From a reader who called Massachusetts Democrat Stephen Lynch:

Because Altmire and Lynch have both come out against the Slaughter Rule (and Lynch released a statement announcing his switch to NO today), I contacted their offices to ask how they could have voted to permit the Slaughter Rule in the just-concluded House vote. Altmire’s office said they haven’t gotten a statement just yet, but Lynch’s office maintains that today’s vote was purely a procedural vote, and one which had nothing to do with health care. They maintain that Lynch is still against the Senate Bill and the Slaughter Rule.
I informed Boehner’s office and they couldn’t explain this except to say that it was technically true (even though everyone knew what the purpose of this procedural vote was), and that there have been cases, such as TARP, where someone will vote to allow legislation to come to the floor and then vote against the legislation.
Perhaps Altmire and Lynch think leadership should have the right to use the Slaughter Rule, even though they personally are against it? Altmire said pretty much exactly this on Hannity last night.
A lot of people are now saying if Pelosi had 222 votes to defeat the Republicans’ attempts to block the Slaughter Rule, that she must then have at least as many to vote for the actual Rule on Sunday (or whenever it’s brought for a vote). But perhaps there other reasons why some Democrats votes with their party this afternoon . . .

I’m not sure how you explain calling a rule “disingenuous” one day and literally vote to okay it the next, but if Lynch votes “no” on health care, I suspect few will remember that aspect of this debate . . .