The Senate Democrats continue to stampede toward passing some form of health reform before year's end, even though only 31 percent of the American people support what Senate Majority Leader Harry Reid (D-NV) is doing, bill language is still not finalized and the Congressional Budget Office still hasn’t released an estimate of how much it will cost the American taxpayer. Several Democratic senators still haven’t committed to vote on the bill, while House Democrats are threatening to oppose the legislation in conference committee and key unions and Democratic party leaders are blasting the legislation. Procedurally, in order to vote before Christmas, Reid has to lock down the 60 votes he needs by tomorrow night. Under that scenario, the Senate would release a revised version of the bill this weekend or on Monday, take a series of votes on the bill next week and end with a vote to close debate at about 7:00 p.m. on Christmas Eve. This is all contingent on Reid’s securing 60 votes together in the coming days and keeping the Senate working practically round-the-clock.
 
As House Minority Whip Eric Cantor (R-VA) predicted this past summer, "If the bill fails it will be because of disagreement among the Democrats." Currently, Senator Ben Nelson (D-NE) remains uncommitted on the bill and on Thursday he rejected compromise language offered by his colleague Bob Casey (D-PA) relative to public financing of abortion-related services in health insurance policies sold through the exchanges. Nelson has publicly threatened to oppose the legislation if it does not include protections against public funding of abortion-related services similar to what were included in the Stupak amendment to the House-passed legislation, but those provisions are vehemently opposed by many liberal senators. Nelson has also expressed concerns about the bill’s cost, the CLASS Act, any public option language and the lack of available bill language to review.

On the other end of the political spectrum, Independent Socialist Senator Bernard Sanders (VT), who caucuses with the Democrats, has also refused to commit to vote on the bill. Sanders was forced to withdraw his single-payer amendment to the original bill, H.R. 3590, this week after Senator Tom Coburn (R-OK) insisted the Senate clerk read the 767-page amendment for three hours on the floor, so that senators and the American people could understand what a single-payer system would entail. Since most variations of any type of government-run public plan option have been taken off the negotiating table, Sanders has refused to say if he will support a compromise Senate bill until he can review it and determine if it is strong enough for him.

Beyond Sanders and Nelson, other moderate Democratic senators like Bayh (IN), Lincoln (AR), Webb (VA), Landrieu (LA), Specter (PA), as well Independent Joe Lieberman (CT), are not certainties either. Currently these senators seems to be on board, but since no senator has seen a completed new bill yet, and since a final cost analysis has yet to be made public, it is uncertain whether or not these moderates will have additional concerns once an actual draft and/or cost analysis is released. We've certainly seen that before in this process!

Reid is also experiencing difficulty from key party leaders outside of the Senate. Former Vermont Governor and Democratic National Committee Chair Howard Dean came out in opposition to the Senate bill in a column in the Washington Post on Wednesday because it does not contain enough government intervention. The Service Employees International Union and the AFL-CIO are also publicly attacking the bill, particularly relative to its financing provisions which would levy a 40% excise tax on the highest cost health plans, like those that unions offer to their members. In addition, a number of more liberal House Democrats are voicing their displeasure about the potential compromises being considered by the Senate that they feel water down the bill, and have threatened to derail the legislation should it get to a conference committee.

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