[Excerpt] Middle class Americans across the country are demanding health reform. Businesses and families are struggling under the increasing financial burden of rising health care costs, and even middle class Americans with health insurance are struggling as their out of pocket health care costs continue to rise. Some employers are facing a decision between scaling back on coverage and laying off workers, and many—especially small businesses—are dropping coverage altogether. Middle class families often find themselves without adequate protection against a major illness and have difficulty obtaining the care they need, and an increasing number are now uninsured. Even among those able to get insurance through their job, middle class Americans are less likely to have a choice in their plan or provider compared to higher-income workers. This report highlights the struggles that middle class Americans face in the current health care system. By examining cost, coverage, access, and choice, this report shows how the current system has failed the middle class and why we must enact health reform this year.