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epa02086979 U.S. House Speaker Nancy Pelosi (Democrat / California), (R) holds the hand of her grandson Paul Michael Vos, 3, as she exits the Democratic Caucus, on Capitol Hill in Washington, D.C., USA 20 March 2010. President Barack Obama addressed the caucus, one day ahead the health care reform vote, to urge undecided Democrats to pass the historic legislation. EPA/MIKE THEILER