President Obama sought to inject a note of urgency into his push for health-care legislation during a rally yesterday at Arcadia University in Glenside, blasting the insurance industry for recent huge premium increases while hitting Washington politicians for dithering.

Shucking his jacket before a crowd of 1,800 in the university's gym, the president made a passionate plea for public support. He dismissed those, including members of his own party, who say that overhauling the health-care system could cost Democrats their majorities in Congress in the Nov. 2 midterm election.

"We've been talking about this for a century," Obama said. ". . . If not now, when? If not us, who? I don't know how health-care reform will play politically, but I know it's the right thing to do."

Obama slammed Republicans for their opposition to the Democrats' proposals, saying they had failed to act when they controlled Congress.

"I got all my Republican colleagues out there saying, 'Well, no, no, no, we want to focus on things like cost,' " the president said. "You had 10 years. What happened? What were you doing?"

He said insurers should no longer be able to deny coverage for preexisting conditions, drop coverage when a policyholder gets sick, or jack up premiums. "We allow the insurance industry to run wild in this country," Obama said.

The health-care package stalled in Congress after Democrats lost their 60th seat in the Senate in a Massachusetts special election, and amid growing concern about the potential $1 trillion cost. Opponents say the legislation would amount to a government takeover.

Underscoring the passions aroused by the issue, about 200 conservative activists from the tea-party movement protested outside the Arcadia gym, while a smaller group of proponents competed with them in chanting and waving signs.

Obama's brief campaign-style trip came at the beginning of a pivotal week, as Democratic leaders ready the legislation for a final vote. The Congressional Budget Office is expected to release a fiscal analysis of the bill later this week, and Obama is scheduled to travel tomorrow to Missouri, an electorally important swing state like Pennsylvania.

Under Democrats' strategy, the House is to try to pass the version of the legislation the Senate approved last year, then vote on a separate bill that modifies some provisions. The Senate would then vote on those changes under a parliamentary move known as reconciliation, which allows a simple majority to pass legislation rather than the 60 votes needed to cut off filibusters.

Getting the legislation through the House, where Republicans are united in opposition, will take 216 votes. And House Democrats are split among liberal members who say the proposal does not go far enough, and more-conservative members who say its costs are too high. Democrats in competitive districts worry that the tax increases and cuts in other spending to finance the overhaul would slow economic recovery and prove unpopular with their constituents.

Rep. Jason Altmire (D., Pa.) of suburban Pittsburgh, who voted no when the House passed its initial health-care bill in November, has expressed concerns about the latest proposal.

Controversy also persists over abortion language in the measure that could cost the support of some Democrats who oppose abortion rights. Rep. Kathy Dahlkemper, an Erie Democrat, has said she wanted more restrictions on federal subsidies for insurance plans that cover abortions.

Bill Burton, the deputy White House press secretary, said officials had no "specific targeting" in mind when they picked the Philadelphia suburbs for Obama's visit. "If you look at where we're going, it doesn't really have an impact on a particular member," Burton said.

But pollster Chris Borick of Muhlenberg College said the Philadelphia area, besides being convenient to Washington, is home to thousands of independent voters who, according to polls, have cooled to Obama and have concerns about overhauling health care.

"Wavering support in swing areas such as Montgomery County has been crucial in jeopardizing reform efforts," Borick said, "and in his last big push to get something through Congress, he needs to get some of those questioning citizens to give his ideas a second look."

The two members of Congress whose districts are closest to Arcadia, Democratic Reps. Allyson Y. Schwartz and Chaka Fattah, support the legislation.

But Rep. John Adler (D., N.J.), who voted against the initial House health-care bill, said he had "serious concerns that the current proposals do not go far enough to lower health-care costs in the long term."

Rep. Patrick J. Murphy (D., Pa.), a member of the Blue Dog caucus of fiscally conservative Democrats, voted for the House bill last year, and faces a strong challenge this fall. A spokeswoman said Murphy would read the final language of the new proposal before making a commitment.

Obama expressed little patience yesterday for what he called the "sport" of politics. He cited letters he has received from cancer survivors burdened with debt and from ordinary people priced out of the market for health insurance, worried about putting their families at risk.

"So what should I tell these Americans?" Obama said. "That Washington is not sure how it will play in November? That we should walk away?"

He said it was time for people in Congress to "make a decision" and take a stand. Obama urged his listeners to knock on doors, make phone calls, and support the overhaul.

Sen. Arlen Specter (D., Pa.), who accompanied Obama to Arcadia along with other state Democrats, said later that Obama's remarks there were "the most fiery I've seen him since the early campaign."

Gridlock in Congress over health care has raised the stakes for the Democratic Party, Specter said. "The bill is really a test of whether the Congress - whether we can govern," he said.

Rep. Jim Gerlach, a Republican who represents the neighboring Sixth District, disagreed. "The legislation taxes business owners and individuals too much over 10 years and puts too much power in the hands of government," Gerlach said in a conference call after the event.

Obama spoke before a cheering, foot-stomping crowd with a large number of Arcadia students. Some of the biggest cheers came when he touted a provision in his proposal that young people could be covered under their parents' plans until age 26.

That resonated with Jackie Sentz, 20, a chemistry major from Adams County whose brother, 22, lost his job and his insurance.

"I don't think he understands the severity of not having insurance," Sentz said. And, she added, "I'm afraid that's going to happen to me. I'm not 100 percent sure I'm getting a job when I graduate."

After the event, Trisha Urban, 33, of Hamburg, hurried out to her car, in a race to get there before her daughter, Cora, 13 months, began to cry.

"My husband died on the day she was born," said Urban, who had been invited to attend by Sen. Bob Casey (D., Pa.). She and her husband, Andrew Urban, had insurance, she said, but when he was diagnosed with a heart condition and started needing regular medical care, their coverage was dropped.

They struggled to keep paying the bills, but Andrew Urban decided to skip his last doctor's appointment because they couldn't pay for it. Less than a month later, on Feb. 5, 2009, Trisha Urban found her husband unconscious in their home as she went into labor. She was unable to revive him.

"If he could have gone to the doctor," she said, "it would have made a world of difference."

Read the president's remarks at Arcadia via EndText