Passing significant health care reform could be a legacy maker for this president but it is far from a done deal.
The White House wants a bi-partisan bill, but President Obama wants a government run health care plan as part of the package and that is becoming a major stumbling block.
In a just-released letter to Senators, top insurance companies like Blue Cross Blue Shield expressed concern that a government plan would take over the health care system.
"We do not believe that it is possible to create a government plan that could operate on a level playing field," the insurance company said in a statement. "A government plan would use its built-in advantages to take over the health insurance market."
Republicans are echoing the same theme.
"Let me put it this way. Having the government compete against the private sector, it's kind of like my seven-year-old daughter's lemonade stand competing against McDonald's," Rep. Paul Ryan, R-Wis., said. "It's the government being the referee and player in the same game."
Senate Minority Leader Mitch McConnell said the U.S. could end up with no other insurance companies.
"Which then puts us very close to a single-payer system, which inevitably in European countries and in Canada has led to delays, denial of care, the kind of rationing that Americans I think would have a very difficult time dealing with."
Most polls show a majority of Americans favoring a government run option. In his sell job, the president is going around the country saying if you like your current health care plan and doctor, you can keep both.
But what if employers start dropping your private insurance plan for the cheaper government plan?
"What about keeping your promise to the American people that they won't have to change plans?," resident Jake Tapper asked the president.
President Obama clarified what he meant.
"When I say that you don't have to change plans, what I'm saying is the government is not going to make you change plans under health reform," he replied.
The president has another problem too. Not all Democrats are on board with all of his ideas for reforming health care.
"I don't know that he has the votes right now," Sen. Diane Feinstein, D-Calif., said.
Democrats are worried about an estimated $1.6 trillion price tag and the fact that their individual states may take a hit if the plan calls for covering costs by reducing Medicaid and Medicare payments which help support local hospitals and the public health system.
For right now at least, all options are on the table.
"We are still early in this process. So, you know, we have not drawn lines in the sand," Obama said.
The president will play Salesman-in-Chief when he pitches health care reform Wednesday night at the White House as part of an ABC News prime time Town Hall Forum.
ABC News is taking hits from conservative critics who say the network is being too cozy in their relationship with the White House. The Washington Times reports that ABC employees gave 80 times more money to Obama than McCain during the general election.
But on the show itself, the president is pulling no punches and making a bold prediction.
ABC News anchor Diane Sawyer asked Obama if he expects to have health care formed by the end of the year.
"Yes. Absolutely," he replied.