After an exhausting year of debating health reform, we have finally reached the home stretch. We are closer than we have ever been to affordable, comprehensive health reform. However, opponents of reform continue to do everything in their power to delay, mislead, and disrupt the process. While they may score short-term political points, I have to wonder if they know what is truly at stake.

Families USA recently released a special report, The Dangers of Defeat: The Cost of Failure to Pass Health Reform, which lays out what failing to pass health reform would mean for the future of American health care: rising costs, insurance insecurity, increasing budget deficits, and more Americans dying prematurely due to a lack of health insurance.

Between 1999 and 2008, average annual family premiums more than doubled, and without health reform, premiums are projected to increase to more than $22,000 per year for families. Most families are already struggling with the high cost of premiums; further increases will price more and more Americans out of their health insurance. Health reform will not only stabilize premiums, but according to the non-partisan Congressional Budget Office (CBO), the legislation will put the breaks on the sky-rocketing premium increases.

Without health reform, insurance companies will continue to deny coverage to people with pre-existing conditions and charge higher premiums based on gender and health status. Out-of-pocket costs will soar and more Americans will either be forced to file bankruptcy or join the ranks of the uninsured. If all of that isn't enough to convince opponents of reform, perhaps the 68 Americans who die every day because they don't have health insurance will open people's eyes to the dangers of failure.

Health reform is about controlling costs, regulating insurance companies, and providing security to the millions of Americans who have private insurance. But, above all, health reform is about making sure that no more Americans will lose their lives because they don't have health insurance. There are few moments in history when we stand on the brink of positively changing the lives of millions, but this is our moment and we must succeed.   

We may say it a lot, but it bears repeating one more time: We are closer than ever to enacting comprehensive health reform. So close, in fact, we can almost taste it over here at Stand Up for Health Care.

Unfortunately, not everyone is as excited about the prospect of passing health reform as we are.

No strangers to stall tactics, opponents of health reform have developed a habit of telling us to "start over" and "scrap the bill" instead of just compromising and forging ahead with the bills the Senate and the House have passed.

We need your help to tell Congress that health reform can't wait. We know it, you know it, and millions of uninsured Americans know it.

Our friends over at the American Cancer Society have created a really cool petition that we wanted to share with you. You can join us, the American Cancer Society, and a few other groups to tell Congress that Americans can't afford to wait for Congress to start over.

Congress has already spent months debating legislation. We've come way too far to just turn around and start from scratch.

Americans with pre-existing conditions need access to health insurance now. Families with rising premiums need to be protected from excessive rate hikes. Americans who fall between the cracks need a safety net during troubled economic times.

It's time for Congress to pass health reform once and for all-Americans simply cannot wait. And right now, millions of Americans are learning that lesson the hard way.

First, there were the highly publicized rate hikes in California. Then, the Department of Health and Human Services released a report detailing rate hikes in several more states. And then there was WellPoint, who joined the club last week by jacking up premiums in 11 states.

Doesn't it seem like we should have hit rock bottom by now? That insurance companies couldn't stoop any lower by continuing to increase their profits while gouging their customers? Well insurance companies in Illinois sure don't seem to think so. This week, they announced that they too would be raising premiums for Americans in the private market, who are often already in a financial bind.

According to the Chicago Tribune, customers in Illinois can expect a rise in premiums up to 60% in the private individual market.

These are people who have no option to buy anything except individual insurance. Due to the recession, they have either lost their job, or are purchasing insurance in the individual market because their employer has decided to drop coverage. They are paying the full cost of any increases in their premiums, because they do not get help from an employer to pay for their coverage. Any of us could end up in this situation.

The Tribune notes that the rise in premiums is just for base rates; rates that,

"do not take into consideration health status, gender, age, place of residence and length of a policy -all factors that could raise premiums further."

Health reform will hold insurance companies accountable by keeping them from dropping those who are sick, and from spending less on care, and hiking premiums while still maintaining high profits. Without reform, premiums will just continue to go up.

When will the opponents of health reform finally join the American people in saying "enough is enough"?

How many more rate hikes do they need as proof that costs are out of control, and insurance companies need to be held accountable? How many more Americans need to die because they don't have access to affordable health care?

We believe that we can't wait any longer -these outrageous rate hikes have got to go. And we need opponents of reform to stand with us, not with the insurance companies.

P.S. Families USA has a new report available about holding health insurance companies more accountable for your premium dollars. Click here to read it.

The fight over health reform has reached a fevered pitch, but between all the arguing over process and the lies and distortions that have been thrown around by the opposition, the true meaning of reform seems to have been lost: People's lives are at stake.

Families USA has released a new report, Lives on the Line: The Deadly Consequences of Delaying Health Reform, which examines the consequences of Congress failing to act on health reform not only in the future, but also the negative impact past inaction has had on the lives of growing number of people who lack insurance coverage.

In 1994, the number of uninsured was 40 million. Today, as a result of Congress's past inaction, that number has soared to nearly 50 million. Looking forward, without reform that number will grow by an estimated 1 million a year. But just looking at the number of uninsured does not give a true picture of what it means to lack health insurance coverage.

Those who are uninsured are more likely to be burdened with medical debt and unable to afford the cost of care. As a result, many forgo routine preventive care or worse, when they're sick, they may choose not to be treated at all. What does this all mean? Thousands of Americans are dying prematurely. The numbers are staggering: Since the end of 1994, more than 294,000 American adults (25-64 years old) died prematurely due to a lack of health coverage. And it will only get worse. If Congress fails to act now, a projected 275,000 Americans will lose their lives by 2019 due to a lack of coverage.

Every day in 2010, approximately 68 non-elderly Americans died too soon because they lacked health coverage. These are people who died because they couldn't get preventive care and were diagnosed with an illness too late to treat, or who could have treated their illness but due to their lack of coverage, simply couldn't afford proper treatment. That is reprehensible, and shouldn't be happening in the wealthiest nation in the world. What's worse, if Congress fails to act now, that number will only continue to grow, and by 2019, 84 people will die prematurely every day because they do not have health coverage.

The numbers alone should be enough to shock Congress into action. However, the real tragedy is that these are not just statistics; they represent someone's mother, father, sister, cousin. These are real people being harmed by Congress's inability to see past the politics and do what's right for the American people.

We can no longer wait. Delaying action on health reform will have deadly consequences. The time to act on health reform is now; no one else should have to die.

If I learned anything from the Summit last week, it was this: Democrats and Republicans agree that denying health coverage to people based on pre-existing conditions is wrong and should be stopped. However, while the Democrats' plan will ban insurers from these pre-existing condition exclusions, the Republican plan does not. Why doesn't the rhetoric match the policy?

