"I think the president in the calls and meetings he's having with individual leaders is making great progress," Gibbs said, adding Obama believed his place was to be in Washington "seeing this through".


House Democratic leaders finished work on the last changes to the overhaul on Thursday, which the Congressional Budget Office (CBO) estimated would expand insurance coverage at a cost of $940 billion over 10 years and cut the deficit by $138 billion in the same period.

"It took some time but we are very pleased," Nancy Pelosi, the House speaker, said after the meeting on Thursday.

Pelosi said the overhaul represented the biggest change to healthcare in decades [AFP]

"This is history, and this is progress," she told reporters of the overhaul, which would represent the biggest changes to the $2.5 trillion healthcare system in the last four decades.

At the White House, Obama said the healthcare bill, which has faced solid Republican opposition, represented "the most significant effort to reduce deficits since the Balanced Budget Act" of 1993.

After weeks of wrangling over the package to make the numbers come out favourably, House leaders presented the final changes to Democrats at a morning caucus and will post them online later on Thursday.

The changes include expanding subsidies to make insurance more affordable and more state aid for the Medicaid program for the poor.

They also would eliminate a controversial Senate deal exempting Nebraska from paying for Medicaid expansion costs, close a "doughnut hole" in prescription drug coverage and change the threshold on a tax on high-cost "Cadillac" insurance plans.

"I don't think I'd call it a Cadillac tax now," Henry Waxman, chairman of the House Energy and Commerce Committee, said. "I'd call it a Rolls Royce."

The overhaul would extend coverage to 32 million uninsured Americans, the CBO estimated, and ban insurance practices like refusing coverage to those with pre-existing medical conditions.