Three Senators appear to be key to passage of health reform, Ben Nelson of Nebraska, Joe Lieberman of Connecticut, and Blanche Lincoln of Arkansas. Their support of the Senate version of the health bill, which was required for passage, was hard won and could evaporate over any little deviation from the Senate version in the final bill. That would leave the Democrats without the 60 votes needed to pass the legislation. For example, some House Democrats are insisting that the final bill contain a provision for a national health exchange instead of state-based exchanges as contained in the Senate bill. Nelson is opposed to a national exchange and might bolt if it is included.
The January 19th election to fill Ted Kennedy's seat is a further complication. Massachusetts Attorney General Martha Coakley is still favored to win but Republican state Senator Scott Brown with the help of teaparty money has closed the gap. If Coakley loses, Senate Democrats would lose the 60th vote even if they keep the votes of Nelson, Lieberman, and Lincoln. A Coakley loss would mean the Democrats would have to get the final health bill voted on before the winner of the Mass election could be certified and sworn in which would be Jan 29th at the earliest.
This is coming down to the wire. I still think the Democrats and Obama administration will put it off. However, if they fail, forget about any major health reform for a generation and expect health insurance premiums to skyrocket. Having won, health insurance companies will raise premiums and deny coverage at will. There will be nothing to stop them.
Let's hope that doesn't happen. And, if you have any spare cash, send it to Coakley to help her fight the swiftboating teapartiers ASAP. There is no time to lose.