With the Obama administration's top domestic priority struggling in Congress, supporters and opponents of the healthcare proposals are focusing on the constituency that both sides agree has become pivotal to the debate: the majority of Americans who have health insurance and are generally satisfied with their care. Although polls have consistently shown that just over half of Americans think the healthcare system is in need of reform, a substantial majority say they are satisfied with their own insurance and care. Any hope of change will require their support, according to experts and advocates across the ideological spectrum.