Just do the math. 45 million more people to insure.

Obama says that he wants to insure EVERYONE. OK
He says he wont sign a bill that costs any extra money.
There are about 260,000,000 people insured in the United States now.
To insure everyone you have to add those 45 million to some sort of plan.
Tell me how you are going to add 17% more people to any system and it won't cost any more.
Where are we going to find that 17% savings to offset the additional people?

That 17% is going to come out of taxpayer's pocket.
It is going to come out by rationing care.
It is going to come out of those who receive "End of Life" counseling, when they are allowed to die.

If you think it is bad when the insurance company says "we don't cover that". Imagine when the government says it. Who will you turn to then? The UN?