But as with so much in politics, especially when it comes to Senate procedure, things are not nearly so simple. In fact, if Reid did try using reconciliation, he could end up having to remove key parts of the legislation, not to mention hurting his party politically and losing an extra couple of votes in the Senate -- and, having done all that, he might well find out that he still needed 60 votes in order to get a public option approved.

Reid has ruled out the idea for now, saying last week, "I'm not using reconciliation." And other senators, like Sen. Tom Harkin, D-Iowa, agree with their leader, believing the procedure would end up doing more harm than good. An aide to a senior Democrat, who asked for anonymity in order to discuss the issue more freely, told Salon, "This isn't like a two-week delay, or a three-week delay. This fundamentally changes what we have promised to the American people, and it's risky, and I'm not talking about a little bit of fucking risk, I'm talking about a lot of risk ... It puts universal coverage at risk ... [and] risks allowing insurance companies to discriminate against those with preexisting conditions."

And of those pushing for the use of reconciliation, the aide concluded, "A bunch of people that watched 'Schoolhouse Rock' growing up think that they understand how the Senate works, and they don’t."

The problem is that budget reconciliation isn't really supposed to be used to make policy. Instead, as the Congressional Research Service's Robert Keith said in a 2008 report, reconciliation "is a procedure ... by which Congress implements budget resolution policies affecting mainly permanent spending and revenue programs." In the procedure's early years, however, it was used to circumvent the filibuster on provisions unrelated to that purpose. So in the 1980s, then-Minority Leader Robert Byrd led the Senate in a crackdown. What resulted was the Byrd Rule, which prohibits the Senate "from considering extraneous matter as part of a reconciliation bill."

The definition of "extraneous matter" is fairly broad, and subject to interpretation -- during the Bush administration, Republicans passed tax cuts using reconciliation -- but it generally includes any provision that fails one of these six criteria, as listed in Keith's CRS report:

• it does not produce a change in outlays or revenues;
• it produces an outlay increase or revenue decrease when the instructed committee is not in compliance with its instructions;
• it is outside of the jurisdiction of the committee that submitted the title or provision for inclusion in the reconciliation measure;
• it produces a change in outlays or revenues which is merely incidental to the non-budgetary components of the provision;
• it would increase the deficit for a fiscal year beyond the "budget window" covered by the reconciliation measure; and
• it recommends changes in Social Security

Even if a provision violates one of these rules, it won't automatically be stricken from a bill. In order for that to happen, a senator has to take action, generally by raising a point of order. Then, the chair (the majority leader or a designee) rules on whether to sustain that point of order and remove the offending part of the bill. That may seem like an easy victory in the making -- Reid rules that the public option passes the Byrd Rule's tests, and that's that -- but that's not necessarily the case.

Liberals argue that the public option could survive the Byrd Rule, pointing to tax cuts that Republicans passed using reconciliation during the Bush administration as precedent, and arguing that the public option would pass the tests anyway because it would theoretically decrease the federal deficit.

They may have a point, but it doesn't much matter -- the only thing that does is the opinion of Alan Frumin, the Senate parliamentarian. Technically, Reid isn't required to abide by Frumin's judgment, but according to Robert Dove, who served twice as Senate parliamentarian, he will anyway. "It's not that they have to [listen to the parliamentarian]," Dove told Salon, "but absolutely they do ... The past history is that the view of the parliamentarian becomes the ruling of the chair."

If Reid did rule the public option out of order under the Byrd Rule, the whole point of using reconciliation would be rendered moot. The only way to overturn the chair's ruling in such a case would be with a three-fifths vote of the Senate -- that is, with the same 60 votes the majority leader would need to round up in order to defeat a filibuster. In that eventuality, there's no way Reid could get the supermajority; Lieberman would certainly abandon him, and moderate Democrats might too. Plus, Byrd has already expressed his distaste for the idea of using reconciliation for health reform, and could be expected to vote to support the rule that bears his name.

Dove wouldn't speculate on what Frumin might decide, or give his own view on the matter, but aides from both parties have met with him, and Reid's office made "preliminary inquiries" about the public option, the aide to a senior Democrat told Salon. No one's offering much detail about what Frumin said, but the fact that Reid has taken reconciliation off the table could well have something to do with those meetings.

The public option might not be the only thing dropped from a bill that's pushed through the Senate using the procedure. Republicans would almost certainly object as often as possible to elements in the legislation, and they'd win many of those battles -- maybe even the war. "If you're a Republican, your job in reconciliation is to do two things: One, to put Democrats in an untenable position to have to vote for or against things that are going to bite them in the ass when they run for re-election; but more importantly, your thing is to find provisions where if you snip that out, it's going to bring down the entire bill," the aide to the senior Democrat said.

Ultimately, passing a reform bill with reconciliation is "feasible," Dove says, but the resulting legislation "would not be pretty, and it couldn't contain a lot of things that people want to be in it."

One member of the Senate's Democratic caucus, Sen. Joe Lieberman, I-Conn., has already said he intends to support a filibuster if the bill includes a public option. And he's not the only one saying something like that -- Sens. Blanche Lincoln of Arkansas and Ben Nelson of Nebraska are also talking defection.

That means that unless Reid can work out some sort of deal, he'll need to look for votes elsewhere: specifically, across the aisle. The New York Times reported Monday that he's already done that; along with the White House, he's courting Maine's two senators, Republicans Susan Collins and Olympia Snowe. Both voted with their party on Saturday, but both have also shown signs that they're willing to defect for the right bill. Snowe, for instance, became the only Republican to have voted for any of the Democrats' proposals when she supported the Finance Committee's version of reform legislation.

