On the floor of the U.S. Senate, Mitch McConnell, among the cagier and more effective Republicans, uttered a final thought in his fiery denunciation of the health-care bill: “All it takes is one. Just one. One can stop it — or every one will own it.” Every one of the Democrats who voted in lockstep for cloture after 1 a.m. now owns the health-care bill. Each of the senators up in 2010 becomes the decisive vote. And each of them up in 2012 as well. In each and every race, this vote will be one of the top, if not the top issue, and voters enraged by one or another of the bill’s provisions (e.g., abortion subsidies, the violation of Obama’s pledge not to tax families with income less than $250,000, the slashing of Medicare) will get to register their disapproval.

As McConnell pointed out dryly, “But make no mistake: if the people who wrote this bill were proud of it, they wouldn’t be forcing this vote in the dead of night. … The final product is a mess — and so is the process that’s brought us here to vote on a bill that the American people overwhelmingly oppose.”

The bill will have to go to conference committee after passage by the Senate. Speculation is that Nancy Pelosi will run roughshod over her caucus and try to change virtually nothing so as to hold in place hard-won Senate votes. The task won’t be easy, as she may well have to go scrambling for votes lost from Rep. Bart Stupak and other pro-life Democrats unwilling to accept the Ben Nelson abortion language, which has been roundly condemned by pro-life groups. But make no mistake about how shrewd she can be. As one Hill aide put it:

Pelosi can be pretty persuasive down there on the floor. She turned 10 Dems who didn’t want to vote for their second stimulus last week to get the votes she needed. She’ll promise everything under the sun — campaign cash, committee slots, pork projects, etc — whatever she needs to put it over the top.

And she’ll need to offer a lot. For by then, the American people will have learned more about the “mess” they’re about to receive, and House members will be demanding plenty of those Pelosi goodies in exchange for a vote that could quite possibly end their careers.