I just watched the House vote on final passage of the health care reform bill: 220-215, with one Republican (Cao of Louisiana, who replaced Bill Jefferson in a solid Dem district).
So, was the very close vote a sign that the bill really was close to losing -- and that perhaps it would have lost, if Republicans had just managed to win a couple more seats?
Almost certainly not. The dynamic here is very straightforward. Everyone believes that the Senate bill will be perceived as more conservative than the House bill. Thus anyone who votes for the House bill can be portrayed as more liberal than (hmmm...I don't know who the poster boy or girl is now for liberals in the Senate -- I sort of think they'll want to use Al Franken, but it really stinks for the GOP that they don't have Kennedy or Clinton in the Senate any more)...well, more liberal. Most Members in marginal seats don't want that, especially if they can vote no (at least on this go-round) and still get the bill.
There's a second dynamic too, one that will still be around on final passage. I've talked about this before: It is definitely in the Democrats' political interest to pass the bill. Democrats are going to do better if the party is perceived to have its act together; they'll also do better if Obama's approval ratings are higher, and it's fair to assume that, all else being equal, his approval ratings will be higher if the bill passes than if it fails. However, the bill is probably not especially popular in many districts; even more to the point, individual provisions of the bill will probably prove to be unpopular in many districts. So for marginal Democrats, the preferred outcome may be to have the bill pass without their vote. Since it doesn't really matter to anyone how big the margin of victory is in the House, the logical choice for the Democrats is to stop encouraging yes votes once they reach 218.
So, two conclusions. First, on this vote, it seems very, very likely to me that Pelosi had at least a dozen votes available if she needed them. And, second, final passage after the conference with the Senate should be easier than passing just this bill.
It is worth noting that the opposite dynamic will be at work in the Senate -- the final vote on the merged bill will probably be tougher for marginal Democrats than the vote on the Senate bill. Fortunately for Harry Reid and the Dems, that's canceled out a bit by the extreme rhetoric that Republicans are likely to use in the debate over the Senate bill; if you're already a grandparent killer and a socialist for one vote, the incentive to switch should go way down.
OK, on to the Senate!