Congressional liberals are getting kicked in the teeth repeatedly on their way out of town for the holidays.

Are they getting a public health insurance option? No. Medicare buy-in? No. That jobs package? Not so fast. Don’t even ask about cap-and-trade.

A health care bill that is taking a sharp right turn has prompted a gag reflex among some liberals, but they may yet swallow it anyway at the urging of President Barack Obama.

Obama told the entire Senate Democratic Conference on Tuesday afternoon that “ideological purity cannot get in the way,— according to one Senate source, in a clear effort to sell the latest compromise to liberals even though it doesn’t have a public option or a Medicare buy-in provision.

“These aren’t small changes — these are big changes,— Obama said of the remaining legislation. “They represent the most significant reform of our health care system since the passage of Medicare.—

He added that the legislation includes measures that Sen. Tom Harkin, the liberal Democrat from Iowa, “has been a champion of for years.—

“What I told my former colleagues today is that we simply cannot allow differences over individual elements of this plan to prevent us from meeting our responsibility to solve a long-standing and urgent problem for the American people,— he said.

Later, White House Press Secretary Robert Gibbs rejected a call by former Vermont Gov. Howard Dean (D) to “kill— the bill.

“What people like Howard Dean wanted, what Members of the Senate and the House want now, is a mix of increased accessibility for the millions of Americans that go every day without the safety net of health insurance. What others in the Senate and the House want are ways that we can control and contain costs for health care,— Gibbs said. “Those are currently contained in the Senate bill.—

Obama told the Democrats they should not underestimate the ability of a government-sponsored health insurance exchange to create the kind of choice and competition that a public option was intended to achieve and said a Senate plan to tax high-cost insurance plans would hold most families harmless.

Senate liberals seemed mostly ready to go along with the latest bill, despite their misgivings, while some House liberals took a harder line.

The left wing spread its criticism around on Tuesday. Some hit White House Chief of Staff Rahm Emanuel as their deal-cutting nemesis.

Sen. Joe Lieberman (ID-Conn.) was sharply criticized for appearing to flip-flop on the Medicare buy-in and repeatedly threatening to bring down health care reform unless public competition for insurers was removed.

Senate Majority Leader Harry Reid (D-Nev.) took shots for not moving a bill to the floor months ago.

Despite the largest Democratic majorities since the 1970s, liberals are left with their top priority in the hands of Lieberman, a former Democrat who spoke at the Republican National Convention last year to endorse the presidential candidacy of Sen. John McCain (R-Ariz.).

A few Senate liberals, such as Sen. Roland Burris (D-Ill.), have yet to sign on to the bill.

More senior liberals such as Majority Whip Dick Durbin (D-Ill.) and Sens. John Kerry (D-Mass.), Jay Rockefeller (D-W.Va.) and Barbara Boxer (D-Calif.) essentially argued during a Members-only special caucus Monday night that the bill as it stands would constitute a victory for Democrats who have been attempting to reform the health care system for decades.

Burris, who has threatened to vote against any bill that does not include a public option, took to the floor immediately following Monday evening’s caucus.

“I am committed to voting for a bill that achieves the goals of a public option, competition, cost savings and accountability,— Burris warned. “I will not be able to vote for lesser legislation that ignores these fundamentals.—

House liberals ranged from resigned to outraged and were almost uniformly frustrated.

Judiciary Chairman John Conyers (D-Mich.) said Obama has been too easy on the banks and hasn’t pushed hard enough for another jobs package or for health care.

“The president keeps listening to Rahm Emanuel,— he said. “He doesn’t listen to— the Congressional Black Caucus.

As for the Senate health care bill, Conyers went through a list of defeats: “No public option, no extending Medicare to 55, no nothing, an excise tax, God! The insurance lobby is taking over.—

Rep. Anthony Weiner (D-N.Y.), who had crowed that the Medicare buy-in option for people ages 55-64 was better than a public option and would help lead to single-payer health care, seemed to throw up his hands in disgust.

“We’re reaching a breaking point,— he said. He also found Lieberman’s apparent flip-flops on the issue flummoxing and shrugged off a question about whether his comments prompted Lieberman to change his mind.

“Trying to divine the motivations of Joe Lieberman has been difficult even for those who know him well,— Weiner said. “The idea that my three or four sentences persuaded Joe Lieberman to reverse his position over the past decade to me is a bit of a stretch.—

House Democrats insisted they would not simply accept whatever the Senate sends to them, although the conference committee would appear to be overshadowed by the Lieberman threat.

Some are still pointing to reconciliation as a possible route to bypass filibusters and enact significant reforms.

Weiner noted that Democrats had said all along that reconciliation was a last resort. “Well, now it’s last resort time,— he said.

Most Senate liberals have said they realize that reconciliation is untenable, and the few still clamoring to use the restrictive rules have few friends in Senate Democratic leadership.

“Reconciliation is a very spare and thin process with limited opportunities. For example, no insurance reform [would be in the bill] if we do reconciliation,— Durbin said Tuesday on MSNBC. “We want to give American consumers the tools that they need to fight back against insurance companies.—

Talk like that only stoked liberal anger in the House.

“Since the Senate won’t use reconciliation, which only requires 51 votes, it doesn’t look promising for any real change,— said Rep. Raúl Grijalva (D-Ariz.), co-chairman of the Congressional Progressive Caucus. Grijalva said he would vote against the Senate bill unless the House is able to make significant changes in conference.

Rep. Peter DeFazio (D-Ore.), a leading liberal and transportation advocate, said the frustration keeps building in the House on dozens of issues.

“There is unbelievable frustration with the Senate,— he said. “The Senate is a graveyard. They could run the place with 50 or 51 votes, but they don’t want to hurt the club,— he said. “They are relying on people like Joe Lieberman, who was thrown out of the Democratic Party by the voters of his state, to tell the Democratic Party what its agenda is. That’s a very sad state of affairs.—

Rep. Lynn Woolsey (D-Calif.), co-chairwoman of the CPC, said Democrats could face trouble with their base if they don’t deliver. “Thirty percent of Democrats will not come out and vote if there is no public option in the health care bill,— she said. “What does that tell you?—

Keith Koffler, David M. Drucker and Jessica Brady contributed to this report.