Well, under House Minority Leader Boehner's plan, people with pre-existing conditions could get coverage in high-risk pools. These pools offer a safety net for people who are uninsurable in the private market. Unfortunately, high-risk pools aren't quite the "silver bullet" Republicans would have us believe they are. Without a large number of healthy people in the pool, premiums are much higher for policies sold to healthy people in the open market. In fact, according to Jonathan Cohn's recent article,

Premiums in the high-risk pools are anywhere from 125 to 200 percent of standard premiums.

How can the Republicans claim to care about people with pre-existing conditions while forcing them to pay double for their health insurance premiums?! High-risk pools are a good way to get people with pre-existing conditions some immediate security until the insurance exchanges are up and running, but in the long run, high-risk pools mean separate and unequal.

For Cohn, coverage offered in high risk pools,

ends up as second-class insurance, which really shouldn't be acceptable unless you think the people in them are second-class Americans.

I don't. That's why I'm ready for comprehensive health reform that will produce results, not rhetoric.

A recent Kaiser Poll showed that while Americans are split on their support for the health care legislation in general, they are very supportive of individual aspects of the legislation. The logic then follows-to generate more support among those that are wary, we need to be clear about the all of the protections and benefits Americans will receive with health reform.

Families USA has outlined a dozen excellent reasons why every American should support reform in their new piece, 12 Good Reasons to Embrace Health Reform.

Here are the reasons. Health reform will:

1.      Guarantee that every American has access to high-quality health coverage, regardless of age, gender, or health status.

2.      Create a new, regulated marketplace where people can shop for the health insurance plan that best meets their needs.

3.      Ensure that all Americans have access to stable, high-quality health coverage, no matter where they work.

4.      Place limits on out-of-pocket costs so that Americans have real health security and peace of mind.

5.      Hold insurance companies accountable for how premium dollars are spent, requiring that a majority of the money they collect is spent on patient care.

6.      Clamp down on insurance company abuses, protecting consumers against losing their coverage when they need it most.

7.      Provide sliding-scale subsidies to make health insurance premiums affordable for hard-working, middle-class families.

8.      Extend much-needed relief to small businesses, easing the burden of high health care costs.

9.      Protect access to care to health coverage for young adults by requiring that insurers allow all dependents to remain on their parents' plan through age 26.

10.    Expand Medicaid to millions of low-income working families who currently fall through the cracks.

11.    Improve Medicare by helping seniors and people with disabilities to afford their drugs and preventive care by making Medicare fiscally secure.

12.     Implement long overdue steps to invest in preventive care, improve the quality of health care overall, and curb unnecessary health care spending.

Read the piece to get more detail about why these changes are needed and how they will help the public. With all the misinformation in the media, it's important to bring the focus of the health care debate back to why reform is vital, and to make these reasons clear to health care consumers across the country.

After last week's bipartisan Health Reform Summit, it seems pretty clear that many Republicans are unwilling to help move health reform forward. So what options do Congressional Democrats have? The most likely course of action is to pass the bill through reconciliation. The process would begin with the House passing the current Senate bill, which would then be signed into law by President Obama. Then both bodies would begin the process of passing an amended health reform bill, which has yet to be seen, through both the House and the Senate through the reconciliation process. This is the preferred method as it only requires a simple majority (51 votes) in the Senate and would avoid the inevitable filibuster by Republicans who oppose reform.

Seems pretty simple, right? Not quite. As I'm sure you've seen, read, and heard, opponents of reform are against this option. Many Republicans have been openly criticizing the Democrats for even considering using reconciliation on health reform. According to Orrin Hatch (R-UT), "[t]he use of expedited reconciliation process to push through more dramatic changes to a health care bill of such size, scope, and magnitude is unprecedented."

Not surprisingly though, Senator Hatch's statement is inaccurate both in that reconciliation has been used in the past to pass comprehensive legislation and it has been used to pass health care legislation. Further, many of the bills passed via the reconciliation process were supported by a Republican Administration, Congress, or both. Seems a bit ironic that they're crying foul now...

In light of recent criticism, Families USA released a special report documenting previous support for the reconciliation process by past Republican leaders as well as Republican leaders currently serving. Given their latest course of attack, it's pretty shocking. Not only has the reconciliation process been used to enact major, consequential laws such as welfare reform, but since it was enacted in 1980, 19 reconciliation bills have been enacted into law. Of those 19 bills, 14 of them were signed by Republican Presidents. Further, current Republican leaders have consistently voted for - and supported - reconciliation bills. According to the report, several of the current leading Congressional Republicans, like Senate Minority Leader Mitch McConnell and Senate Minority Whip Jon Kyl have voted for reconciliation bills numerous times in their past.

But what pokes even more holes in the Republican's argument is that not only has reconciliation been used by Republicans numerous times in the past, but it has been used on health care legislation many times before. The reconciliation process was used to create COBRA, the law that helps you keep your employer's insurance after you leave your job. According to Sara Rosenbaum, who chairs the Department of Health Policy at George Washington University:

"The correct name [for COBRA] is continuation benefits. And the only reason it's called COBRA is because it was contained in the Consolidated Omnibus Budget Reconciliation Act of 1985; and that is how we came up with the name COBRA, COBRA..., was actually a much larger bill."

But COBRA wasn't the only health care legislation passed through the reconciliation process. Reconciliation was used to expand insurance coverage for low-income children as well as to make several major changes to Medicare. So it's hard to agree when Republicans claim that the reconciliation process has never been used on such major or expansive health care legislation like the health reform bill, because-simply put-it has. According to Sara Rosenbaum:

"[L]iterally we've changed everything about insurance coverage for children and families, and we've changed access to health care all across the United States all as a result of reconciliation."

Regardless of what lies and misinformation the opposition wants to continue to throw out, the bottom line is that it's time to finish health reform. As President Obama stated in his Saturday radio address:

"The tens of millions of men and women who cannot afford their health insurance cannot wait another generation for us to act. Small businesses cannot wait. Americans with pre-existing conditions cannot wait...It is time for those of us in Washington to live up to our responsibilities to the American people and to future generations."

If reconciliation is the way for them to bring affordable, quality health care to all Americans, then it sounds good to us. 

The news of WellPoint's Anthem Blue Cross Blue Shield hiking up premiums for its customers in California by 39% made waves across the country, and many other of WellPoint's affiliates will soon follow suit.

