"Health insurance reform and what it means for our families is very much a women's issue," Obama said, speaking to a group of female advocacy leaders at the White House. "If we want to ensure women have opportunities that they deserve, if we want women to be able to care for their families and pursue things they could never imagine, then we have to reform the system."
Women play a unique and increasingly significant role in families, she said, with eight in 10 mothers reporting they are the ones responsible for choosing their children's doctors. More than 10 percent of women in this country are caring for a sick or elderly relative, she said.
"Being part of the sandwich generation, raising kids while caring for sick or elderly parents, that's just not a work-family balance issue anymore... it is a health care issue," Obama said.
Speaking before the first lady, Health and Human Services Secretary Kathleen Sebelius said that insurance companies can charge women more than men for the same coverage.
She noted that insurance companies in some states can deny coverage to women who are victims of domestic violence because they are considered to have pre-existing conditions.
"A system that treats women like that is unconscionable," Sebelius said.
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Obama said she approached the health care debate as both a mother and a daughter. She related the story of how her daughter Sasha had to be taken to the emergency room as an infant. She also spoke about her father, who had multiple sclerosis since he was in his 20's.
"I find myself thinking, what would we have done as a family on the South side of Chicago if we hadn't had insurance?" she said. "What if he had lost his job, which fortunately he never did."
Obama said she heard from millions of women with less fortunate stories along the campaign trail. Still, she said, it is understandable that many people want to keep the status quo.
"There will always be folks who will want things to stay just the way they are," Obama said. "I am here today standing before you as the First Lady of the United States of America because you all didn't settle for the world as it is... Health care is the next step."
She described the elements of her husband's plan, including the formation of a health insurance exchange, coverage for routine check ups and preventive medicine, and the limitation of out-of-pocket expenses.
"I think this is a pretty reasonable plan," she said. "No longer can we sit by and watch the debate take on a life of its own. Now more than ever we have to channel our passions into change."