The House should act quickly and pass the Senate bill as is. They should simultaneously use the budget reconciliation process to deal with the main outstanding financial issues: improving the subsidies for lower income families, amending the excise tax on high cost plans and other changes as needed on the financing of the bill. Whatever flaws it has, the bill would expand health coverage to 31 million Americans and provide the rest of us with the security of knowing that if we lose our jobs we will still have access to health care. It would also put in place a series of measures that will help to bring down costs over the long run. In all of the discussion of the political process, we should not lose sight of the stakes.