Swing State/District Democrats: Democrats from states and districts with strident opposition to the bill could face difficult reelection campaigns in November and beyond as the health care vote is expected to be a top campaign issue. "We're going to have a very spirited campaign coming up between now and November, and there will be a very heavy price to pay for it," said Sen. John McCain, R-Ariz., on "Good Morning America."
Bipartisanship: The spirit of bipartisanship was dealt a blow when the landmark legislation passed without a single Republican vote. Similarly contentious bills, such as Medicare and Social Security, passed with large bipartisan majorities in their time. Sen. Max Baucus, D-Mont., spent a lengthy effort to cut a deal with Senate Republicans, and was once close to garnering the support of Maine's Olympia Snowe, among others, but that ultimately failed. "For the first time in history, we will have a major reform enacted without a bipartisan support for doing so," McCain said on "Good Morning America."
Tea Party Movement: Born out of opposition to Democrats' health care reform proposals, the vocal movement failed to leverage enough pressure on members to vote no, and the acts of a few prejudiced members who hurled racial epithets and homophobic slurs tainted their message.
Conservative Business Groups: The U.S. Chamber of Commerce and the National Federation of Independent Businesses spent millions fighting the proposed mandate on employers to provide health insurance for workers or face penalties. Their efforts failed.
High Wage Earners: Nobody likes to pay more taxes, but for individuals earning $200,000 or more and for couples earning $250,000 or more the bill will impose a new Medicare payroll tax by 2013.
"Young Invincibles": Young and healthy people who would prefer to go uninsured must now get insurance or pay penalties.
Public Option Supporters: Despite endorsement from the president and liberal members of his party, the government-run insurance option failed in the face of concerns about cost.
'Death Panels:' They weren't in the bill, and the threat of them didn't sink the bill.
State Budgets: Many states already cash-strapped will now face new costs under an expanded Medicaid program.
National Organization for Women: NOW says it is "incensed" over the president's executive order on abortion to appease pro-life House Democrats. They have attacked Obama as a sellout and expressed disappointment that he did not use the health bill as an opportunity to expand federal funding for abortion beyond the Hyde Amendment.
Catholic Bishops: The U.S. Conference of Catholic Bishops opposed the Senate bill for what it says would allow federal funding for abortion. They also criticized it for not doing more to provide immigrants access to health care. President Obama's eleventh hour executive order to appease pro-life House Democrats didn't sway the UCCB, which remains opposed to the bill.