Marc Ambinder has a nice analysis of how health care reform came back to life after the Scott Brown election in January. He calls it a "perfect storm": President Obama and the Democratic leaders in Congress made some smart choices, but they also benefited from good fortune, in the form of outside events that helped alter the political landscape. Chief among these was the decision by Anthem Blue Cross in California to announce its huge premium increases.
Ambinder's summary is a good way to catch up on the debate if you've been tuned out for the last few weeks. And it ends with this analysis, which--like most of Ambinder's reporting--rings true to me.
What Democrats now have as an incentive to vote against their short term political interests -- "the health care reform bill" is not popular, but reform is -- is that it has become a moral crusade of sorts. They've got to pass it to show the American people that they can govern. They've got to pass it to show the American people that Republicans have no good alternative to expanding coverage and cracking down on insurance companies. This is what is in their heads now--it's why 10 Democrats (at least) who voted no in the House are willing to give an even more expensive bill (the Senate bill plus the Obama fixes) a second chance.