WASHINGTON -- The head of the Health and Human Services Department is sketching out a stark choice for the nation's insurers: oppose reform and eventually lose customers, or work with the Obama administration to improve the legislation.

Secretary Kathleen Sebelius told health insurers Wednesday that if overhaul fails, premiums will continue to rise and employers will cancel coverage. She said the industry may make money in the short term, but it won't work for Americans and it eventually won't help insurers.

Sebelius urged the insurers to help create a sustainable market where all Americans could buy coverage. She said they should spend the millions that might go to attack ads on reducing the cost of premiums.

The White House released excerpts of her speech.