But Nelson also says he isn't necessarily on board for the long haul. "This cloture vote is based on a full understanding that there will be a limited conference between the Senate and House," he told reporters Saturday morning. "If there are material changes in that conference report, different from this bill, that adversely affect the agreement, I reserve the right to vote against the next cloture vote." That's not likely to please House progressives, who are hoping to use the conference committee to undo some of the damage Nelson and Sen. Joe Lieberman, I-Conn., did to the bill on the Senate side.

The text of the legislation is available here -- be warned, it's a 383-page PDF. (Republicans are making the Senate clerk read the whole thing out loud, and you can watch on C-SPAN.) A senior Democratic aide passed along the summary documents that Reid's office has sent out to the rest of the Senate. The bill would ban insurers from imposing annual limits on healthcare payouts after 2014, and ban lifetime limits immediately; it would require insurers to pay out at least 80 percent of premiums on care; it would ban insurers from denying coverage to children for preexisting conditions immediately (and, within a few years, would give adults the same protection); and it would expel insurers who jack their premiums up from the new exchanges, which could -- in theory, at least -- discourage them from doing that.

Below, a look at what Democrats are calling the highlights in the proposal:

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Manager’s Amendment to the Patient Protection and Affordable Care Act

Providing More Competition & Affordable Choices for Americans

The Manager’s Amendment to the Patient Protection and Affordable Care Act builds upon the strong bill we already have. It demands greater accountability from health insurance companies while creating more choice and competition for consumers. It implements new programs to further rein in health costs and makes health insurance policies more affordable; and it improves access to quality, affordable health care for children and vulnerable populations.

Tougher Accountability Policies for Health Insurance Companies

• Stronger medical loss ratios. Health insurers will be required to spend more of their premium revenues on clinical services and quality activities, with less going to administrative costs and profits – or else pay rebates to policyholders. These stricter limits will continue even after the Exchanges begin in 2011, and apply to all plans, including grandfathered plans.

• Accountability for excessive rate increases. A health insurer’s participation in the Exchanges will depend on its performance. Insurers that jack up their premiums before the Exchanges begin will be excluded – a powerful incentive to keep premiums affordable.

• Immediate ban on pre-existing condition exclusions for children. Health insurers will be immediately prohibited from excluding coverage of pre-existing conditions for children.

• Patient protections. Health insurers will have to abide by a set of patient protections that, for example, protect choice of doctors and ensure access to emergency care.

• Ensuring access to needed care. The use of annual limits on benefits will be tightly restricted to ensure access to needed care immediately, and will be prohibited completely beginning in 2014.

• Guaranteed opportunity to appeal coverage denials. All health insurers will be required to implement an internal appeals process for coverage denials, and states will ensure the availability of an external appeals process that is independent and holds insurance companies accountable.

Stronger Policies to Make Health Care Affordable

• Innovation. Medicare will be able to test new models and, if successful, implement them via a stronger Innovation Center, Independent Payment Advisory Board, and other authorities.

• Transparency. New requirements will ensure that insurers and health care providers report on their performance, empowering patients to make the best possible decisions.

• Small businesses. A package of improvements include starting the health insurance tax credit in 2010, expanding eligibility for the credit, and improving the purchasing power of small businesses.

More Health Insurance Choices

• Multi-state option. Health insurance carriers will offer plans under the supervision of the Office of Personnel Management, the same entity that oversees health plans for Members of Congress. At least one plan must be non-profit, and the plans will be available nationwide. This will promote competition and choice.

• Free choice vouchers. Workers who qualify for an affordability exemption to the individual responsibility policy but do not qualify for tax credits can take their employer contribution and join an exchange plan.

Improved Access to Quality Health Care for Seniors, Children, and Vulnerable Populations

• Quality of care in Medicare. Seniors will benefit when additional health care providers are reimbursed by Medicare for the quality of care they deliver, not the quantity of services they provide.

• Children’s health. Support will be extended for the Children’s Health Insurance Program and the adoption tax credit. Foster care children aging out of Medicaid will be able to retain its comprehensive coverage.

