Passage of the health care overhaul bill has sent ripple effects through the political world and the nation's health care system, with Democrats hailing a legislative victory and Republicans promising to have it overturned.
But the politics of the historic and controversial bill – which passed by a narrow vote of 219 to 212 – will continue to play out, as analysts examine where the chips fall on what President Obama has called the "tallies of Washington winners and losers."
Here's an early look by ABC News' political team on who stands to gain – and lose out -- in the wake of the new law and a bruising health care reform battle:
President Obama: It took over a year to pass and he used up a lot of political capital, but Obama's health care bill will be a defining legislative achievement of his presidency. White House chief of staff Rahm Emanuel and health reform director Nancy Ann DeParle are praised for seeing the effort through and for helping round up key Democratic votes, like those of Rep. Dennis Kucinich and Rep. Bart Stupak, in crunch time.
House Speaker Nancy Pelosi: Pelosi and her leadership team got the votes they needed to pass a Senate bill unpalatable to many House Democrats. Some members of congress and the administration had wanted the bill scaled back after Republican Sen. Scott Brown's victory in Massachusetts nearly derailed the legislation.
Labor Unions: Major labor groups led the charge to get universal health insurance back on the national agenda and helped shore up last-minute votes by threatening third-party challenges to Democrats who announced they would vote against the bill.
Pharmaceutical Industry: Drug companies cut a deal at the outset of the reform effort and largely avoided negotiation of drug prices as part of the overhaul bill.
Public Option Foes: Conservatives for Patients Rights and other opponents of any new government-run insurance program succeeded in killing the public option.
Uninsured Americans and People with Pre-existing Conditions: 32 million more Americans will have access to health insurance under the bill, and those who get sick will still be able to retain coverage. The measures effectively fulfill a campaign promise made by Obama and Democrats in 2008 campaign. Will these newly insured Americans turn out to vote their satisfaction?
Louisiana: The so-called "Louisiana Purchase" – a special provision in the bill that allocates $300 million in federal subsidies for Medicaid to Louisiana alone – survived revisions of the bill and helped secure the support of Democratic Sen. Mary Landrieu.
Pro-Life Democrats: Rep. Bart Stupak and other self-described "pro-life, whole life" Democrats got the president to sign an executive order clarifying that provisions of the bill are not to circumvent a long-standing ban on federal funding of abortion.
John Lewis and Barney Frank: By responding gracefully to racial epithets and homophobic slurs, Lewis, an African American and former civil rights leader, and Frank, the second openly-gay member of the House, helped marginalize protestors as being motivated by more than simple opposition to health reform.