California consumers are not alone as they face huge premium hikes. Other consumers in states across the country also will see rate hikes from WellPoint this year. According to the Center for American Progress,

In fact, double-digit hikes have been implemented or are pending in at least 11   other states among the 14 where WellPoint's Blue Cross Blue Shield companies are active: California, Colorado, Connecticut, Georgia, Indiana, Maine, Nevada,           New Hampshire, New York, Virginia, and Wisconsin.

This means that families who are already struggling to pay for their health costs will have to dig a little deeper to afford premiums.

Although WellPoint claims that they will increase rates to make up for lost costumers, they are still making huge profits. According to the Center for American Progress, the company in 2009 made $4.7 billion in profits.

Why does a company that is making huge profits need to raise insurance rates up to 50% on their costumers?

The answer to that question may not be clear. But we do have a solution to begin fixing the problem: health reform.

The bills already passed by both the House and Senate-and in the President's proposal-include rules that will give states and the federal government authority to ask insurance companies to justify high premium increases. If an insurance company isn't spending a specified portion of premium dollars on health care expenses, then the company will have to provide a refund to consumers.

Health reform will help to balance the relationship between consumers and insurance companies in the marketplace-no longer will insurance companies have all the power.

Last week, a few of my colleagues and I had the honor of meeting up with a group of 10 dedicated health care activists from Philadelphia Unemployment Project and Pennsylvania HCAN who were finishing up the last leg of a 150 mile march from Philadelphia to Washington, D.C. Melanie's March, named after an avid health reform activist, Melanie Shouse, who recently passed away from breast cancer, sought to show legislators just how urgently we need health reform.

We began the march, bright and early in College Park, Maryland. Along the way, marchers told us stories of the support they received throughout the past eight days. One driver stopped to tell them that she had three adult children, all uninsured, and God bless them for what they were doing. Then there were also the countless honks and cheers they heard as they walked, and walked, and walked. Even in the few short hours that we walked, we came across numerous drivers and pedestrians who all supported our cause as well as people who wanted to tell us their health care stories. As we marched to the Capitol, not only did we know we had the support of the American people behind us, but we knew that they needed this reform now more than ever.

We marched through D.C. and ended up at Union Station, where we were met by over 200 activists ready to march to Capitol Hill to tell Congress to finish health reform now and finish it right! Before we left Union Station, we handed out 1,000 carnations in honor of the number of people who had died during the eight days of the march due to lack of health insurance coverage.

As we left the center circle of Union Station and made our way over to the Dirksen Senate building, we were surrounded by chants of "What do we want - heath care! When do we want it? NOW!" that resounded throughout Capitol Hill. We were pretty hard to miss, which couldn't be better. Everyone working in those buildings needed to know that it was time to finish health reform, and there were a lot of loud, angry Americans who were ready to tell them why.

We were then joined by a group of inspiring speakers that included Senators, Representatives, leaders in the health reform community, and most importantly members of Melanie Shouse's family as well as those who have suffered at the hands of our broken health care system.

Senate Majority Leader Harry Reid (D-NV) opened up the event with friends and family of Melanie Shouse. He made it clear where he stood on health reform by saying, "Health care is not about political parties fighting with each other, it's about people fighting for their lives." He was followed by key members of the Senate Health, Education, Labor, and Pensions (HELP) Committee: Senator Arlen Specter (D-PA), Senator Chris Dodd (D-CT), Senator Tom Harkin (D-IA), and Senator Bob Casey (D-PA). Senator Harkin, the Chairman of the HELP committee, mirrored Senator Reid's remarks stating:

"People always talk about the dollars and cents [of health reform]... It's time to get down to the nub of it. The fact that we have 45 million uninsured people is a moral blight on our nation!"

Senator Reid and the Senators from the HELP committee were followed by many other moving speakers like Senator Sherrod Brown (D-OH), Representative Rob Andrews (D-NJ), Andy Stern of SEIU, and Ron Pollack of Families USA who got the crowd going with chants of "Yes we WILL!"

But by far, the most poignant speakers were those who were there to tell their own health care story like Regina, from right here in Washington, D.C., who had to watch her husband die from kidney cancer, caused by a minor urinary condition that could have been fixed by an elective surgery. But because neither of them had insurance, not due to unemployment, but due to the wrong employment, her husband never received care until it was too late. And even when he was hospitalized, because he was uninsured, they wouldn't even let him pass comfortably in a hospital, under the care of a doctor. He was sent home to die.

Or Marcus, who was a teacher at a charter school and could no longer afford to pay his premiums after they were raised $300. Like millions of Americans, he took a gamble and went without it. Marcus is diabetic, but he thought he was healthy enough, that he'd be okay, but he was wrong. Marcus lost his vision. Though the vision loss was reversible by surgery, the surgeon needed a $3,000 down payment. Marcus did not have that kind of money, and with no insurance, he was unable to get the surgery. Now, he is permanently blind and on disability. Ironically, the government will have to pay millions over the course of his life for his care, just because he couldn't afford to get insurance that would help him pay the $3,000.

These people are the reason we must continue to fight. These people are the reason Congress must continue to fight. As the Congressmen who visited us Wednesday left, we hope they took Melanie's, Regina's, and Marcus's stories with them along with the knowledge that there are millions of Americans just like them who need them to finish this job and bring health reform across the finish line once and for all.

After all the questions and anticipation surrounding yesterday's health care summit, it was finally here! Congressional leaders and President Obama had a unique opportunity to discuss health reform and, for the most part, move beyond popular talking points toward a substantive discussion of what's really in health reform. Despite moments of honest debate, Republicans tended to revert back to those tried-and often untrue-scare tactics about health reform. I'd like to set the record straight on some misinformation presented at the summit.

1. We should "start over on a blank sheet of paper" and take baby steps to reform health care.

Unfortunately, doing one reform at a time will actually make things worse. For example, prohibiting pre-existing conditions without expanding coverage will result in sicker and older people enrolling in coverage, while younger and healthier people drop coverage until they get sick, causing premiums to skyrocket.

2. The Senate-passed health reform bill will raise premiums.

The bipartisan, independent Congressional Budget Office (CBO) states that premiums will actually be lower under health reform. While a few plans offered in the individual market will have higher premiums, the savings in lower out-of-pocket costs and premiums subsidies will more than offset these increases.

3. Selling insurance across state lines will lower premiums and give consumers better choices when shopping for insurance.

Selling insurance across state lines without any consumer protections would allow insurance companies to get around state regulations by locating their headquarters in the state with the fewest consumer protections, and then selling policies in other states without having to comply with their rules and protections. This could lead to a "race to the bottom" where insurers are competing to sell the LEAST comprehensive policies to consumers.

