Over the past few days, Senate Majority Leader Harry Reid (D-NV) has indicated publicly that the Senate will begin to consider health care legislation on the floor next week. And he did take a procedural step this week to do so by initiating the Senate Rule 14 process on the House-passed reform measure, H.R. 3962. However, just because the procedure was begun does not necessarily mean the Senate will take up the House bill next week or any merged bill next week. It just means that the House bill will be available on the legislative calendar after its second reading on Tuesday, November 17.

Since all revenue-related measures must originate in the House of Representatives, Senator Reid was always going to have to use a shell bill from the House in order to proceed on health care reform. Now that the House has passed its version, Reid can use that measure as his shell. The shell bill then will be fully substituted by the merged Senate health care bill.

Regarding that merged bill, Reid is still waiting on a final score from the Congressional Budget Office and the bill still needs to be drafted in actual legislative language. Furthermore, the Senate still has to complete a military appropriations measure and a cloture motion has been filed on a 7th Circuit judicial nomination. In order to begin consideration of the health care bill next week, Senator Reid would have to get a unanimous consent agreement to skip those measures. Assuming at least one senator will oppose, he will then have to file a cloture motion on Tuesday, meaning the vote on the motion to proceed to the health care bill could not occur until, at the earliest, Thursday morning. If all 30 hours of post-cloture debate is used (a possibility that seems extremely likely), the motion to proceed wouldn’t be adopted until Friday afternoon. That would be the earliest Sen. Reid could offer the actual Senate bill as a substitute amendment, assuming the bill is ready by that time. Also, keep in mind next Friday is the Friday before the week-long Senate Thanksgiving recess, which also plays a role in timing.

Once the Senate bill is actually ready to bring to the floor, which in all likelihood will not happen until the week after Thanksgiving (beginning November 30), due to vastly different House and Senate rules, the bill will still proceed very slowly through the Senate. It could take weeks or even months to be brought up for a vote.  

The first hurdle Reid will have to clear is getting the 60 votes he needs to prevent a filibuster on a “motion to proceed.” While normally this would be a non-controversial procedural step, in this case key moderates have been slow to promise their votes and are seeking key assurances and changes to the bill before they will vote to move forward. For example, Senator Ben Nelson (D-NE) is refusing to support bringing a Senate bill to the floor at all if it does not initially include a provision protecting against public financing of abortion like the Stupak amendment that was added to H.R. 3962.  

Once the bill comes to the floor, it must adhere to all of the budget caps and spending limits in the budget resolution passed this spring. If it does not, a Republican could raise a “point of order” and again 60 votes would be required to continue debating the measure.

Then the floor amendment process will begin and, unlike in the House, the Senate Democratic leadership has very limited ability to control what amendments are brought to the floor. Consequently, the GOP is expected to raise hundreds of messaging amendments on things like the public plan, the employer mandate, coverage for undocumented immigrants, financing of abortion, medical liability reform and more, forcing Democrats to take votes on tough political issues. In addition, the GOP can decide to filibuster any Democratic amendment for which Reid does not have 60 votes. 

The result will be that the Senate floor debate will likely take weeks, and could result in some very politically entertaining scenes on C-SPAN. The Democratic leadership does have some control over the number of amendments allowed on the floor at a time and how those are voted on in terms of order and procedure, and Reid can use those procedural tools to try and thwart Republican opposition. However, heavy-handed tactics like that may just encourage GOP filibusters and other delay tactics the GOP has in its procedural arsenal. Senator Coburn (R-OK) has already threatened to read the entire bill (which will probably top 2,000 pages) into the Senate record. 

To cut off the floor debate and force a final vote, Senator Reid has two options. The first would be the traditional use of 60 votes to close debate and vote on a final bill, but Reid has already faced threats from key moderates like Senator Joseph Lieberman (I-CT), who has said that he will stand with the GOP to prevent the end of debate if a government-run public plan option is in the final bill. 

The other option Reid could exercise is to try and pass the bill using the budget reconciliation rules, which would allow for only limited debate and require only a simple majority. But, under those rules, only budget-related provisions could be considered, meaning that all of the insurance regulatory reform requirements like the exchange and rating provisions, would likely be stricken from the bill as part of a protracted procedural debate. That means they would have be considered later in a potential second bill under normal rules where those provisions would be unlikely to survive, and it also means that the Senate-passed bill would be next to impossible to conference with the House-passed legislation. Also, it is worth noting that many key Senate Democrats, including Senate Finance Chair Max Baucus (D-MT), Senate Budget Chair Kent Conrad (D-ND) and Senate President Pro Tempore Robert Byrd (D-WV), have vociferously opposed the use of reconciliation rules relative to attempting to pass health care reform.

Assuming a bill makes it this far and passes through the Senate, it will then have to be conferenced with the House-passed legislation. By this point, if there is a Senate-passed bill, it will likely only barely resemble H.R. 3962, so melding those two measures together in a way that that conferees believe that the bill will pass both houses again will be tough.