• Community Health Centers. A substantial investment in Community Health Centers will provide funding to expand access to health care in communities where it is most needed

• Rural and underserved communities. Access will be expanded through funding for rural health care providers and training programs for physician and other types of health care providers.

• Vulnerable populations. A range of new programs will tackle diseases such as cancer, diabetes, and children’s congenital heart disease, will improve the Indian Health System, and will provide support for pregnant teens and victims of domestic violence.

Identifying Alternatives to Litigation

• Testing new models. States will be eligible for grants to test alternatives to civil tort litigation that emphasize patient safety, disclosure of health care errors, and early resolution of disputes, with a provision for patients to opt-out of these alternatives at any time. Alternatives will be evaluated to determine their effectiveness.

Like the big banks, these four companies would no doubt prefer to be free of government assistance, which comes with pay and other restrictions on their executives. But they appear at risk of getting onto a debt merry-go-round, where they have to draw new money from the government just to keep up with their existing government debts.

Fannie Mae recently warned, for example, that it could not pay the dividends it owes the Treasury, so “future dividend payments will be effectively funded with equity drawn from the Treasury.”

All told, the four have already drawn $600 billion combined and that figure could grow to $1 trillion. To put that figure into perspective, if unpaid it would be more than the 10-year cost of the healthcare plan. My word.

And how are they doing so far in honoring their obligations? Answer: mixed.

A spokeswoman for GMAC pointed out that the company had made all its scheduled dividend payments to the Treasury, as had Freddie Mac. While Fannie Mae has said it will have trouble paying its dividends, A.I.G. does not have to pay dividends.

A spokeswoman for A.I.G. said that the insurance company was committed to repaying taxpayers, but repayment would depend on market conditions. A Freddie Mac spokesman said that the company was dependent on continued support from the Treasury to stay solvent. A.I.G.’s latest request for money offers an example of why it needs more government aid to pay its debts.

Wilson's also finding himself popping up in quite a few year-in-review recaps as December draws to a close. Dictionary publisher Merriam-Webster named "admonish" its 2009 word of the year, because it received the most intense search traffic of the entire English language after the House voted to, well, admonish him. (For the record, the dictionary defines the word as "to express warning or disapproval to especially in a gentle, earnest, or solicitous manner," which is about right for the toothless resolution on Wilson.)

That wasn't it. Time magazine named Wilson's outburst number three in the year's top 10 political gaffes. Yale University is listing "you lie!" in its book of memorable 2009 quotes (alongside Kanye "I'm going to let you finish, but Beyonce had one of the best videos of all time" West and South Carolina Gov. Mark Sanford's spokesman's claim that his boss was "hiking the Appalachian Trail").

Obama's next big speech to a joint session of Congress -- the 2010 State of the Union -- won't come for another month or two. But given all the notoriety for Wilson, will some other GOP backbencher feel moved to shout during that one, too?

But killing the bill could mean absolutely nothing happens on healthcare reform at all. The Senate has been working on this for most of the year; if it dies now, it's not coming back. And even though Senate Majority Leader Harry Reid is unlikely to find 60 votes to restore the public option or the Medicare buy-in, there are other ways to make a bad bill better before lawmakers vote on final passage. Here's a breakdown of some progressive concerns about the healthcare reform bill most likely to face the Senate, and what Senate Democrats can do to address them. One word of caution: So far, there is no "bill," there are numerous amendments being floated, and it's not sure exactly what will emerge for a Senate vote. And of course, whatever the Senate passes still has to be merged with the House's far stronger legislation. But here are the top five critiques about what's out there for now, and how to improve the bill to answer them:

1) Individual mandates

The problem: Without a public option, the Senate bill would force Americans to buy healthcare from private insurance companies, who could act as a monopoly. So according to this line of reasoning, the real winners would just be the private insurers who got us into this mess in the first place. MSNBC's Keith Olbermann is one proponent of this point of view, arguing on "Countdown" Wednesday night that he will go to jail rather than purchase private insurance under this mandate, and urging his progressive audience to do the same.