4. The health reform bills and the President's proposal will cut benefits in Medicare.

Health reform will actually use savings gained from stopping overpayments to insurance companies in the Medicare Advantage program to improve benefits in Medicare and close the prescription drug "doughnut hole." Health reform will stop these kick-backs to insurance companies and instead focus on improving Medicare for seniors.

5. We can't afford to do comprehensive health reform.

We can't afford NOT to pass health reform. Health care spending is a huge burden on federal and state budgets, and the economy; these costs will continue to rise without health reform. The proposals before Congress will not only help bring these costs under control, but they will actually lower the federal deficit by more than $150 billion over the next ten years.

6. This process has been too rushed; we should slow down and take our time.

Take our time?! Congress has been carefully preparing this legislation for a year (not to mention the last 50 years)-they've had hundreds of bipartisan hearings, discussions, and long mark-ups to construct these bills. It's not time to slow down; it's time to finish the job.

Passing comprehensive health reform is too important to waste time perpetuating misinformation that might poll well, but doesn't solve our nation's problems. It's time to stop playing politics and start getting serious about passing affordable, comprehensive health reform.

The beltway has been abuzz ever since President Obama announced he plans to hold a Health Care Summit between key Congressional leaders. Will Republicans attend? Will President Obama provide a health reform proposal? Will the Republicans provide their own proposal? If they do provide a proposal, will meet the criteria of meaningful health reform?

Today, at least one of those questions was answered when the White House released, The President's Proposal, which incorporates the work that the House and the Senate have done and adds additional ideas from Republican members of Congress.

President Obama adhered to his key priorities when mapping out his proposal, which include ensuring affordable, accessible coverage; security; and reducing the deficit. The proposal made targeted changes to the Senate-passed health reform bill, pulled key elements from the House-passed health reform bill, and included new provisions to crack down on waste, fraud, and abuse.

Some of the key changes include:

• Strengthening "rate review," which ensures that if rate increases is unreasonable or unjustified, health insurers must lower premiums, provide rebates, or take other actions to make premiums more affordable. A new Health Insurance Rate Authority will be created to provide oversight at the Federal level and hopefully prevent any more absurd rate hikes like we saw recently in California and other states.

• Improving affordability of health care by increasing the premium subsidies as well as the cost-sharing subsidies for families low- and middle-income families and by strengthening protections from high out-of-pocket costs under insurance plans.

• Creating a nationwide Medicaid income eligibility standard of 133 percent of the federal poverty level (individuals and families above 133 percent will be eligible for premium subsidies for private plans sold in state exchanges).

• Strengthening provisions to fight waste, fraud, and abuse in Medicare and Medicaid;

• Increasing the threshold for the excise tax on the most expensive health plans from $23,000 for a family plan to $27,500, starting in 2018 for all plans.

• Eliminating the Nebraska FMAP provision and providing uniform Federal financing to all states for the expansion of Medicaid. Starting in 2014 and going through 2017, states will receive 100% Federal support for newly eligible individuals. In 2018 and 2019, states will receive 95% support, and in 2020 and subsequent years, 90 percent.

• Closing the Medicare prescription drug "donut hole" coverage gap.

With this proposal, President Obama has bridged a gap between the House and Senate bills. He has made key changes to both bills, taken strengths from each bill and created new elements to reduce waste and protect consumers. Early reactions show that key Congressional leaders are pleased with President Obama's actions. This morning House Speaker Nancy Pelosi released a statement in response to the President's Proposal. She said:

The President today made available to all Americans the Administration's health insurance reform proposal, which contains positive elements from the House and Senate-passed bills, I look forward to reviewing it with House Members and then joining the President and the Republican leadership at the Blair House meeting on Thursday.

She finished her statement with,

We must pass comprehensive, affordable health insurance reform, and I am hopeful that Thursday's meeting will help us achieve this goal.

Let's hope everyone goes into the Blair House with such a positive attitude-the American people deserve it.

If the news of impending premium hikes in California wasn't enough to convince you of the urgency of passing health reform, then the news that insurance companies in at least six other states (and counting) have proposed dramatic rate increases as well should shock you into the realization that the time for reform is NOW!

Health and Human Services Secretary Kathleen Sebelius released a report yesterday that details recent proposed rate increases in Connecticut, Maine, Michigan, Oregon, Rhode Island, and Washington as well as record profits by the nation's top insurance companies and their CEOs. According to the report, the one of the worst offenders requested a rate increase of 56 percent for plans sold on the private market in 2009!

What makes these requests even more offensive is that even though health care costs have increased, the report found, "some of the premium increases requested by insurance companies are 5 to 10 times larger than the growth rate in national health expenditures."

Further, many of these companies are certainly not hurting for profits:

"[P]rofits for the ten largest insurance companies increased 250 percent between 2000 and 2009, ten times faster than inflation"

Unfortunately, what happened in California and these other states aren't isolated incidents. Without comprehensive health reform, insurers across the country will continue their assault on consumers unabated, with "rate increases of 20, 25, [and] 30 percent."

Insurance companies should not be allowed to enforce unjust rate hikes on families who are already struggling to deal with a recession and rising health care costs. While a few states have meaningful health insurance rate review mechanisms, the vast majority don't.

Comprehensive federal reform will establish standards for strong premium rate review in every state with opportunities for consumer input, rules that require insurance companies to spend a reasonable percentage of premium dollars on health care, and the authority to give a refund to consumers who are overcharged. 

The HHS report could not be more on point, stating:

"These massive increases are disturbing examples of the problems that make reforming our health insurance system more important than ever."

Hopefully Congress will listen.

P.S. If you've encountered rate hikes in the past few months, let us know in the comments secion below!

Despite the recent epic snowfall in D.C., our congressional leaders and President Barack Obama have continued to work towards a compromise on the health reform bills, in hopes of finding a way to move it across the finish line. Unfortunately, reform has not come quickly enough for many people in California.

Anthem Blue Cross of California recently informed  many of their approximately 800,000 customers who buy individual policies that they will see a sharp rate increase in the coming months. According to the Los Angeles Times, some individuals were told to expect a rise as large as 39 percent, and this on top of past rate hikes!

To say this is unfair to policyholders would be an understatement, especially since WellPoint Incorporated, Anthem's parent company, made a profit of $2.7 billion in the last quarter of 2009. Luckily, officials at both the state and federal level took notice of Anthem's dramatic rate hike and took swift action to investigate-and hopefully halt-the increase.

