It's payback time.
The bill's narrow passage was inarguably a victory for President Obama and a blow to those who opposed it. Though Tea Partiers joined with Republican officials to rally in Washington and across the country against the package up until judgment day, Democrats were able to assuage skeptical lawmakers and muster the votes needed to send the sweeping overhaul of the nation's health care system to the president's desk.
Now those lawmakers have to go, Tea Partiers say, and they're planning to sustain their fight into November by registering voters, pumping money into ad campaigns against Democratic incumbents and supporting their challengers.
Some want to elect lawmakers with the ultimate goal of repealing the bill; but with repeal a heavy lift, at the minimum the groups are out for vengeance.
And while the Sunday vote was a defeat for the cause, it was potentially a boon for membership.
"I am deluged with phone calls this morning (from) people wanting to join the Tea Party," said Gina Loudon, a founder of the St. Louis Tea Party, which campaigned against the bill during Obama's stop there two weeks ago. "I literally cannot even return the phone calls quickly enough. ... This has absolutely awoken a giant."
Loudon said she and other activists -- who met up at a pub in downtown St. Louis Sunday night to mourn the passage of the bill -- are already drafting a game plan for the months ahead. She said getting involved in congressional campaigns will be a big part of that.
Expect Tea Party political action committees (PACs), to gain a lot more prominence in the months ahead. Loudon said the Ensuring Liberty PAC, the political group announced last month at the Tea Party Convention in Nashville, is going to be raising money and influencing targeted races -- her husband is a board member of that group.
Debbie Dooley, co-founder of the Atlanta Tea Party and a national coordinator of Tea Party Patriots, agreed that the focus will be on voting out health care reform bill supporters.
"Yesterday, they chose not to listen to what the people want," she said. "We, the people, will have our say in November."
She said lawmakers like Rep. Bart Stupak, D-Mich. -- who had been a holdout against health care reform over abortion funding concerns but who switched to a yes vote after striking an agreement with the White House -- are top targets. She said Tea Party groups plan to continue holding rallies and showing up at lawmakers' town hall meetings and congressional offices to protest the bill.
"This health care vote was not the end. It is just the beginning of the fight," she said.
The House on Sunday passed the Senate-approved health care bill along with a package of changes that House Democrats want the Senate to approve next. The bill is being considered under reconciliation rules, which would allow Democrats to pass it with just 51 votes, as opposed to the 60 that would otherwise be needed to avoid a filibuster.
Dooley said Tea Party groups will do what they can to fight the reconciliation bill as well -- not out of any particular objection to its contents but out of concern about the reconciliation process and a desire to hold House members accountable for the vote on the Senate bill.
They argue that preventing the reconciliation bill from passing could make some House Democrats even more vulnerable in November.
"We want to make this election a referendum on the bill," said Brendan Steinhauser, director of federal and state campaigns for FreedomWorks, the conservative organization that's closely aligned with Tea Party groups across the country.
Tea Party Express, a separate group of conservative activists, is also planning to kick off a nationwide tour Saturday in Searchlight, Nev.
Levi Russell, spokesman for the group, said the tour will focus on health care and on highlighting the "worst offenders" in bringing the bill over the finish line. Senate Majority Leader Harry Reid will be the top target at the Tea Party Express kickoff, which former Alaska Gov. Sarah Palin is expected to attend.
Though health care reform may continue to be the overriding issue for Tea Party groups in the months to come, the activists say they're ready to divide their attention among whatever issues Obama chooses to pursue -- immigration reform or cap-and-trade or something else.
"We are as passionate about those as we are about health care," Loudon said.