The fate of health care reform lies in the hands of the U.S. Congress, but the White House will use every weapon it has to steer its top policy priority through the legislature and into law.
President Barack Obama and aides will make the public case for reform in speeches, interviews and blog posts in the weeks ahead.
"I'll be rolling up my sleeves and spending some time before the full Congress even gets into session, because the American people need it now," Obama said in an interview with PBS' "Newshour" that aired on Dec. 23.
But they will also work behind the scenes to push Democrats to get over any objections and back a plan resembling the one passed by the U.S. Senate.
"The White House has some serious human assets to deploy, not only a skilled and experienced legislative relations staff, but also a chief of staff who understands the way the Hill works and is pretty good at the carrots and sticks game," said William Galston, a former policy adviser to President Bill Clinton now at the Brookings Institution.
Obama's chief of staff, Rahm Emanuel, was a veteran of the Clinton White House who became a power player in the House of Representatives and is considered a master of the art of cutting back-room deals.
"The White House has been preparing for this end game for a long time," Galston said.
After passing their own versions of the sweeping push to overhaul the $2.5 trillion U.S. health care industry, the House and Senate must now merge them into a single bill, which each has to pass before sending it to Obama.
Obama and his fellow Democrats have trumpeted progress on the health care overhaul as a major achievement, but they must resolve significant differences between the House and Senate bills and, after months of wrangling, do it quickly.
"We're like 90 percent there. We're really close," said David Kendall of Third Way, a centrist Washington think tank that supports the health care bill. "The differences that remain are significant, but they're not overwhelming."
The biggest difference between the House and Senate bills is how they are financed, and analysts said that disparity could be the highest hurdle for congressional negotiators.
The House would impose a 5.4 percent surtax on high-income Americans.
The Senate has a 40-percent excise tax on high-cost "Cadillac" insurance plans, strongly opposed by labor unions typically among the Democrats' strongest supporters.
Kendall said House and Senate differences over how to pay for reform could be overcome by doing more to control costs in the final bill and exempting some Cadillac insurance plans for union members doing high-risk jobs.
The White House says negotiations will not force the House to accept all of the Senate Democrats' plan.
"There are elements of it (the House bill) that we definitely like," one administration official said.
Democrats want to deliver a major legislative victory for Obama and sell the public on what they believe are the benefits of reform, well before they fight to preserve their majorities in the House and Senate in November elections.
"A lot of Democrats are running scared right now, they're looking for help and they are looking for a safety net and the White House is in a position to provide both," Galston said.
The administration is determined not to be sidetracked by security concerns after the botched Dec. 25 airliner bombing and efforts to cut high unemployment.
"When you're president of the United States you've got to be able to walk and chew gum at the same time," deputy White House press secretary Bill Burton told reporters.
Obama was meeting in the Oval Office on Tuesday with House Democratic leaders, and leaders of the Democrats in the Senate were to participate by teleconference.
With Republicans staunchly opposed to the reform plans — only one House Republican backed its bill and no Senate Republicans voted in favor — the final measure is likely to be negotiated among Democratic leaders and the White House.
They are likely to skip a formal House-Senate conference that would include Republicans who could use the process to slow down the bill.
That plan has been criticized as contravening Obama's promises to run an open government and include Republicans in the process, but Democrats contend that skipping formal conferences has become common practice on Capitol Hill.
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