California Insurance Commissioner Steve Poizner announced that he will hire an independent actuary to scrutinize the planned increase, and both the House Energy and Commerce Committee  and Health and Human Services Secretary Kathleen Sebelius launched inquiries.

Anthem cited the economy and the rising health costs as explanation for the dramatic rate hike. But, as Jonathan Cohn explains,

"[t]his is not, to be clear, just another story of medical care getting more expensive because of technology, over-treatment, monopoly pricing, or any of the other familiar drivers of system-wide costs."

According to Cohn, WellPoint's medical expenses rose by only around 9 percent this year, well below the increase expected by inflation. Further, Anthem claimed the economy is forcing many young and healthy individuals to either drop coverage or forgo buying it altogether, resulting in higher premiums for everyone else. If this is the case, there couldn't be a stronger argument to reform our health care system to one in which everyone is offered affordable, quality insurance that they can maintain. The health reform bills currently being debated would create such a system.

Amidst pressure from consumer advocates, Commissioner Poizner, and even President Obama, Anthem Blue Cross announced late last week that they were delaying the rate hikes. This is a step in the right direction, but a delay simply means the rate hike will be put off until another day, and consumers will still have to shell out higher prices for the same coverage.

Health and Human Services Secretary Kathleen Sebelius put it best in her response to Anthem's explanation for their rate increase:

"Without comprehensive reform, fewer people will be able to afford health insurance and Anthem's decision to raise their rates only demonstrates the urgent need for real reforms that fix our broken health insurance system. Reform will end the worst insurance company practices and put doctors and patients-not insurance companies-in charge of medical decisions. If we fail to implement reform, insurance companies will continue to prosper while families will continue to struggle."

In order to protect consumers, to protect the American people, we must finish health reform.

Sometimes you have to hit the streets to make a difference. And sometimes, you have to go a bit further. We're not talking about the usual suspects, like protesting or a two-hour march. We're talking about huge march across three states that will urge Congress to finally push health reform over the finish line.

Starting in Philadelphia on February 17^th, hundreds of people will begin the 150-mile march, which will end on Wednesday, the 24^th at a major event in Washington, D.C. On the way there will be stops in Wilmington and Baltimore to drum up support for health care reform.

The event, March to the Finish Line for Melanie, is in honor of Melanie Shouse, a health reform advocate who recently lost her battle with breast cancer. When she was diagnosed with cancer, she couldn't find health insurance-a story all too common in our current system. She campaigned for President Obama, and in the past year has fought hard, not only against her cancer, but for every American's right to quality, affordable health care.

So join our friends from Pennsylvania to march in Melanie's honor.

Anyone can get involved. Whether you want to march the whole 150 miles or just 500 feet, click here for the details.

After 4 years of hard work, the day finally came for me to get my college diploma. Though I was proud of my accomplishment, I knew that the second I received my diploma, I lost my health insurance. After commencement, there was a long period of time when I was without coverage. Unfortunately, this is not uncommon. My fellow classmates and other graduating students across the country began their lives in the "real world" without insurance.

As a group, young adults have been largely ignored in the health reform debate, even though they have the most gain. According to the Kaiser Family Foundation,

Young adults, age 19 to 29, have the highest uninsured rate of any age group in the United States. Members of this age group comprise 30 percent of the overall uninsured population.

Whether it is because of a recent graduation, moving, finding a new job, or having to wait for employer benefits to kick in, young adults are at high risk of financial devastation if they become sick.

The Kaiser Family Foundation report goes on to explain how health reform could help this vulnerable population. By providing more affordable coverage in the private market, more young people would be able to purchase coverage. Furthermore, by allowing children to stay on their parents' insurance until 26 or 27 gives young adults a cushion as figure out where and how to get their own coverage.

I wish I had the protections that either the House or Senate bill offers young adults. I rolled the dice and went without coverage for a long time, and luckily made it through unharmed. Many other "young invincibles" are not so lucky. 

A year ago, President Obama signed the Children's Health Insurance Program Reauthorization Act (CHIPRA) into law. As we look back on the impact of this new legislation over the past year, it is obvious that we have much to celebrate. CHIPRA made vast improvements to kid's coverage and access to care. Specifically, it:

• Significantly increased the funding states receive for their CHIP programs.

• Improved the CHIP benefits package by requiring dental coverage and mental health parity.

• Addressed racial and ethnic health disparities by investing in improved outreach, interpretation, and translation services.

• Simplified enrollment by allowing state to accept an income determination from another state agency.

Organizations across the country are hosting events to commemorate this momentous occasion. Additionally, Secretary of Health and Human Services, Kathleen Sebelius, released a report marking CHIPRA's one-year anniversary that highlights the tremendous achievements states have made over the past year.

As we reflect back on CHIPRA's accomplishments, it is important to remember the critical role that CHIP played as a safety net over the past year. As the recession deepened, and more people lost their jobs and their health insurance along with it, families were able to rely on CHIP and Medicaid to protect the health of their children and shelter them from this economic storm. Thanks to President Obama and Congress' commitment to children's health, millions of families were able to find affordable coverage for their kids. 

However, even with all the gains states have made with kids coverage over the past year, there is still ground left to cover. 

Nearly 5 million kids nationwide are eligible for Medicaid or CHIP but remain uninsured.  All over the country advocates and state legislators are getting to work to find new strategies to get these kids enrolled. What's more, Secretary Sebelius and Secretary of Agriculture Tom Vilsack are teaming up on a new initiative to ensure that every child has access to affordable health insurance coverage. With all these new efforts, it's clear that by the time CHIPRA turns two, we'll have even more to celebrate!

It may seem obvious, but these days it's necessary to say: Health reform will help Americans across the country.

If Congress passes reform, people with pre-existing conditions will be able to get insurance, those who are sick will not lose care, seniors will not have to worry about the ‘doughnut hole' anymore, and young people will be able to stay on their parents' plans longer.

One issue that almost every American struggles with is skyrocketing costs. As costs continue to soar, and more people are priced out of coverage, it's become more and more apparent that the status quo is simply unsustainable.

Case in point: According to a new study by Bucks' Consulting 21^st National Health Care Trend, costs will continue to surge. In 2010, health care costs for all type of plans will increase over 10% across the board.

According to Health Populi,

The double-digit cost increases that Buck Consultants expect are over twice the rate of general inflation in the U.S. expected in 2010. Thus, the marketplace isn't nearly moderating health costs on its own without the influence of health reform.

Simply put, American families and business will pay even more each year for health care if Congress fails to pass reform. Health care will become increasingly less affordable, thus leading to heavier burdens on businesses and families throughout the country, and growing numbers of people without health coverage.

