U.S. President Barack Obama accused insurance companies of placing profits over people and said Republicans ignored long-festering problems when they held power as he sought to build support Monday for swift passage of legislation stalled in Congress.

“Let's seize reform, the need is great,” Obama said at an appearance in Glenside, Pennsylvania, that had the feel of a campaign rally.

“How much higher do premiums have to rise before we do something about it?” said President Obama, making the first in an expected string of out-of-town trips to pitch his plan to remake the health care system.

The president said dismissively that Republican critics in Congress say they want to do something about rising health care costs, but said they did not when they held power. “You had 10 years. What happened. What were you doing?” he said to applause from an audience at Arcadia University.

President Obama made his appeal as Democratic leaders in Congress worked on a rescue plan for sweeping changes in health care that seemed earlier in the year to be on the brink of passage. The two-step approach calls for the House to approve a Senate-passed bill despite opposition to several of its provisions, and both houses to follow immediately with a companion measure that makes a series of changes.