Well, the unthinkable has happened: a Republican has been elected Senator from Massachusetts. This is certainly a repudiation of the current state of the health care bill. For one thing, Brown ran (in part) on a platform of voting against it. For another, he will replace Ted Kennedy (not counting placeholder Paul Kirk), the Senator most responsible for driving health care deform to where it is today. For a third, lots of voters polled said that their experience with MassCare had soured them on a federal version.
It would be madness for the Democrats to double down and try to ram through a bill via trickery. Using the reconciliation process seems to be off the table. Having the House simply pass the Senate bill remains an option, but given the narrow 220-215 passage of even the House bill, it's not at all clear where Pelosi finds the votes for this. That's especially true given the political environment that all House members must be eyeing warily. The public's ire is aroused and a wrong vote at this juncture could be fatal in November - which is rapidly approaching. The window for Obamacare may have just closed.
One more thought: we should celebrate Brown's victory tonight. But expectations should not go too high. He isn't going to become another Rick Santorum. In my opinion, that's a good thing. It's possible that Brown is close to my ideal candidate: fiscally conservative, socially moderate. He was elected primarily on the former, and we will have to see how he does. But even farther-right conservatives than I should be happy if he legislates around the middle of the party.