U.S. Speaker of the House Nancy Pelosi (C) laughs next to Majority Leader Steny Hoyer (D-MD) (R) and Rep. George Miller (D-CA) (L) during a news conference about the House vote on health care reform on Capitol Hill in Washington November 7, 2009. The U.S. House of Representatives approved a sweeping healthcare reform bill on Saturday, backing the biggest health policy changes in four decades and handing President Barack Obama a crucial victory.
REUTERS/Yuri Gripas (UNITED STATES POLITICS HEALTH)