This optimistic assessment of the prospects for health reform from senior Democratic and Republican congressmen spells out several reasons why reform can be achieved early in the first year of the Obama administration. Political and policy factors suggest that President-elect Barack Obama is in a much better position than his predecessors to achieve comprehensive health reform, including universal coverage. The Obama administration will have to overcome numerous obstacles and resistance to enact reform. Still, after decades of frustration and disappointment, policymakers should set aside their differences and enable the United States to join the ranks of developed nations by making sure every American has health insurance.