The Stupak five seem to make the difference 

Did the Democratic leadership need the vote of Bart Stupak and several other anti-abortion Democrats to pass the Senate health care bill? The vote on the rule to consider the legislation suggests they did. The rule carried 224-208.

The intrepid David Dayen of firedoglake.com notes that 28 Democrats voted against the rule. All but one had previously made public commitments to vote against the legislation; one, Mitchell (AZ 5) made a public commitment to vote for it.

In addition, 7 Democrats made public commitments to vote against: Berry (AR 1), Peterson (MN 7), Teague (NM 2), McMahon (NY 13), Kissell (NC 8), Altmire (PA 4), Tanner (TN 8). Assuming all vote on the bill in line with previous public commitments, the legislation will pass by a 218-213 margin.

Appearing with Stupak at his press conference announcing with executive order deal were five other members. Two had already announced they’d vote for the bill: Kaptur (OH 9), Carney (PA 10). Five had not: Stupak (MI 1), Driehaus (OH 1), Dahlkemper (PA 3), Mollohan (WV 1), Rahall (WV 3). All voted for the rule and can be presumed to vote for the bill. Without those five votes, the bill—if this count is correct—would have gone down 213-218.

Conclusion: the Democratic leadership had to make a deal with Stupak in order to avoid defeat. As was the case in November. The large number of Democratic defections suggests how unpopular this bill is with the voting public. Without the abortion deal, the leadership was losing 40 of the 253 House Democrats. Perhaps some other Democrats will come on board; we'll see. But I doubt it.

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