05/25/2010 11:55 pm ET Updated May 25, 2011

How They Passed Health Care: The Final Installment

Nancy Pelosi was in the Old Executive Office Building when one of her advisers gave her a message: Obama wanted her next door, in the White House. Martha Coakley was about to lose the election for Ted Kennedy's old seat and, with it, the Democrats' filibuster-proof majority. Obama had summoned Harry Reid, too, and together they discussed options. Exactly who said what depends on who's telling the story, but a few things seem clear: They all wanted to keep pursuing comprehensive reform, but they couldn't agree on how. And they were all frustrated--with the political situation and, increasingly, with each other.

It didn't help that the original negotiations over merging the House and Senate bills had left nerves frayed. From afar, the bills looked similar: They had the same basic structure, the same basic scope, and the same kind of regulations. But, up close, their differences, starting with the choices for raising money, looked a lot bigger--and Pelosi, speaking for a caucus that already felt bloodied, hated giving every inch. Obama had personally taken charge of the negotiations, hauling everybody into the West Wing: "The president understood the issues better than many if not most House and Senate members," said an impressed Henry Waxman. But, at one point, he got so exasperated he got up and left the room, leaving Rahm to knock some heads.

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