Although Democrats are touting the 220-215 passage of the House leadership health care bill as a historic victory, the outcome of the vote raises serious concerns when 39 Democrats voted against the bill. Of all the healthcare bills in congress, this one is the most expensive at an estimated $1.1 trillion and is the most progressive with the inclusion of a public option. These aspects proved too politically risky or fiscally unfeasible for Democrats from conservative districts to support, and the narrowness of the vote shows that the bill needs to change dramatically to have a chance at passing the Senate. Although the bill's passage provides House Democrats and the White House with a brief victory to show the public, the biggest challenge to health care reform remains with a minority of conservative senators whom they will have much less influence on.

Although Obama has refrained from formally proposing health policy, he has lent his public voice to garner political support for his affiliates in Congress and to call out the opposition. The day after the vote, he took to the podium to applaud those who voted yes in the House and to press the Senate to set a quick timetable for its passage in the Senate. Because most of the policy matters will be left out of his hands as it passes through the Senate, the president's role will be relegated to one of lending his popularity to uncommitted senators precariously straddling the line and likewise, using his personal influence to undermine the tactics of an already decided Republic opposition. Compromises in actual policy though will be administered through Democratic senators such as Majority Leader Harry Reid. Although Reid has been an advocate of a progressive agenda much in line with the White House, he is looking towards next year's midterm election and appeasing a constituency with conflicting state priorities in mind. Obama's supplemental role will be that of providing political coverage to cooperating senators like Reid who are taking political risks in deferring state responsibilities to tackle health care reform.

Although Democrats control the majority in both houses of Congress, it's apparent that their strategies are drastically different in moving the bills through the vote. The Senate Finance Committee bill had started out under a naive overture of bi-partisanship; proposing a bill that lacks a public option and costs a modest $8.3 billion. Meant to court conservative Democrats and moderate Republicans, the bill's centrist approach proved unpopular on both sides as liberals criticized the amount of compromise made and the antagonistic attitude of conservatives had not change. Rather than risking the uncertainty of courting moderates, House Democrats seem to have chosen to exploit their stronger majority to jam a bill through. However, House Democrats must also realize that their bill will change substantially in the Senate, and they won't have control over which compromises are made. Nonetheless, their approach of packing the bill with as much as possible may be the best way to make sure House Democrats' priorities are addressed in Senate floor debate.