WASHINGTON - It could have been the Nazi comparisons. Perhaps it was recent remarks from top Republicans that they'd support no health-care reform bill. Or it could just be spent reserves of patience following weeks of misinformation about death panels and health insurance for illegal aliens.
Whatever the reason, Democrats appeared to be fighting back on Wednesday amid relentless attacks from Republicans and their supporters about President Barack Obama's sweeping health-care overhaul.
The White House and leading Democrats were reportedly plotting to "go it alone" - in other words, to ram health-care reform legislation through Congress without the bipartisan support Obama had promised.
Two top Democrats in the House of Representatives, meantime, have asked dozens of the country's biggest health insurance companies to provide detailed financial records by early September. The House returns from summer recess on Sept. 8, when health-care reform will be the top item of business.
Fifty-two letters have been sent to health insurers making US$2 billion or more in annual premiums, upping the ante as the White House reportedly prepares to demonize the health insurance industry in the next round of the reform battle.
The letters were sent as part of a congressional probe into executive compensation and other business practices in an industry that vehemently opposes Obama's health-care reform plans and is suspected of organizing some of the grassroots opposition to it.
It's another sign suggesting the Democrats are swinging back. It follows days of signals from top Republicans that they won't vote in favour of any health-care bill, and stems from a growing sense of frustration among Democratic lawmakers and Obama's liberal support base about the venal tone of the arguments against reform.
The ever-outspoken Barney Franks, the chairman of the House financial services committee, minced no words on Tuesday night at a town hall meeting in Massachusetts when someone likened Obama's health-care plans to "Nazi policy."
"On what planet do you spend most of your time?" Franks replied to the woman as constituents cheered and applauded.
Franks assailed her for carrying a photograph of the president defaced to look like Adolf Hitler - the type of sign that's been seen among Obama opponents since the so-called teabag protests in April.
"It is a tribute to the First Amendment that this sort of vile, contemptible nonsense is so freely propagated," Franks said. "Trying to have a conversation with you would be like trying to argue with a dining room table; I have no interest in doing it."
Franks's "mad as hell" moment, captured by CNN cameras, went viral on Wednesday, showing up on countless websites, blogs and Facebook walls and met largely with celebration.
Could it symbolize a change in tone and tactic by the White House?
White House chief of staff Rahm Emanuel talked tough about Republicans in the New York Times on Wednesday.
"The Republican leadership has made a strategic decision that defeating President Obama's health-care proposal is more important for their political goals than solving the health insurance problems that Americans face every day," he said.
But press secretary Robert Gibbs denied that the administration had reached its breaking point with congressional Republicans, saying Obama still hoped to win bipartisan support for health-care reform.
"The president has said countless times he will work with anybody in any party," he said.
Some say the Democrats don't have the votes in the Senate to pass a bill - it needs 60 to break a Republican filibuster and only has 58 due to two ailing senators, Ted Kennedy and Robert Byrd. As well, some fiscally conservative Democratic senators, known as Blue Dogs, may not support a final bill.
But there's another potential option - something called budget reconciliation. That would allow Democrats to push the bill through with only 51 votes.