President Barack Obama’s leadership in the days ahead will determine whether his forceful health care address to Congress heralds the kind of sweeping change he promised while campaigning for the White House.

Addressing Democrats and Republicans in the House chamber, along with Washington insiders and Americans with and without health insurance, Obama spelled out where he stands on key issues in dispute as Congress struggles to revamp the nation’s health care system. While some of his explanations — notably on costs — were incomplete, he left no doubt he’s taking ownership.

"To this date, the health care debate has looked like a tennis match between leaders in Congress, with the president sort of watching as it goes back and forth," said Robert Blendon, a public opinion expert at the Harvard School of Public Health. "He’s taken control of this issue for now, and into the future it looks like there’s a plan, and he’s leading it."

If the summer belonged to opponents of his health care overhaul, Obama is hoping to lay claim to the rest of the year — and close it by getting a bill on his desk.

A CNN/Opinion Research Corp. snap poll of people interviewed before and after Wednesday night’s speech indicated that the president shifted public opinion in his favor. After the speech, two-thirds said they supported Obama’s health care proposals, compared with 53 percent in a survey days before the president spoke.

Moderate Democrats responded positively, while Republicans said Obama came up short, even if he showered them with attention. Liberals seemed to take it in stride that Obama signaled flexibility on the government-sponsored plan they want to create to compete with private insurers.

"If the details live up to the quality of the speech, then it’s a good plan," said Rep. Jim Cooper, D-Tenn., one of the fiscally conservative "Blue Dog" Democrats.

Senate Republican leader Mitch McConnell of Kentucky said he believes Obama is still out of step with the kind of health care changes most Americans want because his plan entails too much government.

"The White House changed its sales pitch tonight," McConnell said. "But Americans weren’t looking for a new sales pitch. They’re looking for a new proposal."

Obama said his plan would give the majority of people who have health insurance greater security. Their policies could not be canceled if they get sick. And they would be able to find affordable coverage if they get laid off or decide to start a business. Insurers would not be able to deny coverage for pre-existing conditions.

For the millions who lack insurance — or have trouble getting it — Obama’s plan would set up a new marketplace in which consumers could pool together. Government subsidies would be available to make premiums more affordable. But individuals would be required to get coverage, and employers would have to contribute.

The president’s speech came as Senate Finance Committee Chairman Max Baucus, D-Mont., announced he will move forward on legislation by the end of the month. The Finance Committee is considered pivotal because it mirrors the composition of the Senate. Baucus had delayed action for months, hoping to win a bipartisan agreement. But Wednesday, he said he would press ahead with or without a deal.

Obama said he remains ready to listen to all ideas but added, in a clear reference to Republicans, "I will not waste time with those who have made the calculation that it’s better politics to kill this plan than to improve it."

In an unusual outburst from the Republican side of the House chamber, Rep. Joe Wilson, R-S.C., shouted out "You lie" when the president said illegal immigrants would not benefit from his proposals. The president paused briefly and smiled, but from her seat in the visitor’s gallery, first lady Michelle Obama shook her head from side to side in disapproval of the interruption.

Wilson later apologized for "this lack of civility."


Associated Press writer David Espo contributed to this report.

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