And Collins is quoted in the Times as saying, "“I have ruled out voting for this bill, but I still very much want to vote for a bill and that is why I am continuing to have discussions. I still cling to the belief that it is possible for a group of us to come together and rewrite the bill in a way that would cause it to have greater support.”

But this is just one procedural vote. The more daunting hurdle of the cloture vote to break a filibuster and hold an up-or-down vote on the bill itself still lies ahead, and there Reid may have serious trouble, especially if a plan to create a government-run insurance provider -- the public option -- remains in it.

Sen. Joe Lieberman, I-Conn., who is a member of the Democratic caucus, has already said he'll vote to filibuster a bill that contains any form of the public option. (He is voting for cloture tonight, but not, he says, the next time around.) And on Saturday, Lincoln too threatened to support a filibuster of the legislation if it includes the public option.

Both will be tough nuts for Reid to crack. Lieberman's not up for re-election next year, and has already been taunting liberals by saying he's not afraid of possible retribution. Lincoln, on the other hand, is up for re-election -- and that's the problem. She's seriously vulnerable, and is looking at polling numbers that seem to indicate voting with her party to support a public plan would only put her in a more precarious position.

 

Public Option: Will states be allowed to “opt out”?

Both bills include the creation of a government-run insurance provider to compete with private insurers. However, the Senate version would allow states to opt out of the public plan.

Abortion: The Stupak Legacy

To garner much-needed support from anti-abortion Democrats, House Speaker Nancy Pelosi (D-CA) allowed them to attach the infamous Stupak-Pitts amendment to her chamber's version of the bill. The provision would bar women who are receiving federal subsidies for their insurance from purchasing plans that cover elective abortions. It would also bar the public plan from offering abortion coverage. The Senate version takes a more moderate approach: Those receiving federal subsidies could buy insurance that covers abortion -- but insurers would have to place federal money in separate accounts and could only use private dollars to cover the procedure. The public plan could also offer abortion coverage, as long as it segregated federal subsidies in the same way.

Cost: The difference a year makes

According to the Congressional Budget Office, the House bill would cost about $1.052 trillion and reduce the deficit by $138 billion. The CBO predicts that the Senate bill would cost $849 billion, while cutting $130 billion from the deficit. This difference is largely due to the fact that many major provisions in the Senate proposal would not go into effect until 2014 -- a year later than in the House bill.

Coverage: Universal? Not quite

For decades, the Democrats talked of providing universal healthcare. These bills come closer, but neither quite reaches that goal. Both, however, will significantly reduce the number of uninsured. Today, 83 percent of non-elderly legal residents have health insurance. (The elderly are covered by Medicare.) Under the House bill, 96 percent of that population would be covered by 2016. The Senate's legislation would expand coverage to 94 percent. Still, about 18 million people would remain uninsured under the House's proposal, as would about 23 million in the Senate's.

 

Paying the bills: What gets taxed

Under the House bill, much of the money to pay for the reforms would be raised through a 5.4 percent surtax on high-income people -- that is, individuals making more than $500,000 a year or couples with annual incomes in excess of $1 million. The Senate version, on the other hand, would impose a different series of new taxes including: A 40 percent tax on “Cadillac health plans” (employer-sponsored group plans with premiums of over $8,500 for individuals or over $23,000 for families); the introduction of annual fees for health care companies; an increase in Medicare payroll taxes from 1.45 percent to 1.95 percent for those earning more than $250,000 a year and the implementation of the so-called "Botox tax," which is a five percent tax on elective cosmetic medical procedures.

Employer mandates: Do companies need to offer health insurance?

The House bill stipulates that employers with payrolls of more than $500,000 must offer health coverage or pay a federal tax. The Senate version does not explicitly require employers to provide coverage; however, companies with 50 or more full-time employees would have to pay a penalty of $750 per employee if they fail to offer coverage and if any of their employees obtain federally subsidized care via the new health insurance exchanges.

Friday, Senate Democratic leaders agreed to include the Wyden amendment in their healthcare proposal. Under this provision, employers would have one of two options. Companies could offer their employees a single plan and give all eligible workers the option of accepting a voucher to independently purchase their own insurance. Alternatively, an employer could offer two or more health care plans, provided that at least one has a premium that costs no more than the average premium of the two least expensive health plans in the local exchange. The House bill includes no comparable language.

Individual mandates: Penalties for remaining uninsured

Both bills require most Americans to maintain a minimum level of health insurance. However, the penalties for not doing so are much stiffer in the House bill: Those who failed to acquire insurance would pay a tax equal to 2.5 percent of their gross income of over $9,350 for individuals or $18,700 for couples. Under Reid’s legislation, the penalties would start at $95 per person in 2014 and gradually go up to $750 a head in 2016.

Insurance Exchanges: State-based or national

Both bills would create some sort of health insurance exchange, a marketplace where individuals and small companies can shop for insurance and compare benefits and prices. The exchanges would put individuals into large risk pools, which are intended to provide them with leverage to purchase insurance at a lower cost. The House bill would create a national exchange, although states could petition to run their own exchanges as well. Under the Senate proposal, states would form their own exchanges. This, however, could prove problematic, as it is unclear whether state exchanges would be able to attract a sufficient number of enrollees to push for lower premiums.

Illegal Immigrants

The House bill would allow illegal immigrants to buy insurance from the exchanges, but would not allow them to obtain federal subsidies. The Senate version prohibits illegal immigrants from purchasing insurance from these exchanges, even if they could pay for their own coverage in full. This could have the effect of preventing illegal immigrants from buying individual insurance altogether.