WASHINGTON -- One of Sen. Arlen Specter's favorite jokes during the second week of August, when he was on the business end of raised voices and wagged fingers in a series of town hall meetings across Pennsylvania, was that you couldn't change the television channel without seeing his face.

The events hosted by the Republican-turned-Democrat became a cable television news sensation and evidence of the public outrage that Congressional health care reform plans have provoked.

The public anger, stoked by Republicans and conservative groups opposed to the legislation, has put the White House on the defensive and set the stage for a battle when Congress returns to Washington on Tuesday.

Western Pennsylvania's elected leaders, including Mr. Specter, will be in the middle of a highly charged debate on President Barack Obama's chief domestic policy priority -- expanding health insurance coverage while curbing long-term costs.

"When we return to Washington, we need to be a lot more specific on how we're going to address the deficit so that we can show the people that when the President has committed not to sign a bill that adds to the deficit -- I've committed not to vote for one that adds to the deficit -- we're being realistic," Mr. Specter said in an interview last week.

He added that the vitriol that marked his early town halls seemed to wane later in the month.

"I think those first town meetings, where people had a real chance to vent and express themselves, I think took a lot of the steam out," he said.

Mr. Specter cited the more placid events of his Senate delegation counterpart from Pennsylvania, Democrat Bob Casey Jr., who held a handful of town halls -- including one Tuesday at the North Side campus of the Community College of Allegheny County.

After the CCAC event, Mr. Casey told reporters he expected a successful compromise bill to emerge once Mr. Obama lays out his plan. Mr. Obama will address a joint session of Congress Wednesday night to present more specific details of what he wishes to see in a health care bill.

"He's not going to say, '100 percent or nothing,' " Mr. Casey said.

Mr. Casey serves on the Health, Education, Labor and Pensions Committee, which has passed a version of the bill, but Capitol Hill eyes are most keenly focused on the Senate Finance Committee. The HELP bill moved without Republican support and did not include a mechanism to fund the reforms; that lies outside the committee's jurisdiction.

Finance Chairman Max Baucus, D-Mont., has a self-imposed Sept. 15 deadline to draft a bill. Mr. Baucus is working with fellow Democrats Kent Conrad, of North Dakota, and Jeff Bingaman, of New Mexico; and Republicans Mike Enzi, of Wyoming, Olympia Snowe, of Maine, and Chuck Grassley, of Iowa.

The "public option," a government-run health insurance plan that has drawn considerable ire from conservatives, is unlikely to be included in the Finance Committee bill, and Mr. Obama might abandon it in an effort to woo moderate Democrats and a Republican or two in the Senate. Such a compromise also could alienate the left. Several liberal members of Congress have said they would not support a measure that did not include a public option.

In the House of Representatives, versions of the Affordable Health Choices Act passed through three committees, and a few differences must be ironed out before it can hit the floor. The measure creates a Health Insurance Exchange, where those without insurance can select from private plans and the public option.

The government will fund universal coverage by helping to pay for premiums on a sliding scale related to income. Insurance companies cannot impose lifetime spending caps or deny insurance for pre-existing conditions under the plan, in addition to other new restrictions.

Among local representatives, Mike Doyle, D-Forest Hills, voted for the bill in the Energy and Commerce Committee, where Rep. Tim Murphy, R-Upper St. Clair, voted against it. Rep. Jason Altmire, D-McCandless, voted against the bill in the Education and Labor Committee.

In an appearance before more than 600 constituents last month at a town hall in Farrell, Mercer County, Mr. Altmire drew a standing ovation when he explained his vote "because the bill as I saw it was flawed. We can do better."

A member of the fiscally conservative Blue Dog Democratic caucus, Mr. Altmire said the bill didn't do enough to rein in costs and punished small businesses with an unfair tax hit if they do not provide coverage to employees. He also said he would not vote for any bill with a tax increase, which the House bill imposes on top earners.

Still, the former UPMC lobbyist said he does believe in a moral imperative to provide universal health care, though spreading the risk pool makes sense financially as well.

That pragmatic streak makes Jim Kessler, vice president for policy at the progressive Washington-based think tank Third Way, predict that Mr. Altmire and his fellow Blue Dogs will come into the fold and support a reform bill.

"With the Blue Dogs, they are going to be listening very carefully to the President's speech," Mr. Kessler said. "And in my organization's dealings with the Blue Dogs, I think about two-thirds are inclined to support health care reform, especially if the public option is resolved to their satisfaction."

Mr. Kessler said he thinks that can be resolved with a so-called "trigger," in which the public option would take effect in a few years only if the private insurance reforms didn't meet certain benchmarks.

Robert Moffit, director for the center for health policy studies at the conservative Heritage Foundation, disagreed, saying the response shown at the town halls suggests the public option has been roundly rejected by the American people.

"If they cannot win the debate right now on the public option, why should we shut the debate down and then let them win the debate down the road by default?" he said of the proposed trigger.

Mr. Moffit said Democrats and Republicans can find common ground to provide insurance for working people who can't afford it, perhaps through a tax credit or voucher system. Next, he said, the federal government should provide assistance to states to come up with their own plans to make insurance cheaper while covering more people -- such as the different models used in Massachusetts and Utah.

Mr. Murphy, a Republican, said he is seeking common ground with Energy and Commerce Chairman Henry Waxman, D-Calif., but has been rebuffed so far. One idea would be to allow insurers to sell policies across state lines to foster competition, Mr. Murphy said. Another would be to allow people to purchase a very limited, and thus cheaper, plan, rather than the higher mandated minimum level of care in the House bill.

Mr. Murphy said he hoped the recess flare-ups prod legislators to return to Washington with an inclination to compromise.

"We have got to start working together," he said.

Rep. John Murtha, D-Johnstown, who does not serve on the committees wrangling with legislation, agreed that the bill must be carefully considered with price as a foremost concern. The nonpartisan Congressional Budget Office predicted in July that the measure would add $239 billion to the federal deficit over a 10-year span -- though Democrats' pay-as-you-go legislation enacted new accounting rules that disregard extra Medicare payments to doctors, resulting in a $6 billion surplus.

"We're going to pass this at some point, and we're trying to get costs under control," Mr. Murtha said, although he later added, "I'm not sure I can predict it can be passed this year."

The unquestioned effect of the August uproar and the widespread impact of a potential bill have prompted citizens to seek information and engage their representatives at an extraordinary rate.

Mr. Doyle said he is much more optimistic about having the public on his side now than in the first week of August during the first wave of antireform protests.

He said Democrats, though slow to respond, have been able to debunk some myths, such as the twisting of a provision about end-of-life counseling into a so-called "death panel" by some opponents of reform. Constituents are researching and dissecting the bill for themselves, Mr. Doyle said.

"An informed electorate, that's the best thing we can hope for in a democracy. ... At least people are interested. At least if they ask me the question I can give them the answer, which is a lot better than them not asking."