U.S. President Barack Obama and his Democratic Party allies in Congress are making one last push for health care reform after more than a year of debate. Republicans and grass roots conservative activists are making their own last ditch attempt to block the health care bill, and the passionate battle over reform has spread from the halls of Congress into the streets surrounding the Capitol.
They have come to Washington from across the country in a combative mood with one mission in mind - to stop President Obama's health care bill.
Opposition Republicans bent on killing the bill like Indiana Congressman Mike Pence whip the crowd into a frenzy.
"Let's go from here," he said "Let's scrap the bill. Let's build health care reform that respects the limited government and liberty of the American people, so help us God!"
Grassroots conservatives, many of them members of the so-called Tea Party movement, are out in force at the rally, eager to spread their anti-Obama, anti-tax, anti-big government message.
For many of these activists, stopping health care reform is the first step toward defeating Democrats in Congress in November and President Obama in 2012.
They are rallying around Minnesota Republican Representative Michele Bachmann and other rising conservative stars.
"And we are going to win in November and President Obama will be a one-term president!," said Michele Bachmann.
After more than a year of debate, the president is equally determined to make one last push for health care, including a recent stop in Ohio.
"And so I am calling on Congress to pass these reforms and I am going to sign them into law," said President Obama. "I want some courage. I want us to do the right thing, Ohio, and with your help we are going to make it happen!"
Democrats need every vote to pass Mr. Obama's top domestic priority, and the president did win over one liberal holdout.
"I've decided to cast a vote in favor of the legislation," said Dennis Kucinich.
Ohio Democratic Congressman Dennis Kucinich had opposed the bill because he said it did not go far enough. Now he says Mr. Obama's presidency may hang in the balance.
"How can we empower our president and the Congress and the government to start to move the country forward, notwithstanding the differences we have," he said.
But even on the political left, not everyone is happy.
Health care activists who favor a more comprehensive approach to reform staged their own protest outside the Capitol, complete with signs and even a special song for the occasion.
Donna Smith is a cancer survivor and health care activist. She had hoped President Obama would fight harder for comprehensive reform.
"I ended up bankrupted by cancer and by my husband's serious illness," she said. "That should not be happening in this country, and this bill doesn't stop that, that is my concern. So, am I disappointed? Sure, absolutely."
Despite the objections from both the left and right, House Speaker Nancy Pelosi remains confident that Democrats will prevail in the health care battle.
"We will do what is necessary to pass a health care bill to improve quality, lower cost and make America healthier," said Nancy Pelosi.
With passions running high on both sides of the health care debate, it's likely they will only intensify in the hours leading up to final congressional action.