President Obama signs the Health Insurance Reform Bill in Washington

Speaker of the House Nancy Pelosi (D-CA) holds up a pen President Barack Obama used to signed the Health Insurance Reform Bill after he gave it to her at the signing ceremony, in the East Room at the White House in Washington, March 23, 2010. Senate Majority Leader Harry Reid (D-NV) (R) and House Majority Leader Steny Hoyer (D-MD) watch on. UPI/Kevin Dietsch