James Madison (37 at the time), wrote, This power over the purse may, in fact, be regarded as the most complete and effectual weapon with which any constitution can arm the immediate representatives of the people, for obtaining a redress of every grievance, and for carrying into effect every just and salutary measure (Federalist 58).
Architecturally, the Senate stripped a House bill of all words, inserted Zerocare, sent it back, they passed it and here we are. Literally a magic trick at midnight at Christmas.