We've seen what happens with the status quo, and we've seen a preview of what costs will look like down the road. We cannot stop these skyrocketing costs without reform. Americans are waiting.

Did you know that over 4 million people in this country were born with a right to health care? Through treaties, American Indians and Alaska Natives were guaranteed the right to health care and protection from the United States government in exchange for land.

Shockingly, though they are born with this right, according to a recent Kaiser Family Foundation paper, American Indians and Alaska Natives (AI/AN) have the worst health outcomes for preventable conditions compared to other racial and ethnic groups; a higher percentage of AI/AN people live with more than two chronic conditions than other groups; and AI/AN adults have the highest rates of some health conditions, such as diabetes and obesity. In addition, on average, they are dying 10 years earlier than the general population, according to Donald Warne, the Executive Director of the Aberdeen Area Tribal Chairmen's Health Board.

At the American Indian Health Policy: Where We're Going workshop at our Health Action conference, Donald Warne, along with Jennifer Cooper of the National Indian Health Board and Cara Thunder of the American Indian Community House emphasized that the unique issues facing the American Indian and Alaska Natives are often ignored and have not been a focus in the health care reform debate.

But Indian issues should be a focus of the health care reform. One of the most pressing issues is that the Indian Health Service, the agency responsible for providing care for the AI/AN population, is significantly underfunded and cannot provide quality care. As Donald Warne pointed out in his presentation, IHS gets only $2,130 per person per year, compared to Medicare, which receives over $7,000. 

There are things you can do to help in their fight for health care equity. For one, support the current health care reform efforts. The Senate bill renews the Indian Health Care Improvement Act (IHCIA), which authorizes the appropriation of funds towards American Indian and Alaska Native health. It also focuses on eliminating health disparities, attracting Indian health care professionals to programs, and providing more efficient delivery of health care services. IHCIA is vital to the health of American Indians and Alaska Natives.

Another important thing you can do to help is to educate yourself about the unique problems facing American Indians and Alaska Natives, and share what you learn with others. Spreading awareness of these issues is vital to American Indian and Alaska Native health becoming more of a priority for our legislators.

As the health reform debate rages on, proponents of reform are finding it more and more difficult to find effective messaging against the opposition. Lucky for the attendees of Health Action 2010, we were able to attend the workshop "Messaging Challenges for States," where we were provided effective messaging tips to help advocates effectively address health reform implementation and connect with the public.

As many health care advocates, and any one paying attention to the debate, know, the biggest challenge to convincing the public of the benefits of health reform is the public's general distrust of government. But how do we overcome this distrust, especially when the opposition is working so vigorously to spread this message with lies like, "health reform is a government take-over of medicine" and "the government is trying to get between you and your doctor!"

Here are some helpful tips to take back the debate and win over the public:

• Be proactive and take back the health reform discussion - make the opposition explain why they don't want reform

• Explain the bill. People like the bill, they just don't truly believe the policies will be implemented. Break down the bill for them, and make it easy to digest.

• Story telling. Bring real stories to the public. Not only show them how our broken system has hurt their friends, families and neighbors, but also show them how reforms that have already been implemented, like CHIPRA or the extended COBRA, have helped people.

• Respond effectively to the opposition. This can be especially effective for people who are on the fence, and not sure whether or not reform is good for them. A strong response can sway them.

• Respond to fears created by the opposition.

Jim Duffett from Campaign for Better Health Care, Illinois, Cynthia Zeldin, Georgians for a Healthy Future and Jeffrey Liszt, Anzalone Liszt Research also spoke. Jim and Cynthia gave us a state perspective and explained what they were doing in their communities to get an effective message across. Both were using traditional approaches as well as taking innovative approaches to tried and true methods. For instance, to ensure that the Illinois legislature is on message with reform, Jim Duffett and his group have put together a resolution that reinforces the benefits of the health reform bill and the need to embrace the bill after it passes and implement its policies.

Although we still have a few tough battles ahead of us in the fight over health reform, I'm confident, with the tips and strategies our advocates learned in this workshop, we will overcome these challenges and pass health reform soon!

I just want to say one thing to all of you who are worried: Health reform is NOT dead. Seven hundred health reform advocates descended on DC last week to attend Families USA's annual conference, and everyone here is re-energized and ready to tell Congress and tell the President that the time is now to pass health reform.

Headlines about health reform have been heartbreaking lately to those of us who have worked so hard for so long. They say health reform is dead, or that Congress is moving on to other legislative priorities. The coverage of reform has become focused on the petty fights between Senate and House members and Democrats and Republicans and the process behind reform, while WHAT this reform is all about has been lost.

Being at the conference has helped me remember what we are fighting for, and the fatigue that I began to feel after last week has dissipated. It's important that we all stay in the game, and that we all stay focused on our goal.

Talk to your friends and educate them. Maybe they are concerned about the costs. Tell them that thousands of pilot programs in the bill will help us build more efficient systems--urge them to read this article about how pilot programs have worked in the past. Preventive care measures and making sure doctors are rewarded for the quality of care not the quantity of care will also save money.

You may know people who are upset that reform isn't going far enough. Ask them to think of this as a step-a step towards a greater goal. And encourage them to think of what will happen if we do not pass health care reform: Medicare will run out of money, millions of kids and adults will remain uninsured, costs will continue to rise, and every year, tens of thousands of people will die because of lack of coverage. The system we have isn't sustainable, and it isn't working.

Senator Al Franken spoke to the Health Action conference attendees yesterday, and he told us that he is dedicated to the passage of reform. So tell your health reform fatigued friends that there is hope.

And for those who wonder just what the Senate bill does, tell them what Sen. Franken told us:

• Coverage for 31 million more Americans.

• No denying coverage or charging more for pre-existing conditions or gender.

• Subsidies for low-income Americans to purchase insurance.

• Getting rid of lifetime and annual limits.

• Small business tax credits.

• Getting recommended preventive care covered by all insurance plans at no cost. 

• And health plans putting more money towards actual health care.

So that is what it is all about. And the people who need to hear from you the most right now are your Senators and Representatives. Call them and tell them that you want to see health reform passed now, and encourage your friends and family members to call too. We are still here, and we will continue to fight. 

Brian Smedley from the Health Policy Institute and Joint Center for Political and Economic Studies moderated the discussion and Chinwe Onyekere from Project HEALTH and Carol Bryant Payne from the Department of Housing and Urban Development shared how they approached this issue and some of the success they've had.

Carol's background as a registered nurse has helped her transform the Department of Housing and Urban Development into an agency that looks at how social determinants like housing, food security, and environment affect health. She talked a lot about partnering with other agencies and community based organizations to attack this issue in individual communities.

