That one question - how the nation really pays for health reform - just got a shocking wake up call. The Congressional Budget Office, or CBO, said Sen. Ted Kennedy's health care proposal could cost $1 trillion over 10 years and 36 million Americans would still be uninsured.
"It's a preliminary set of numbers," said Sen. Chris Dodd.
Democrats called the numbers inconclusive. Even the CBO called its own report incomplete. But the sheer magnitude of what Congress is considering is undeniable, reports CBS News correspondent Wyatt Andrews.
"The news yesterday from the CBO is a turning point in the health-care debate," said Rep. Eric Cantor.
So what will health reform cost? The president has also estimated a $1 trillion - and he claims he can achieve reform without raising the deficit. The reality is - this means raising taxes. And where the president believes he can raise $267 billion, by limiting the tax deductions of high income wage earners -the reality is most of Congress opposes the idea.
"And if they're unwilling to do that, they're going to have to pick an option that has other political difficulties," said Jonathan Oberlander, an associate professor of Social Medicine at University of North Carolina. "So the question is which kind of poison do they want to drink."
The president has also outlined more than $600 billion worth of spending cuts, some of which cut Medicare payments to hospitals. Last month, the hospitals claimed at the White House they'd support billions in savings - but the reality, they now say, is they never meant cuts -that "payment cuts are not reform."
And so what's coming very soon is a dogfight over that trillion dollars. And every interest group that once promised compromise to achieve health care reform will be arguing someone else should go first.