With the outcome of the Massachusetts special election weighing heavily on the Senate, Democratic leaders are being forced to consider "what if" scenarios to respond to the turnover of the late Sen. Ted Kennedy's seat to Republican state Sen. Scott Brown.
A GOP win would tip the Senate balance away from a filibuster-proof 60-seat majority for Democrats and in a direction that could spell the death of current health insurance reform efforts, the cause of Kennedy’s life.
Finishing up marathon negotiations with the White House, congressional staffers worked furiously through the weekend to send "various parts" of a compromise to the Congressional Budget Office for analyses to be used to make tweaks to get a final deal done in roughly the next two weeks, possibly before Brown could be seated should he defeat Democrat Martha Coakley.
If the seat did change hands, the easiest and quickest option for Democrats would be for the House to simply swallow whole the Senate bill. But many House Democrats oppose key provisions of the Senate bill, including 40 anti-abortion Democrats who voted for the House bill only after tough language authored by Rep. Bart Stupak, D-Mich., was included, and analysts say several will not budge on that matter.
"If the Republican is elected in Massachusetts, all eyes will be turned on (House Speaker) Nancy Pelosi. If she is willing to lead Democrats toward the Senate version, this could pass. If she is willing to fight, this is going to get real messy," Jordan Lieberman, publisher of Politics magazine, told Fox News.
Another suggestion is that Democratic officials in Massachusetts could slow down the certification process for Brown, giving Democrats in Washington a small window to pass a deal. Others have suggested that Republican Sen. Olympia Snowe could be convinced to support the bill, since she was the lone Republican to vote for any health bill while it went through the committee process last year.
On senior House Democratic leadership aide told Fox News that the "what if" game has Democrats considering an idea they once rejected out of hand -- a fast-track legislative procedure known as "reconciliation."
Reconciliation allows members to pass a bill with a simple majority as long as the bill is limited to budget reduction efforts. However, that would mean big alterations for the legislation.
"It's like a car that's missing a couple of tires, a window," said Republican pollster Dave Winston. "It'll be a mess."
The Democratic aide said it was far less likely that reconciliation would be used for the overall bill, but that it might be used down the line to pass "corrections."
Under that scenario, the House would have to accept the Senate-passed bill, something the aide described as "an extremely high hurdle." That sentiment is echoed by numerous Senate aides involved in the overhaul talks.
A majority of House Democrats are ardently opposed to the Senate's excise tax. They are supported by unions that prefer the House version with its tax on high-income earners rather than the compromise tax on high-value premiums that laborers would be given, according to a new deal.
Reconciliation is not as simple as it sounds. First off, any reconciliation bill must deal solely with spending and taxes to bring the bill in line with the budget, a move that its creators back in 1974 made to keep extraneous legislation from being passed under this expedited process. Those rules were tightened even further in 1990 by Sen. Robert Byrd, D-W.Va., who has decried the use of the procedure for anything other than budget deficit reduction.
That means the current bill could easily be stripped of measures like delivery system reform and preventive care, cornerstones of the bill. Senate Budget Committee Chairman Kent Conrad, D-N.D., who has derided the use of the tactic, said the bill would be legislative "swiss cheese" after all is said and done.
To be sure, the process has been used more by Republicans in the past, primarily on tax cuts, but in this case, critics of its use (Republicans and some Democrats) point to a massive restructuring of one-sixth of the nation's economy.
Sen. Judd Gregg, R-N.H., the primary point person in the Senate for reconciliation matters as the top Republican on the Budget Committee, has called this "Chicago-style politics" and has vowed to raise scores of objections, called "points of order." There are about 13 different ways Republicans can challenge Democrats, and nearly all of these will require votes.
But time is not unlimited. If Democrats can cobble together a reconciliation product, they have to endure only 20 hours of debate, per the budget rules, before the voting starts on all the points of order.
Health insurance reform is a top priority, and it is clear Democrats are rushing to find a way to pass a bill, but reconciliation is not an easy choice.
One senior Democratic leadership aide, eschewing any possibility that the Massachusetts race could go to the Republican, said, "The current operating idea is to get this (compromise) bill done as soon as possible. We need to get past the disinformation and the half-truths used by opponents, and people will realize this is a good bill that will help them."
Fox News Jim Angle and Trish Turner contributed to this report.