Chinwe's work in urban hospitals has transformed the way physicians deliver care. Project HEALTH operates help desks in urban hospitals that help patients get connected to needed social services outside of health care like housing, food stamps, and other assistance. (Check out if Project HEALTH operates in your city and get involved!)

Health equity continues to be a tough issue to deal with, but communities across the country are making a difference and so can you!

My grandparents are monumentally confused about health care reform. And rightfully so-opponents of health reform have told them that they're going to lose their Medicare, and that they will have to defend their life in front of a death panel.

Today, at the Families USA Health Action Conference, I attended a workshop that gave me information that will assuage my grandparent's fears. Speakers at the Medicare after Health Reform workshop outlined how Medicare will really change with reform: How the claims of opponents are far from the truth.

Let's start with Medicare program cuts. There will be no cuts in guaranteed benefits. And, instead of losing benefits, benefits will be improved. For example, preventive care will be free. That way, seniors will be able to catch health issues before they become deadly. And I will make sure that my grandparents take advantage of this new benefit.

Also, many seniors are scared they will fall into the doughnut hole, the gap in the Medicare prescription benefit where seniors have to pay for prescriptions out of their own pockets. Without reform this gap is projected to grow, and every year, millions of seniors who land in the doughnut hole are forced to pay thousands of dollars for the medicines they need. Health reform will reduce or completely eliminate the gap. Reforms will also stabilize Medicare fiscally, ensuring it will be around for generations to come.

These facts will reassure the seniors in my life and the seniors in your life too. Make sure to share them with someone you love. If you have any questions about what will happen with Medicare in reform go to familiesusa.org or seniorstoseniors.org to get your questions answered.

Health Action 2010 has so many great workshops that it's hard to figure out where to start! After an amazing plenary presentation with great speeches from Sec. Kathleen Sebelius, Senator Al Franken, Representative Donna Edwards, and a moving tribute to Senator Ted Kennedy's contributions to the health reform movement, I wanted to hear what different advocates were doing on the ground to get health reform across the finish line.

The workshop - Implementation Challenges Roundtable: Post-Reform Grassroots Organizing - was led by two long-time advocates: Jim Duffet from the Campaign for Better Health Care in Illinois and Amy Smoucha from Missouri Jobs with Justice.

Jim and Amy shared their experiences organizing and working on health reform. The discussion focused on how we can build on the existing movement; how we can reenergize our communities and take back the conversation that Republicans have been hyjacking for the past few months.

Advocates discussed the challenges they face and the successes they've had in their communities educating people about health reform. We walked away with a lot of helpful ideas and a renewed sense of strength and optimism about passing health reform. Yes we can and finally, yes we WILL!

Deborah Kilstein from the Association for Community Affiliated Plans, Claudine Swartz from the National Association of Public Hospitals, and Phil Villers from Families USA, along with over 40 advocates from across the country, tackled this tough subject, and explored innovative strategies to increase access to care.

They discussed the myriad of ways Medicaid managed care plans and public hospitals can work to increase access to care now, and after health care reform implementation.

Claudine Swartz highlighted an example from North Carolina, where a community care initiative to make sure patients have health care homes has generated $60 to $160 million in savings over three years for the state's Medicaid program.

Deborah Kilstein provided examples from Medicaid managed care plans, one of which has increased the number of immunizations by over 40% in the last seven years. Many more examples can be found at http://communityplans.net/.

These thoughtful presentations provide a clear path to implementation and a health care system that will be ready to treat newly-covered patients.

In a word, the general mood at the opening plenary was "optimistic." Senator Al Franken remarked, "this isn't a funeral," and HHS Secretary Kathleen Seblius said, "We're at the one-yard line. We've received a penalty but the game is still on!" According to the advocates around the room, the game is, indeed, still on.

Last night during the State of the Union, President Obama did not spend the majority of his time on health reform. It's not, however, because it's not on the agenda- it's simply because now it's in the hands of our elected officials in Congress. The President told Congress loud and clear: do not walk away.

Secretary Sebelius made it clear that without each and every one of our voices, we might not get this done. But with all of us demanding that Congress pass this legislation and put people before profits, we can -and we will- get this done!

We've already come so far. Lately, we've done more to improve the security of working families in America than we've ever done. We are truly at the one-yard line. We can't go for a field goal, or call a time out. We have to make this happen, and we have to act now.

Sen Franken took the stage and not only brought the laughs but he bought the facts: thousands of Americans die every year because they don't have access to health care, thousands of families are forced into bankruptcy due to medical debt, and thousands of Americans stay up late praying their loved ones won't get sick. And that's in Franken's homestate of Minnesota alone.

Across the United States millions of Americans are without insurance and without access to quality affordable health care. With each day that passes, they're losing hope. We have to pick the ball back up, and pass this bill for them.

Sen. Franken reminded us that the opposition's answer to solving the broken health care system can be summed up in one word: "No." That's just not good enough for us.

Our message is longer, louder and more meaningful: Americans need health reform, they need it now, and won't stop until we pass this bill.

 We will get this done.

In the holiday classic Home Alone, Kevin McCallister is petrified of his next door neighbor, "Old Man" Marley. That is, until the end of the movie, when he actually takes the time to get to know him. "Old Man" Marley turns out to be a kind man with a good heart. We've all learned lessons like this, where we've found out the hard way that our fears or judgments are false. The same is actually true for health reform.

According to a new poll conducted by the Kaiser Family Foundation, many Americans become supportive of the provisions in the health care legislation when they are explained accurately to them. The Kaiser poll found that

...large shares of people, including skeptics, become more supportive after being told about many of the major provisions in the bills.

Unfortunately, the scare tactics of our opponents have worked to confuse people, and many still do not understand the most important concepts in the bills. The rumors of killing grandparents, reducing doctor choice, and higher costs have trumped reality, but when the truth emerges, a brighter view of health reform comes with it. According to Kaiser,

...majorities reported feeling more favorable toward the legislation after learning about key elements such as the availability of tax credits for small businesses, the creation of health insurance exchanges, the inability of insurers to deny people coverage because of pre-existing conditions and the move to close the Medicare drug benefit's "doughnut hole."

These are critical pieces of legislation, which a majority of Americans agree are crucial. Although the future of health reform might seem unknown, what we can learn from this poll is crystal clear: When Americans are given the facts, they realize that death panels and scare tactics are little more than sorry political plays by politicians.

It's time to speak out loud and clear about the benefits of the bill-and there are many. Don't let the opposition control the debate-let your friends know today why reform will make every American's life better.