The diagnosis: There is no way to expand the current insurance system to cover everyone without an individual mandate. At the moment, insurance companies discriminate against people who would be most likely to use insurance by making it unavailable to those with preexisting conditions. Healthcare reform would make this illegal and force insurers to make coverage available to everyone. But without an individual mandate, young, healthy people might not buy healthcare at all, causing premiums for older, sicker people to skyrocket. That's why every healthcare system (British, Swedish, French, Canadian, you name it) with anything approximating universal coverage has some version of individual mandates. Otherwise, universal coverage just doesn't work.

Salon's prescription: Keep individual mandates -- and work on introducing higher subsidies and better regulations to help make insurance affordable for the millions of people who will suddenly have access to it.

2) Who's covered, and how?

The problem: While proponents say the bill will extend coverage to another 31 million Americans, that's a shell game; they're doing it by mandating Americans to purchase insurance.

The diagnosis: The bill would do more than just make people purchase private healthcare: 14 million of these people would gain coverage through the expansion of Medicaid. The other 17 million, who would effectively be "forced" to buy into some private plan, are mostly people who can't currently afford to buy healthcare. Under the Senate bill, people making up to 400 percent of the poverty line ($88,200 for a family of four) would be given subsidies to purchase this insurance.

Salon's prescription: Again, push for higher subsidies extended to more Americans, so the new insurance isn't as unaffordable as the status quo is.

3) Preexisting conditions

The problem: Allegedly, the ban prohibiting insurers from denying coverage to people with preexisting conditions is meaningless. Sure, insurance companies would have to sell these people a plan -- but they could still charge exorbitant premiums and effectively price them out of the market.

The diagnosis: Under the most recent draft of the Senate bill, insurance companies can still charge more for insurance under certain circumstances. However, the bill dictates that premium rates can only vary based on age (older people can be charged up to three times as much for insurance as other planholders) or tobacco use (smokers or other users can be charged up to 1.5 times as much for insurance). Of course, in an ideal world, these factors wouldn't affect premium costs either, but the Senate bill would still make it significantly easier for people with preexisting health conditions to buy insurance.

Salon's prescription: Other than ensuring that there aren't any hidden loopholes, leave it be. The Senate's regulations regarding preexisting conditions would actually accomplish quite a bit.

4) Annual care caps

The problem: The Senate healthcare bill would allow insurance companies to implement annual dollar limits on medical care for people with a costly illness like cancer. This would defeat the purpose of health insurance, since it would no longer protect people from the worst-case scenario (you know, the one where you contract an incredibly costly illness whose treatment you can't possibly afford).

The diagnosis: Although the Senate Finance Committee prohibited annual caps altogether, the Senate bill would only bar "unreasonable" annual caps on medical costs. A Reid spokesperson justified the decision by citing concerns that banning all annual limits could lead to higher premiums. Getting rid of these caps might lead to higher premiums, but permitting them would definitively defang health insurance: It would provide coverage for everyone except people who need it most.

Salon's prescription: Remove this provision from the bill, or define "unreasonable" caps at a level that actually makes sense for the average family's budget. This shouldn't be too difficult: The White House has already indicated that it wants to strike the provision, and even Lieberman hasn't threatened to filibuster a bill that doesn't permit annual caps.

5) Insurers operating across state lines

The problem: The Senate bill would permit insurance companies to sell policies across state lines -- and let the companies choose which states' laws and regulations they would have to follow. This would allow insurers to avoid the strongest consumer protections and benefits required by state governments. A group of House Democrats from Maine and California argue that the arrangement "will lead to a race to the bottom in insurance regulation and severely threaten the important and often lifesaving protections the residents of our states enjoy."

The diagnosis: The bill does already contain several provisions to help avert this scenario. First, states would only be able to join interstate compacts by enacting a state law. So, any state that ended up undermining its own insurance regulations by joining an exchange would have done so through its own legislation -- which is unlikely. Also, insurance companies -- regardless of where they were based -- would still have to comply with some of the regulations of the state where the insurance purchaser lives. Finally, insurers would also need to obey the federal requirements stipulated by the bill in order to participate in the insurance exchanges it would set up. (But these regulations have yet to be spelled out.)

Salon's prescription: Push for stricter federal requirements as part of the insurance exchange system the bill would set up. Doing so would force insurance companies to provide better coverage across the nation, regardless of what state they were based in.