The special election in Massachusetts today may largely determine whether Democrats can pass the conference committee version of the health care bill through the Senate. If they can't, Dems have been suggesting that the House will simply take the Senate bill. I think that is implausible for several reasons, but the most important is that unions are furious that their top quality health care benefits will face the 40 percent tax. If that occurs, there will definitely be some defections in the House. While 11 House Dems have promised that they will vote against the health care bill unless it has the Stupak abortion amendment that bars the government from paying for abortions (the Senate version pays for abortions), I assume that at least 4 House Dems will vote against the bill for this reason. The governors of California, New York and a couple of other states are warning that their states don't have the money to pay for the health care tab that they will face with the current Senate bill. The congressional delegations from those states will face pressure. The Congressional Hispanic Caucus is insisting that there be no restrictions on illegals getting health insurance. With Wexler's Democrat seat vacant and Cao voting against the bill, that gives Dems only a one vote margin among those who originally voted for the bill. Presumably Dem leaders will convince some of the 38 Dems who voted against the health care bill the first time to switch their votes, but the Massachusetts Senate race could make it very hard for them to pull more than say 19 of those 38 votes.