Daschle: House Dems Should ‘Do the right thing,' pass Senate bill -The Hill

House Democrats should "do the right thing" and approve the Senate's healthcare bill, former Senate Majority Leader Tom Daschle (D-S.D.) said Monday.

Transcript: Diane Sawyer Interviews Obama -ABC News

SAWYER: So, looking back a year, going before a joint session of Congress. What's the biggest difference in going this week?

OBAMA: Well, you know, this may seem counterintuitive, but the biggest difference is that I was more worried about where the country was going a year ago than I am now.

Dem Leaders Unite on Health Care Strategy -AP

Democratic congressional leaders are uniting around their last, best hope for salvaging President Barack Obama's sweeping health care overhaul.

Pass the Bill Now, Continued -The New Republic

Timothy Jost and I assembled a letter signed by 51 health policy experts asking that the House pass the Senate bill and then fix this bill's significant shortcomings through the reconciliation process. We got a very strong group of people from across the ideological spectrum to sign on. For the most part, our letter has been favorably received in most quarters.

Health Insurance Reform Remains Critical to Economic Growth -The Committee on Education and Labor

A lot of things may have changed in light of the Massachusetts special election upset Tuesday, but one thing that hasn't changed is the health insurance crisis in America. We must address this crisis.

Don't Give Up Now -The New York Times

It would be a terrible mistake for Democrats to abandon comprehensive health care reform just because voters in the Massachusetts Senate race last week decided that they liked the Republican, Scott Brown, more than the Democrat, Martha Coakley.

Whether it is an obsession with town halls, vote counting, or negotiations, much of the focus during this health reform debate has not been on the actual human reasons why reform is so important.

Let's get us back to reality, at least for a quick second.

Joshua Lemacks should be considered a miracle. Born with a severe heart defect, he is now a thriving six-year-old without a trace (except a scar) of his past struggles. Thanks to numerous successful surgeries, Joshua survived his ordeal.

Wait! This seems like a health care success story, right? Not quite.

Seeking the best care for their sick child, the Lemacks, who live in Virginia, decided on a surgeon in Philadelphia. And their insurer approved their choice. However, the joy they felt coming out of successful surgeries was short-lived. Not long after they returned home, they received an unexpected bill.

According to Jordan Rau of Kaiser Health News,

...what the relieved parents didn't realize was that their financial life would be drastically impaired. They ended up with $70,000 in doctors' bills that their insurer, Anthem Blue Cross and Blue Shield of Virginia, refused to pay-even though it had approved the couple's choice of surgeons. After the second surgery, they were responsible for $15,000 more. Debt collectors have been calling ever since.

The Lemacks were billed because they had to go out-of-network to save the life of their son. The House health reform bill attempts to ease the unexpected costs of out-of-network care by allowing portions of out-of-network costs to be included in an out-of-pocket cap. Furthermore, according to Jordan Rau,

...the pending legislation would require insurers to have enough specialists to ensure patients could get care within their insurers' networks.

The reform legislation represents a step in the right direction to help prevent these sorts of injustices: No one should go into debt because they or their children become sick.

MLR: Those three letters seem like an acronym for an obscure tropical disease, but we promise this won't hurt a bit. MLR stands for Medial Loss Ratio. The technical term may be a snooze-inducer, but stick with us for a moment longer.

Imagine you went to a change machine, put a dollar in, and only got back 75 cents. Well, a medical loss ratio can be similar.

If an insurer only uses 75 cents of every premium dollar on health care, they have a medial loss ratio of 75 percent. In short, it's the share of the money you pay in premiums that the insurance companies use for actual medical care.

You may be thinking, so insurance companies don't spend 100% of my premiums on health care? Unfortunately, they don't. Insurance companies use the money they don't spend on health services for things like profits, marketing, and administration-they even use it for a process called underwriting (a fancy term that means they hire people to figure out whether or not they are making a financial risk by insuring you).

Some insurers charge very high premiums and then spend a startlingly low proportion of those premiums on care. In 2008, Families USA learned that some insurers in the individual market spend as little as 60 percent of every dollar on health care. That means that 40 percent of premiums go to administration and/or profits.

So how can we change the game for insurance companies who aren't spending our dollars on health care? We need to reform the health insurance industry and pass the legislation currently moving through Congress.

In both the House and the Senate bill there are major provisions that will set requirements on how much of your premium dollars can go towards administration and profits. In short, insurance companies will be forced to spend more of your premium money on actual health services than they do now.

These requirements not only provide transparency to the consumers-who spend their hard-earned money on premiums-but they also keep insurance companies honest.

As health care premiums rise, consumers deserve to know that their money is being spent on health services and improving the lives of Americans, not on lining pockets of insurance company CEOs.

Health reform has never been easy. That lesson has come up throughout this year's legislative process - as if decades of failed reforms had not yet made that clear.

Health reform, however, is an imperative for our nation's families. Without reform, health costs will continue to grow much faster than wages.  Without reform, many millions of hard-working people and their families will join the ranks of the uninsured and underinsured.

And without reform, businesses, staggered by increasing employee health costs, will either drop coverage or will be unable to make needed investments. As a result, our nation's economy - and the ability to create good jobs - will suffer.

We must not let that happen.

Some members of Congress have said that we should abandon health reform for a later time. But make no mistake, if we abandon reform now - after moving further than ever before towards meaningful reform - we will not get back to this crucial agenda for a long, long time.

Some other members have suggested that we play "small ball": adopt only the most popular measures, such as prohibiting exclusions of coverage for people with pre-existing conditions, and drop the more systemic reforms.

Unfortunately, that will not work.

As a number of states have learned, insurance market reforms - as important as they are - cannot work without expanded health coverage. Insurance market reforms implemented alone will lead to skyrocketing premiums as sicker, older people secure coverage and younger, healthier people don't.  This incremental approach is a recipe for disaster - both substantively and politically.

The Senate bill would expand health coverage to approximately 31 million people - and the House bill would reach even more. (The state-by-state projected expansions are attached.) Many millions more, who have insurance but are burdened with its costs, would also be helped with new subsidies.

You no doubt met many of these people in the communities you represent. You probably can remember their plea to make our health system better - and to make quality, health coverage and care affordable.

We must not abandon these people.

One last point: The policy slurs and defamations by health reform opponents, which will undoubtedly continue, cannot be effectively answered unless and until reform is enacted into law. It is only then that Americans around the country will see its benefits.

This is your moment for political courage, vision, and leadership. We urge you to move meaningful health reform forward to its needed enactment.