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Lauren Victoria Burke / AP Photo Amid the 11th-hour frenzy to line up the votes on health care, House Speaker Nancy Pelosi gave Matthew Yglesias her best argument: This may be members’ only shot at leaving a meaningful legacy.

Comprehensive reform of the American health-care system passed the House of Representatives last summer. Then in December, a health-reform bill overcame massive Republican obstructionism and repeated filibusters and passed the U.S. Senate. The country seemed on track for President Barack Obama to sign a landmark bill early in the New...