One of the subplots of the health care story is that everybody has woken up to the fact that Nancy Pelosi is an extremely effective Speaker of the House. The House is a pliable, majoritarian institution, so it's not unusual for a Speaker to wield a lot of power (conversely, it is rare for a Senate Majority Leader to be seen as powerful.) Still, even correcting for that, Pelosi deserves enormous credit for the health care bill. In the wake of Scott Brown's election, she stayed clear-headed when Democrats all around her succumbed to panic.
Pelosi lacks much in the way of eloquence -- her speech last night, like her Blair House remarks, was borderline cringe-inducing. But the combination of President Obama as the chief public explainer and Pelosi running the show behind the scenes is an extremely formidable combination.
Michelle Cottle wrote a wonderful profile of Pelosi in 2008. Reading it today really helps explain how she pulled this off.