Mark Mardell explores how the healthcare debate has changed US politics.

Crowds chant “kill that bill” outside Capitol, carrying banners against the US President’s health reform plans.

Their movement has grown with the fight becoming a focus for opposition to the President.

Protestors such as Jim Heath tell me that they fear the President wants to transform the country into a socialist nation and that he can’t wait until the 2012 presidential elections to vote him out.

The campaigners are a group that fear their country has been captured from them.

A recurring theme is a view that strong government intervention in healthcare is not the American way and that discussion has not been open.

There is also a belief that there is widespread distrust and the process of what is happening is "frankly just as bad as the bill".

A view that Obama is not governing is common and many opponents say he has not lived up to his promises.

Some who did vote for Obama are among those making it clear that they do not like his healthcare reform proposals and that America simply cannot afford them.

It seems clear to me, with the vote still to take place, that the lack of discipline over the issue within the Democratic Party has been damaging.

After months of argument, liberals feel the plan has been watered down so much as to make it virtually worthless as the issue returns to the House.

Win or lose, the healthcare issue has dominated Obama's domestic agenda at the expense of allowing him to be heard on the economy and will continue to haunt him.