End Game: So When Will Health Care Really Happen?

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Christina Bellantoni

Yesterday's events have given health care new momentum, but advocates are a long way from popping champagne.

There remain unanswered questions about how the proposed Senate bill and public option opt-out will be structured, along with questions about its final cost and how the government will pay for it.

A Democratic aide told TPMDC today the House is aiming to have its bill on the floor in early November with a vote by Nov. 11, Veterans' Day.

The Senate has several stages ahead - a CBO score for the merged bill Senate Majority Leader Harry Reid introduced yesterday and then an agreement for what amendments will be allowed. It will be on the floor for debate in the next two weeks.

Once each bill passes its chamber, private negotiations will produce a conference report that will get another House and Senate vote.

Translation: there may be snow on the ground in D.C. before anything finally heads to President Obama's desk.

Most of the conservative Democrats Reid is trying to win over aren't saying yet if they will back the party in a procedural vote to cut off debate, a legislative term known as cloture that needs 60 votes. (Joe Lieberman (I-CT) just said he would be okay with a filibuster, while Sen. Blanche Lincoln (D-AR) isn't sure.)

Leadership expects Republican shenangians, and our GOP sources suggest that's an accurate hunch.

House Democrats have been telling TPMDC for weeks they are angling for a "robust" public option so that would give them a stronger negotiating point once both chambers have passed their versions of a bill.

They argue it will be easier to muscle the public option into the final conference report, which must get an up-or-down vote with no amendments possible on both floors. Several House aides have told me they view that stage as easier, since they think Reid can muster 51 votes for final passage.

But Republicans can still filibuster a conference report, and it's back to the question of the 60 votes Reid needs to break one.

He's talking one-on-one with centrists who either aren't comfortable with the public option or who are getting political pressure back home.

And that's where the advocacy groups we wrote about earlier come in.

If the unions and groups like MoveOn do what they are promising and rally for Lincoln and others, that could be the difference between winning and losing in 2010.

MoveOn announced today the results of a survey of its 3.2 million members, showing 93 percent do not think MoveOn should back senators that vote with Republicans to filibuster the health care bill.

"That means no donations, no volunteering, and no help getting out the vote," MoveOn told members, adding stats for the states of Nelson, Lincoln and Sen. Mary Landrieu (D-LA).

MoveOn members who have given previously to Nelson's campaign are sending him letters reading, "If Senator Nelson joins with Republicans to block an up-or-down vote on a health care reform bill, as a past supporter I will refuse to support Senator Nelson's re-election."

Lincoln will get the same treatment.

"Our member vote can provide a clear incentive to senators who are deciding where they stand on Senator Reid's bill," the group wrote in an email to members. "So MoveOn members are hitting the streets, and the phones, to get the word out. We've planned in-person events at the state offices of conservative Democrats starting today, we're developing a new round of ads, and we'll be flooding their offices with phone calls all week."

MoveOn also tells members that even though it's a promising compromise, the opt-out isn't the best type of public option and that they will keep fighting for a "robust" one in the final package.

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