A year ago today, President Obama gathered Congressional leaders, providers, advocates and industry leaders at the White House to start the conversation about health care reform. “The status quo is the one option that is not on the table,” he said then.

And a year later, it’s still not. Millions can’t afford coverage and millions more can’t afford to get sick on the coverage they have. An industry that has profited by exploiting health circumstances that are often beyond people’s control is flaunting 40 percent rate hikes, reminding us that the only people it answers to today are shareholders.  So the status quo is—well—the same.

But we aren’t where we started. In a year of extensive committee hearings, votes and record hours spent working and reworking bills, Congress has crafted a reform that offers coverage to more than 30 million uninsured, allows more people to buy into the private insurance market, and provides help to those who can’t afford it, a reform that prevents companies from denying coverage or sending families into debt spirals after costly procedures, a reform that improves the way we deliver and pay for care in this country – and that pays for itself completely and sustainably. Both chambers have passed such a bill. We are this close.

There are other things that are different a year on. Since the first convening last March and the summer’s glimmer of bipartisan negotiation, Republicans have made a political calculation that though the bills pay for themselves and would offer much-needed help to many people in their districts, they plan to vote against any and all efforts to pass comprehensive health reform.

And after deliberately standing aside to allow Congress to drive and shape reform – (“I just want to make sure that I don’t get in the way of all of you moving aggressively and rapidly,” President Obama said last March) – the President made it clear Wednesday he’s not standing aside anymore.

“Both during and after last week’s summit, Republicans in Congress insisted that the only acceptable course on health care reform is to start over. But given these honest and substantial differences between the parties about the need to regulate the insurance industry and the need to help millions of middle-class families get insurance, I do not see how another year of negotiations would help. Moreover, the insurance companies aren’t starting over. They are continuing to raise premiums and deny coverage as we speak. For us to start over now could simply lead to delay that could last for another decade or even more. The American people, and the U.S. economy, just can’t wait that long.

“So, no matter which approach you favor, I believe the United States Congress owes the American people a final vote on health care reform….and from now until then, I will do everything in my power to make the case for reform.”

Transcript’s end, he stepped away from the mic and said into the applause:  “Let’s get this done.”

–Kate Petersen, Health Policy Hub