In Health Care Fight, Defining Moment Nears For President

WASHINGTON — Six months into his administration, President Obama is at a pivotal moment. He has pushed through a $787 billion economic stimulus package, bailed out Wall Street and, on Tuesday, managed to beat the defense industry in the Senate, which voted to kill a high-profile fighter jet program.

On Wednesday night Mr. Obama addresses the nation in a prime-time news conference as the public, and lawmakers, are growing skittish over his next big plan, to remake the American health care system. How he handles the issue over the next several weeks could shape the rest of his presidency, shedding light on his political strength, his relationship with both parties in Congress and his appetite to fight for his own agenda.

With some fellow Democrats balking over his insistence that both the House and the Senate pass health legislation before the August recess, Mr. Obama has a tough decision to make: Does he take a hard line, demanding that lawmakers stick to his timetable — and risk losing the support of Republicans and moderate Democrats? Or does he signal flexibility, allowing lawmakers to take their time — and give opponents the chance to marshal their case against the bill?

“He’s got to be careful that while he ratchets up the pressure, he doesn’t bet his whole presidency on whether this gets done before the August recess,” said Kenneth M. Duberstein, who orchestrated President Ronald Reagan’s first-term legislative strategy. “He has a broad, broad agenda that he’s in a rush to enact, and if he’s not careful he will be viewed as a steamroller who tries to get things fast and not necessarily right.”

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