House Majority Leader Steny H. Hoyer promised Thursday that he would put a health care overhaul to a vote in the 111th Congress, even if the economy continues to falter. But he did not commit to action this year.

The Maryland Democrat also said that he wants to overhaul the government’s big entitlement programs — Medicare, Medicaid and Social Security — as part of any plan.

Hoyer’s remarks came in a rousing speech to a friendly audience of liberal health advocates, gathered in Washington for a conference sponsored by the left-leaning health advocacy group Families USA. In contrast, Sen. Charles E. Grassley , R-Iowa, told the same audience earlier in the morning that the economy could affect the breadth and success of any health care overhaul effort.

President Obama won office last fall on a promise that he would lead an effort to overhaul the health care system in a way that would guarantee coverage to every American and reduce the spiraling costs of care. Even before he took office, Democratic lawmakers in both chambers were scrambling to lay down their own proposals and promising to advance them quickly this year.

But since taking office, Obama has had to focus on the economic recession, and momentum for comprehensive health care action is slowing. Instead, Democrats are pouring money into existing programs through the economic stimulus package and moving to expand the State Children’s Health Insurance Program.

Leading lawmakers in both chambers, including Rep. Pete Stark , D-Calif., and Sen. Max Baucus , D-Mont., the Finance Committee chairman, now say comprehensive health care legislation could slip into next year.