Participants applaud in the East Room of the White House in Washington on Tuesday, March 23, 2010, as President Barack Obama, flanked by Macelas Owens of Seattle, left, and Rep. John Dingell, D-Mich., right, signs the health care bill. Behind the president, from left are, Senate Majority Whip Richard Durbin of Ill., Vice President Joe Biden, Vicki Kennedy, widow of Sen. Ted Kennedy, Rep. Sander Levin, D-Mich., Ryan Smith of Turlock, Calif., Health and Human Services Kathleen Sebelius, House Speaker Nancy Pelosi of Calif., House Majority Leader Steny Hoyer of Md., Senate Majority Leader Harry Reid of Nev., Rep. Patrick Kennedy, D-R.I., House Majority Whip James Clyburn of S.C., and Rep. Henry Waxman, D-Calif. (AP Photo/J. Scott Applewhite, File)

Participants applaud in the East Room of the White House in Washington on Tuesday, March 23, 2010, as President Barack Obama, flanked by Macelas Owens of Seattle, left, and Rep. John Dingell, D-Mich., right, signs the health care bill. Behind the president, from left are, Senate Majority Whip Richard Durbin of Ill., Vice President Joe Biden, Vicki Kennedy, widow of Sen. Ted Kennedy, Rep. Sander Levin, D-Mich., Ryan Smith of Turlock, Calif., Health and Human Services Kathleen Sebelius, House Speaker Nancy Pelosi of Calif., House Majority Leader Steny Hoyer of Md., Senate Majority Leader Harry Reid of Nev., Rep. Patrick Kennedy, D-R.I., House Majority Whip James Clyburn of S.C., and Rep. Henry Waxman, D-Calif. (AP Photo/J. Scott Applewhite, File)

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