The 17-year-old Sarkisyan died in December in Los Angeles after, her family’s attorney claims, Cigna HealthCare twice refused to pay for the liver transplant she needed to survive.

Opinions expressed by nearly 50 protesters at the rally were constant and furious.

Brenda Langford, a registered nurse, called Cigna “unscrupulous.” Illinois State Rep. Mary Flowers (D-31st) told the protesters “they caused [Sarkisyan’s] death.” Several carried signs that read “Guaranteed Healthcare not Guaranteed Corporate Profits.”

Cigna's response, in a news release, asserted that the company offered to pay for the procedure hours before Sarkisyan’s death “despite the fact that we had no obligation to do so.”

Sarkisyan’s death ups the ante in an already heated debate over health-care reform – in California, in Illinois and in the 2008 presidential election.

No longer bashful about “universal health care”

Democratic presidential candidates are back touting plans for universal health care, a cause that was largely abandoned after 1994. Their adversaries in the health-care lobby are back too.

It’s a Republican however, Gov. Arnold Schwarzenegger of California, who fired the first salvo in what could be all-out war over health-care reform in the 2008 election. In December, the California legislature passed a bill mandating residents to have health insurance, forcing employers who do not provide insurance to pay into a state health insurance program, and preventing insurance companies from rejecting insurance based on pre-existing conditions. (The bill must be approved by the state Senate and the voters by referendum before it becomes law.)

It’s not the first time such legislation has been introduced. Former Gov. Mitt Romney, another Republican, signed a similar proposal into law in Massachusetts in 2006. If a Democrat moves into the White House in January 2009, it's likely to be an issue at the federal level. Leading Democratic candidates Sen. Hillary Rodham Clinton and Sen. Barack Obama advocate health-care reform proposals that include the main points of the Schwarzenegger bill.

Predictably, all have drawn the ire of the health-care insurance lobby.

“If you look at California and Blue Cross-Blue Shield, their biggest provider, they came out against the Schwarzenegger bill because it essentially said the same thing [as Democratic proposals],” said Matthew Holt, a San Francisco-based health-care advocate.

Health care at the forefront in Springfield, Washington

In Illinois, health-care reform will likely be at the forefront of the election debate throughout the year. According to a November 2007 Gallup poll, 15 percent of voters nationwide said that health care was the No. 1 issue they will take into account when deciding whom to vote for in 2008.

That wasn’t a point lost in the minds of the politicians gathered outside the Cigna office Tuesday. Along with Flowers, State Rep. LaShawn K. Ford (D-8th) and John Laesch, a candidate for the 14th district seat vacated by former House Speaker Dennis Hastert, also joined in the rally.

Earlier in January in Springfield, Flowers introduced House Bill 4223, strengthening the right to appeal a health insurance firm’s decision not to cover a medical procedure. It was an effort she trumpeted at the rally.

But it’s a former Illinois state legislator, presidential candidate Barack Obama, who's support among health-insurance reform advocates will be tested in the Illinois primary Feb. 5.

“While his [Obama's] health-care proposals need some work,” said Rose Ann DeMoro of the California Nurses Association, “he is taking a stand.”