lose their job or change their job," Obama said at a prime-time news conference from the East Room of the White House. "It's about every small business that has been forced to lay off employees or cut back on their coverage, because it became too expensive. It's about the fact that the biggest driving force behind our federal deficit is the skyrocketing cost of Medicare and Medicaid."

Obama used the event, the fifth full-scale White House news conference of his 6-month-old presidency, to try to reclaim a debate that has been slipping away from him in recent days.

With Republicans and some moderate Democrats on Capitol Hill balking at both the specifics of the legislation and Obama's timetable for House and Senate passage of the bills, the White House is now trying to rally legislative support and public opinion by linking health care to the nation's economic health and offering the promise of tangible benefits to Americans.

"If we do not control these costs, we will not be able to control our deficit," he said. "If we do not reform health care, your premiums and

out-of-pocket costs will continue to skyrocket." He acknowledged that Americans were anxious, saying, "Folks are skeptical, and that is entirely legitimate."

For Obama, the stakes could not be higher. Health legislation is his highest legislative priority, and his success or failure could shape the rest of his presidency. But while he is under pressure from leading Democrats to delve more deeply into the negotiations, by taking positions on specific policy issues, he largely resisted doing so on Wednesday night.

But the president did weigh in on a controversial idea percolating in the House of Representatives to tax the wealthiest Americans to help pay to extend coverage to the nation's 47 million uninsured. At first, House Democrats were weighing a tax on Americans making more than $280,000 a year; now there is talk of imposing the tax on those households earning $1 million or more, an idea Obama said he favored because it would not put the burden of paying for the bill on the middle class.

"To me, that meets my principle, that it's not being shouldered by families who are already having a tough time," he said.

Obama also signaled that he might be open to another idea under consideration in the Senate: taxing employer-provided health benefits, as long as the tax did not fall on the middle class.

On Capitol Hill, House Speaker Nancy Pelosi of San Francisco, said Democrats remained on track to reach a deal on major health care legislation. But she acknowledged that the process had slowed in response to concerns among conservative Democrats about the cost of the bill, and that some House Democrats were reluctant to embrace the income surtax on high-earners without knowing whether the Senate would go along.

Indeed, even as Pelosi insisted that Congress was closer than ever to achieving a comprehensive overhaul of the nation's health care system, Rep. Mike Ross of Arkansas, a leader of the Blue Dogs, a conservative faction of Democrats, issued a statement saying that a deal was still a long way off. And a senior Democratic aide on Capitol Hill said party leaders now believed it was essential for Obama to be more specific about what he wanted in a health care bill — and not just exhort Congress to pass one.

"The president needs to step in more forcefully and start making some decisions," said the aide, speaking on condition of anonymity because he did not want to be publicly identified as criticizing Obama. "Everyone appreciates the fact that Obama has devoted so much time to health care. The bully pulpit is powerful. But in view of the deadlines Congress has missed, we would like to hear more from the president about what he wants in this bill."

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