Opponents even used technology as a bogeyman in their arguments, pointing to the bill's support of Electronic Medical Records and the work of the Bush-created National Health Technology Information Coordinator, a position now held on an acting basis by Robert Kolodner (right).
But with the passage of the bill comes urgency to spend the money, to create jobs with it. And with up to $47 billion on the line, this means the Administration needs a strategy.
It's in this light that we consider the open letter which open source companies want you to sign. Its aim is purely political, to pressure the President to support open source processes in building new technology infrastructure.
While Obama has consulted with open source advocates like CEO Eric Schmidt of Google, and while Kolodner has experience with the VA's VistA software, there has not yet been a clear direction set.
The problem, for the President, comes down to two questions, one simple and obvious, one far more complex.
Support of open standards would appear to be a no-brainer. Even the health IT industry itself is moving toward interoperability. A clear statement on that would be easy to write, and relatively easy to implement.
Support for the open source process is far more complex. It's not the visibility of the code which is at issue. It's the customer responsibility which comes with it that will prove difficult to implement.
Many agencies, especially the Department of Defense, think only of buying goods, never of their own responsibility in designing or improving them, a responsibility open source really forces on enterprises.
Creating this sense of responsibility throughout the the government will be a big job, demanding commitment from the nation's CTO and the direct support of the Administration.
That is because the last Administration did all it could to kill this necessary spirit of invention. As of this writing it is even on its last legs within the Veterans Administration, the scene of its greatest triumph.
It will take enormous effort, against enormous resistance, to rebuild this spirit, starting in the VA but extending throughout the government.
What happens with this stimulus money will go a long way in deciding whether that work succeeds, or indeed if it ever begins.