By Rajesh Mirchandani
BBC News, Washington
The US House of Representatives and Senate have passed legislation expanding health care to cover an additional four million children but President George W Bush is set to veto it.
A tooth extraction might have saved Deamonte's life
Mr Bush says the bill takes the scheme far beyond its original remit of providing health insurance for children from low-income families.
Whatever happens on the political front, the issue of health care in the US strikes an emotional chord for many.
In February, there was an outcry over the case of Deamonte Driver, a 12-year-old boy who died because his family could not afford private dental treatment.
"The thing about Deamonte was his smile, he was always smiling," says Gina James, principal of The Foundation School in Maryland, where Deamonte was a popular and promising student.
It was while he was at school one Thursday in February that Deamonte complained of toothache. On the Saturday he had emergency surgery. An abscess had spread to his brain.
A few weeks later he died.
"Everyone here was shocked," says Ms James.
"They couldn't understand how he could have toothache and then die. We sometimes give the little kids candy as a reward; well, for a while they stopped taking it because they would say 'if I get a cavity, will I die?'"
Deamonte's mother, Alyce, could not afford private health insurance and in the US there is no state health service.
Mr Bush believes the bill extends the programme too far
For the poorest there is some free treatment, called Medicaid. But not all dentists or doctors accept Medicaid patients, and Alyce Driver could not afford to pay to have Deamonte's tooth extracted.
This story is not a one-off. Some 45 million Americans are without health insurance, nine million of them children.
Many say it is America's national scandal.
In Washington political opponents have come together on this issue, in part driven by the outcry over Deamonte.
This week, lawmakers - both Democrat and Republican - supported a bill that would help fund insurance for four million more children.
In the Senate, the bill passed 67-29. It also passed in the House of Representatives but with less than the two-thirds majority needed to override a presidential veto.
The proposed bill extends the State Children's Health Insurance Programme (Schip) that subsidises insurance for families who may not be the poorest, but who cannot afford private insurance.
Supporters propose paying for it by increasing taxes on cigarettes.
Mr Bush says expanding public funding goes against the principles of private health care, and that subsidising it creates a disincentive for people to buy private care themselves.
He supports tax cuts that will help poorer people buy private insurance and says he opposes this legislation because it "directs scarce funding to higher incomes at the expense of poor families".
So, in effect, both supporters and opponents of the bill say the other side risks health coverage for children.
The political wrangling over the legislation has added resonance coming ahead of next year's presidential and congressional elections.
One Democratic Congressman, Elijah Cummings, from Maryland wants to take the health care issue further.
He has proposed "Deamonte's Law", which seeks to ensure every child has access to dental care.
"It's shocking, it's sad, " Mr Cummings said of Deamonte's death. "It provides a wake-up call to us all that we have to do better."
Amid all the politicking on Capitol Hill, the fate of Deamonte highlights the tragedy at the heart of this issue: the very real questions about how the richest nation on earth cares for some of its poorest citizens.