When President Obama first announced his push for healthcare reform, there were reports that several influential medical associations would back any bill that contained medical malpractice “reform” (better described as medical malpractice access to justice prevention). For a tense while, there were rumors that Obama would reverse course from his pro-access campaign position, and gain political backing by agreeing to include verdict caps, attorney fee limits, and other ruses the purpose of which are to make legitimate medical malpractice actions economically unviable. Shortly after his healthcare reform push began, the President announced that medical malpractice “reform” was not an option. The question now is whether President Obama will hold firm in his assurance that access to justice will not be restrained, now that resistance to his healthcare efforts are strengthening. If his legislative effort, upon which he has staked so much capital, falters, it may be tempting to sacrifice future victims of medical negligence for the perceived greater good of universal healthcare. Guardians of the gates to our justice system would be wise to keep close watch on the course of the healthcare reform perturbations.