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Comprehensive health care reform is teetering on the edge.
The House Democratic whip operation already may need to flip a dozen votes on health care reform into the yes column to pass a compromise overhaul, and all bets are off if Senate Democrats lose Tuesdays Massachusetts special election and shatter their 60-vote supermajority.
President Barack Obama and Congressional Democratic leaders negotiated long into the night last week to hammer out key pieces of the reconciled House-Senate health care package, clearing the most obvious hurdle by reaching a deal with union leaders to pare back a Cadillac tax on high-cost health plans. But attention quickly shifted to Massachusetts Attorney General Martha Coakleys (D) cratering Senate campaign, with multiple polls over the weekend showing her slipping further behind Republican state Sen. Scott Brown in deep blue Massachusetts.
Democratic leaders publicly espoused confidence that Coakley would eke out a victory, but behind the scenes were nearing full-out panic mode. Members were cutting checks to Coakley, Obama jetted to Massachusetts on Sunday to campaign, and House lawmakers like Rep. Barney Frank (D-Mass.) told reporters that a Coakley loss would kill the health care bill.
Even if Frank is wrong, Democrats face a serious climb if Coakley loses in her bid to succeed the late Sen. Edward Kennedy (D-Mass.), the veteran lawmaker who on his death bed called health care the cause of my life.
If Brown wins decisively, Massachusetts election officials would likely have to certify him the winner by early February a time frame that would give House and Senate leaders only about two weeks to pass the health package. Thats a tall order given the need for a Congressional Budget Office cost estimate, House leaders vow to allow Members to review the bill for 72 hours before voting, the lack of a final deal yet on the thorny issues of abortion and immigration, and Senate procedural roadblocks that could add at least another three or four days of delay.
And the political backlash of jamming through the massive bill in the face of a defeat in what was thought to be a solid Democratic seat could make some Democrats balk.
Senate Democratic aides speculated that vulnerable incumbents, such as Sen. Blanche Lincoln (D-Ark.), could rethink their support for health care reform in that scenario. Additionally, Senate Majority Leader Harry Reid (D-Nev.), who is perhaps the most endangered of the chambers Democrats this year, is already facing considerable unrest back home for his role in pushing health care.
Its a similar dynamic in the House, where leaders endgame relies on converting about a dozen moderate Democrats who voted against the bill two months ago. That task could be complicated even by a narrow Coakley win, if its interpreted by vulnerable Democratic incumbents as a sign of waning national support for the health care reform effort.
Some also have floated behind the scenes the prospect of the House simply passing the Senate bill, an idea rejected out-of-hand by Speaker Nancy Pelosi (D-Calif.) and other House leaders, who have talked about using the budget reconciliation process to push through a measure instead. Reconciliation would allow the Senate to pass at least part of the package with a simple majority and avert a GOP-led filibuster.