The slim margin in the House suggests greater challenges in the Senate, where the majority leader, Harry Reid, is struggling to hold on to all 58 Democrats and two independents.
If it was tough for the House speaker, Nancy Pelosi, to win passage of a health care bill, imagine the painful task in store for the Senate majority leader, Harry Reid, who needs the support of all 60 of his caucus members just to bring a health bill to floor.