It looks pretty ugly--the bill includes restrictions on federal funding for abortion and it passed narrowly--with two more votes than necessary.
We should not be surprised by either outcome. Abortion is still a highly divisive issue, and there are enough house seats where an incumbent cannot appear to be supporting the funding of abortion. In surveys, majorities are against banning abortion but they are also against federal $$ for abortion.
I avoided American politics classes throughout my life, but I did pick up one or two nuggets along the way. One of them is consider a vote total as an artifice of party organization, even or especially a narrow one. So, once the Dems knew that it would pass, they let those in more vulnerable positions to vote against. At least, that is the theory, and I have no reason to doubt it here. I am sure that some political scientist will look at the vote on this bill and determine that Dems in red or purple districts, Dems in first or second terms, Dems with stronger competition (I don't know how that would be operationalized) voted against the bill. Just a guess. [NYT has a good start on this]
Oh, and this was the easy part. We knew that a Health Care Reform bill would get through the House of Representatives. Getting through the Senate will be quite difficult, but the chances are pretty good for that now. On the other hand, as both my past week of cards and last night's (and this morning's) final table of the World Series of Poker demonstrate, low probability events just mean that something is unlikely, not impossible.