On the one hand, liberal Democrats in Congress are in a bad position because this (health care) is their issue -- a lot of them probably really agree with the rhetoric we heard throughout the weekend about the historic importance of this bill. Presumably, marginal Democrats could live with themselves quite nicely if health care failed; that makes it easier for them to walk away, and therefore is a bargaining advantage.
On the other hand, moderate Democrats from marginal districts are in a bad position because, whatever they really think about the issue, they're the ones who stand to lose their seats if the bill goes down and Democrats are perceived as incapable of governing. Most liberals are from safe seats. That makes it easier for them to walk away, and therefore is a bargaining advantage.
You may notice that these two things are in conflict, and you would be correct. A lot probably comes down to perceptions (to what extent to marginal Dems feel they would be hurt if the bill goes down?). We know more now than we did -- we know that the numbers look lousy for pro-choice Democrats. On the other hand, Republican rejectionism works against the pro-life side, here; keeping the Stupak amendment will obviously not get any GOP votes for the bill, and whatever the position of the entire House, the Democratic caucus is overwhelmingly pro-choice.
I really can't guess as to where it ends up. I'm sure that Pelosi and the Democrats would love to find a further compromise, and if anyone can find one and sell it I think that the team including Henry Waxman and Rahm Emanuel is the group to do it...but it's not at all likely that the pro-life side is interested in compromise, and not especially likely that the pro-choice side is, either (beyond accepting the "regular" Hyde Amendment style language in the bill before the Stupak amendment was added).
What should liberals do? I think Ann Friedman is certainly correct that the Stupak amendment
...further segregates abortion as something different, off the menu of regular health care. It is a huge backward step in the battle to convey -- not just politically, but to women in their everyday lives -- that reproductive health care is normal and necessary, and must be there if (or, more accurately, when) you need it.But I also think she's also right that, from a feminist point of view, there are a lot of very good things in the House bill, and she doesn't (in that post) really talk about the big stuff -- that a whole lot of women who have no health insurance now -- because of money, or preexisting conditions, or whatever -- would have health insurance if this bill becomes law.
That said...if it was clear that the votes ran against the pro-choice groups, I would say that their best course is just to accept that they can't get a better bill, but that even the likely compromise bill (which will almost certainly lose many of the things that feminists like about the House bill) is so much better for women that it's worth the backwards step Friedman describes. But it isn't at all clear to me if that's the case. At the end of the day liberals, in my view, are going to have to accept a partial victory and talk a lot about FDR and Social Security and plans to improve on the partial victory in the future. However, since it just isn't clear yet where the fault lines are going to be, there's not much to do other than fight hard for whatever can be done to make it a less partial victory.
My advice to people who want good health care reform? Don't worry about principles; don't worry about the bill doing some nasty things, and especially don't worry about the bill failing to do good things that, in your view, it should do. I'd be concerned with two factors: first, the short-term effect of passing the bill on the 2010 and 2012 election cycles; and, second, getting the big things done in a way that allow future additions. Mess up the former, and you'll hurt your chances for improving the bill for a long time; mess up the latter, and improving it will be that much harder to do.
...and, don't forget that no matter how much worse the bill looks than you want it, at the end of the day, after you've fought for every provision that you care about, after sixty years a partial victory (as long as it doesn't sink the Dems in 2010 and 2012 and as long as it's a framework that can be improved over time) is far, far, better than defeat.