WASHINGTON (AP) - President Barack Obama's health care appeal failed to break the congressional gridlock Thursday, dimming hopes for millions of uninsured Americans. Democrats stared down a political nightmare - getting clobbered for voting last year for ambitious, politically risky bills, yet having nothing to show for it in November.
The grim reality opened a divide between the rank and file and congressional leaders, who insisted health care would get done, even though last week's special election in Massachusetts denied Democrats the 60-vote majority they need to deliver in the Senate. Many Democrats saw a problem with no clear solution.
"It's very possible that health care is just a stalemate and you can't solve it this year," said Sen. Mark Pryor, D-Ark.
If Obama and Democrats fail to pass any legislation this election year, Washington would still face the problem of millions of uninsured, rising medical costs and a dwindling Medicare trust fund forecast to run out of money in 2017.
Obama's health care overhaul is "on life support," said Sen. Mary Landrieu, D-La., "but it still has a pulse."
Obama urged lawmakers in Wednesday night's State of the Union address not to abandon the effort on what was once his top domestic priority - expanding coverage to millions of uninsured and reining in medical costs. But his enthusiastic words provided no specific prescription for moving forward, leaving lawmakers little better off than before.
Senate Democratic leaders huddled Thursday afternoon to try to determine how to proceed, and the White House remained engaged in the negotiations. A Senate aide said lawmakers were hoping to decide on a legislative strategy by the end of next week.
Republican senators said senior White House officials had reached out to several in their ranks, including some conservatives, despite the unanimous GOP opposition to the far-reaching bill.
In a sign of how far health care had fallen since Obama campaigned on it, Senate Democrats devoted a weekly policy lunch Thursday to discussing jobs, not health care. Yet House and Senate leaders insisted success was still in reach.
"We're going to move forward on health reform. We're going to do health care reform this year," said Senate Majority Leader Harry Reid, D-Nev.
House Speaker Nancy Pelosi acknowledged in her weekly news conference that plenty of work remained if the House was to agree to changes to the Senate bill.
"We will go through the gate. If the gate is closed, we will go over the fence. If the fence is too high, we will pole vault in. If that doesn't work, we will parachute in," Pelosi said. "But we are going to get health care reform passed for the American people."
Just two weeks ago House and Senate leaders were working round the clock at the White House, with Obama personally involved, to merge legislation passed separately by each chamber and finalize a bill for Obama to sign in time for his State of the Union speech. That effort was upended when Republican Scott Brown claimed the Senate seat long held by the late Edward M. Kennedy.
Since then Democrats have struggled to find a way forward. The leading strategy is for the House to pass the Senate bill along with a package of changes approved by both chambers, but that idea is fraught with difficulties both political and substantive. Some Democrats favor retreating from a comprehensive overhaul and taking a less ambitious approach with a series of individual initiatives or a smaller bill.
"Is there a gate someplace to get through and try to save some common areas of health care reform in both the House and the Senate bill? We'll see," said Sen. Byron Dorgan, D-N.D.
As Democratic leaders sought a way through the health care logjam, they reminded the rank and file that there are no easy solutions, politically or otherwise.
Two unpleasant choices face Democratic lawmakers who voted for the health care changes last month and who now worry about their re-election prospects this fall.
If a bill becomes law, they will have to convince a doubting public of its benefits, and conservatives are bound to keep up the attacks. If no bill passes, it's possible that public anger over the health care issue will subside a bit. But many Democratic strategists say GOP challengers will constantly remind people of the incumbents' December votes, and Democrats will seek re-election with nothing to show on health care despite controlling the House, Senate and White House - and with hefty majorities.
Compounding the problems was growing distrust between the House and the Senate.
While lawmakers struggle, Wall Street is celebrating the sinking prospects for a sweeping overhaul that would put new taxes and requirements on insurance companies. Insurers have opposed the overhaul even though it aims to insure more than 30 million people over the next decade with a new requirement for nearly everyone to be covered.
An analysis distributed by UBS Investment Bank after the State of the Union speech stated: "Investors should proceed as if the health care effort is dead."
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Associated Press writers Ben Evans, Donna Cassata, Charles Babington, Alan Fram and Ricardo Alonso-Zaldivar contributed to this report.