The death of Edward Kennedy has left politicians in Washington pondering what impact the removal of one of health care reform's greatest advocates will have on an increasingly bitter debate.
The issue was a major passion of the late senator's career, and some see his absence as taking away the one man blessed with the political ability to forge cross-party consensus.
Others put forward the counter view that his death will galvanise proponents of reform, giving them fresh emphasis to push forward plans to expand health coverage and bring down costs.
Senator Kennedy's death at the age of 77 could not have come at a more sensitive time for the health care issue.
A series of town hall debates across America has resulted in a hardening of rhetoric, with events often dissolving into little more than shouting matches as tempers flare.
His death has brought about a temporary respite from the war of words between Democrats and Republicans.
It is the kind of consensus that many believe the veteran senator could have fostered in the health care debate, had he been fit to exercise his political skills.
Bill Galston, former policy advisor to President Clinton and expert on domestic policy at the Brookings Institution, said: "Had Senator Kennedy been in full health over the last year we might very well be in a different place right now.
"He had two unique capabilities as a legislator. One was the ability to work out where the centre of gravity would be, where the compromise would be."
"Secondly, he could persuade members of his own party, notably liberals, to make compromises. His absence over the last year has made a difference."
Mr Kennedy's retreat to his Massachusetts home to fight personal health problems removed a key figure who could have persuaded opponents to sign up to President Obama's proposed health care programme.
His death has now deprived Democrats of his consensus-building abilities on a permanent basis.
But others have suggested that his death could provide a rallying call to health care reform advocates to redouble their efforts to get a bill through Congress.
Senator Christopher Dodd, a friend of Mr Kennedy, said: "Maybe Teddy's passing will remind people once again that we are there to get a job done as he would."
Mr Galston said he is not convinced that Senator Kennedy's passing will have a great impact on the debate in the long run.
He said: "When the dust settles and the tributes end, we will be very close to where we were a week ago. I could be wrong, I hope I'm wrong, but I do not think this is a galvanising moment. The divide is too deep."
Karen Davis, former White House adviser on health care and president of the advocacy group Commonwealth Fund, described Senator Kennedy as a gifted champion of reform who could find common ground in the issues.
But she too believes that the impact of his death will not affect the chances of reform getting through.
She said: "I do not think it will fundamentally accelerate or slow health care reform. The issues are now well understood and clearly President Obama is the lead in trying to find something that will get a majority.
"I do not see his death as a major factor going forward in either affecting the contents of the reform bill or building consensus."Reuse content