WASHINGTON -- A key Republican wants President Barack Obama to consider a more incremental approach on health care when he addresses Congress next week, while Vice President Joe Biden said the administration is still pressing for "something substantial."

Mr. Obama has long held back on the specifics he wants in health-care-overhaul legislation. In a speech before a joint session of Congress on Wednesday, he is expected to flesh out some of those details, while stressing significant areas of agreement among lawmakers.

Iowa Sen. Charles Grassley, the top Republican on the Senate Finance Committee, said in an interview Thursday that smaller initiatives have a better chance for success than a sweeping plan.

"It's something I've heard from my town meetings," said Mr. Grassley, a key player in negotiations on health care who has riled the White House.

Activists on both sides were gearing up for the speech. Leaders of a liberal group of House Democrats sent a letter to Mr. Obama calling on him to reiterate his support for a new public health-insurance plan to compete with private insurers. They threatened to vote against any bill lacking a "robust public option."

Conservatives plan to run new advertisements on Tuesday arguing that Democrats' health proposals contain no guarantees to prevent government from rationing health care and creating long waits for treatment. Democrats said their bills wouldn't lead to rationing or longer treatment delays.

White House allies on Capitol Hill expect the president will scale back some of his ambitions, without going as far as Republicans such as Mr. Grassley are seeking.

Backing away from the idea of a public-insurance plan could help win support from Republicans, who oppose the idea, and moderate Democrats, who have expressed concern about it. But it would irk liberals, including key backers such as labor unions, who call it a critical means of ensuring that all Americans can buy affordable health insurance.

Mr. Biden said he remains confident, despite a bruising August. "It's going to be an awful lot of screaming and hollering before we get there, but I believe we're going to get there," he said after a speech in Washington Thursday.

Democrats' health proposals would require nearly all Americans to carry health insurance, with exemptions for those who can't afford it. White House allies are watching to see whether Mr. Obama calls for a scaled-back version of that mandate.

During last year's presidential campaign, Mr. Obama opposed then-Sen. Hillary Clinton's proposal for such a mandate, arguing that it would burden low-income families. In June, Mr. Obama acknowledged that Congress was moving toward adopting a mandate, and indicated that he was open to it as long as the government granted hardship waivers to people who can't afford insurance.

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