Former president Bill Clinton paid a rare visit to the US Senate on Tuesday to urge divided Democrats to unite behind President Barack Obama's historic plan to overhaul US health care.
"This is an economic imperative," Clinton declared after a closed-door session with Democrats at their weekly policy meeting some 15 years after his own dramatic push to remake health care collapsed after a strong start.
The two-term former president came at the invitation of White House chief of staff Rahm Emanuel, a one-time Clinton aide, and Democratic Senate Majority Leader Harry Reid, according to a Democratic Senate leadership official.
Reid has been struggling to draw the 60 votes needed to ensure the ability to break through any Senate parliamentary delaying tactics and pass the bill, a version of which narrowly cleared the House of Representatives on Saturday.
The Senate could take up the bill next week, but Republican opposition and Democratic doubts, notably on the volatile issues of abortion and what role government should play in health care, have clouded the plan's fate.
"I just urged them to resolve their differences and pass the bill," Clinton told reporters after his one-hour talk, which blended politics, policy, and personal experience on behalf of Obama's top domestic priority.
Democratic Senator Sherrod Brown said Clinton had drawn on his 1993-1994 defeat on health care and on then president Lyndon Johnson's victorious push 30 years earlier to create the Medicare health program for the elderly.
Clinton warned lawmakers that "the price of failure is too high, (and) we won't have another chance for a long time," Brown told reporters.
Democratic Senator Christopher Dodd, a key health care overhaul advocate, said Clinton had discussed the stakes "from a policy standpoint and a political standpoint" but had not endorsed specific proposals, "and wisely not."
Dodd said Clinton underlined the "overwhelming" economic argument for changing health care in the United States, which pays vastly more than other industrialized nations with no meaningful edge in quality of care.
Clinton also underlined that the Senate bill was only the starting point and that crafting a better system "will require constant work in the years to come" by Congress, said Dodd.
"But you've got to start, if we don't start, then of course it only gets worse and the answers become more difficult."
Clinton's visit underscored the political peril Democrats may face: Republicans energized by derailing his health care push went on to a landslide victory in the 1994 mid-term elections.
The United States is the world's richest state but the only industrialized democracy that does not ensure that all of its citizens have health care coverage, with an estimated 36 million Americans uninsured.
And Washington spends vastly more on health care, both per person and as a share of national income as measured by Gross Domestic Product, than other industrialized democracies, with no meaningful advantage in quality of care, according to the Organization for Economic Cooperation and Development.
Democratic Senator Ben Nelson said he would be crafting legislation to toughen curbs on government funds helping to pay for abortions "directly or indirectly," echoing a last-minute addition to the House bill that won critical support from a platoon of pro-life Democrats.
But Democrats who favor abortion rights have signalled they will fight such an effort.
Nelson said he would likely not vote for a bill that lacked such restrictions and played down Clinton's impact, saying "I'm not sure what he would say that would" change his mind.
If, as expected, the Senate and House of Representatives approve rival versions of the legislation, they would have to forge a compromise bill and approve it in order to send it to Obama to sign into law.