The House of Representatives just narrowly passed the massive $1 trillion health care bill by a vote of 220-215 (they needed 218 to pass it). Despite the fact that at least 69 Democrats had expressed some sort of opposition to the bill, only 39 had the guts to actually follow through on their statements. Imagine that, somebody saying something and then sticking by it.

These Democrats deployed a very smart argument today in order to justify voting for this monstrosity of a bill. Several claimed that they'd vote for this "flawed" legislation in order to move the process forward and put pressure on the Senate to act. The political undertone to this is: we don't want to hand President Obama a massive loss this early, so we're holding our nose and voting for this in the hopes that we can improve it in conference later. For what it's worth, it is a fool's game to hope that ANYTHING improves in conference.

So, what now? Start saving your pennies, I guess. If the Senate health care bill passes, the President will sign whatever comes out of conference and you'll be stuck with a minimum of $900 billion in new costs over the next ten years. Several analyses have placed the real cost at as much as $1.5 trillion over the first ten years, or more than $2 trillion over a decade when the bill is fully phased in. The House legislation used innumerable gimmicks to artificially reduce its score, including splitting the so-called "doc fix" into another bill to hide a quarter-trillion dollars and not indexing the taxes in the bill for inflation, meaning they'll run deficits in the future if they don't "fix" those provisions like they have to do with the Alternative Minimum Tax.

The real answer to "what now" is that the Senate must act. They have a bill in the works right now, but they haven't seen fit to actually release it to the public so people can review it. In all likelihood, they'll drop it soon before the vote and watch while the American people scramble to read it in its entirety. If/when that happens, President Obama will undoubtedly sign it. It probably won't matter if it follows through on all of his promises, he simply can't NOT sign the thing.

So, get ready America. You're about to get a health care system delivered with the efficiency of the postal service and the compassion of the IRS.