It's interesting to note that for all the mislabelling of a constitutional republic as a democracy by the talking heads of the Left, the last thing the current majority party will allow is a straight-up vote on the current (whatever the latest secret iteration may be) healthcare bill in the House. Not only would it fail massively in a true nation-wide, one-person one-vote referendum, but even via representative voting it's unacceptable, due to being judged simultaneously insufficiently and overly personally invasive.
So it will be "deemed" as passed, as the lumpenproles cannot be permitted to delay the progress of social justice and equality for all. And the people, like chickens, will squawk and run circles for a while, then settle down to their new reality of higher taxes and limited care while looking back in amazement that people once actually chose insurers and had a host of wasteful medical choices that required partial personal payment. Much like many people now find it difficult to believe that the Federal government was once capable of operating without stealing a portion of the citizenry's income every payday.
Which puts us that much closer to older forms of government, in new attire:
"Tyrants would distribute largess, a bushel of wheat, a gallon of wine, and a sesterce: and then everybody would shamelessly cry, 'Long live the King!' The fools did not realize that they were merely recovering a portion of their own property, and that their ruler could not have given them what they were receiving without having first taken it from them."
Estienne de la Boetie
Discourse on Voluntary Servitude