See larger House Speaker Nancy Pelosi of Calif. clutches a pen used by President Barack Obama to sign the health care hill, Tuesday, March 23, 2010,  in the East Room of the White House in Washington. (AP Photo/J. Scott Applewhite)

House Speaker Nancy Pelosi of Calif. clutches a pen used by President Barack Obama to sign the health care hill, Tuesday, March 23, 2010, in the East Room of the White House in Washington. (AP Photo/J. Scott Applewhite)

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