[cnn-photo-caption image= http://i2.cdn.turner.com/cnn/2009/images/09/02/art.obamahand.0902.gi.jpg
caption="President Obama faces wavering support on health care reform, key White House aides told CNN."]
WASHINGTON (CNN) - President Barack Obama, facing wavering support on health care reform, is considering a range of options to recapture momentum on his signature domestic initiative, key White House aides told CNN Wednesday.
"The president is considering all of his options on how to advance the debate and get reform passed. This includes possibly laying out a more
specific vision," said one administration official, speaking on the condition of anonymity.
Among other things, Obama is contemplating giving a major speech detailing specifics on what he would like to see included in a health care
reform bill, added senior adviser David Axelrod.
It's unclear what form a possible speech by the president would take. If he decides to give an address, he could do it from the Oval Office or before a joint session of Congress.
No decisions have been made yet, the official emphasized.
So far, Obama has outlined broad principles for what he would like in health care reform, but he has left most details to leaders in Congress. Now, White House aides say, the dynamic has changed.
"We're entering a new season," Axelrod said. "It's time to synthesize and harmonize these strands and get this done."
The new phase is being "driven in part by the actions of some in the GOP, including Senators Grassley and Enzi," the administration official noted.
The official added, the White House believes those actions indicate that the two key Republicans - Chuck Grassley of Iowa and Mike Enzi of Wyoming, who are part of a bipartisan group negotiating a health care bill - "are essentially walking away from the table."
The official said that "now is the time to begin to pull together the various strands and solutions from the four bills that have been marked up and other proposals... basically all the cards are on the table."
A statement Wednesday to CNN by Grassley spokeswoman Jill Kozeny criticized complaints about the senator's role in the health care negotiations as unhelpful.
"Attacks by political operatives in the White House undermine bipartisan efforts and drive senators away from the table," the statement said. "Anyone who's been working on an alternative plan - one that would actually drive down costs and not drive up the deficit - knows how difficult the issues are, and that Democratic senators involved in trying to work through the details have as many questions about how proposals would actually achieve reform goals as Republicans."
The statement called Democratic proposals before the House and Senate "policy failures" that it contended were "rejected at the grass roots." It
reiterated that the goal of Grassley's negotiations with five other members of the Senate Finance Committee - three Democrats and two Republicans, including Enzi - was "to see if it's possible to develop an alternative that would improve the system and, as a result, get widespread support."
A separate statement to CNN by Enzi's communications director, Craig Orfield, insisted that the senator's opposition to Democratic health care proposals was consistent.
"Repeating that you don't agree with plans put together solely by one side doesn't mean you aren't willing to work together on a different plan,"
Orfield's statement said. "He is. He has been doing that."
However, Grassley, Enzi and other Republicans in both the House and Senate appear unanimous in opposing a government-funded public health insurance option proposed by Democrats, as well the broad scope and cost of Democratic proposals so far. In addition, some moderate Senate Democrats also worry about the cost of a health care overhaul and say the public option lacks enough votes to pass the Senate.
The compromise agreement being negotiated by Grassley and the other Finance Committee members has dropped the public option, proposing instead the creation of not-for-profit health insurance collectives that could negotiate collective coverage for members.
Obama and Democratic leaders argue that a public option would ensure that coverage is available to all Americans, while forcing private insurers to lower costs through competition.
Republicans reject the concept, saying the public option would drive private insurers out of the market. Republican leaders repeatedly call the
public option a first step toward a government takeover of health care, a claim derided by Democrats as deliberately misleading.
Uncertainty over the political viability of the public option has some House Democrats refusing to rule out the possibility of a final bill without
On Tuesday night, House Majority Leader Steny Hoyer of Maryland reiterated his support for a public option, but when asked by CNN if House
Democrats would turn their backs on a final bill without it, he said: "I hope that's not the case."
His statement differed from comments by some other Democratic leaders, who call the public option essential for any health care legislation. For example, House Speaker Nancy Pelosi said last month that there was "no way" she could pass a bill in the chamber without a public option.
Hoyer represents a conservative district that voted strongly in favor of Republican presidential candidate John McCain in last year's election.
He also is considered the strongest ally among House Democratic leaders of the chamber's fiscally conservative Blue Dog Democrats, some of whom have objected to House health care proposals so far.
As momentum for health care reform has slowed, Obama has come under growing pressure from liberal activists and leading congressional Democrats to provide more specifics.
"I think the president needs to step forward," Sen. Sherrod Brown, D-Ohio, said Tuesday. "Be more specific, more aggressively fight for a strong health reform bill with a strong public option. I think he's going to do that."
–CNN's Ted Barrett and Brianna Keilar contributed to this story