Update - There's a reason why I tend to practice cautious optimism - Susan Collins appears to be a solid "No" and Ben Nelson continues to say "No" as well. And the Democratic Left may be unwilling to accept the watered down bill.
Last month I took to this page to argue that health reform would fail to pass. In my original post and one subsequent follow-up I theorized that disagreements within the Democratic Party and between the House and Senate over funding, mandates, taxes, and abortion would ultimately sink health reform - and they almost did. But it is now increasingly likely that health reform will pass and all credit goes to two Senators - Max Baucus (D-MT) and Joe Lieberman (I-CT). Lieberman has become public enemy number one among the Left this week since stating that he would filibuster any bill with a Public Option AND any bill that allowed for a Medicare buy-in. Baucus enjoyed a similar bit of infamy back in September when his Senate Finance Committee drafted health reform legislation that did not include a public option and had watered done the individual and employer mandates. Baucus argued that his goal was to write a bill that could receive 60 votes.
Senate Majority Leader Harry Reid (D-NV) took Baucus' bill and added a public option and has spent the better part of a month trying to reach 60 votes. It seems that Reid has now surrendered. Word out of Washington is that the Senate will strip away the public option, will strip away the recently proposed Medicare expansion and will essentially consider the legislation originally reported by Baucus' committee back in October. Liberal Senate Democrats such as Tom Harkin (D-IA) have stated that they will accept scaled back legislation and the White House has urged Reid to make what ever concessions are necessary to get the bill passed.
Perhaps most significant is the increased likelihood that the scaled back Baucus inspired bill may receive 2 Republican votes – Olympia Snowe and Susan Collins, both from Maine. Snowe supported the Baucus bill in committee and Collins recently praised Lieberman’s efforts to strip away objectionable elements in the bill. So there you have it – the bill that Baucus originally produced has now become the savior of the Democrats' health reform effort and because of the efforts of Joe Lieberman it is likely to pass complete with a Republican vote or two.
If you are wondering why Harry Reid opted to not introduce the Baucus bill in the beginning it is because of the politics of the House of Representatives and the powerful progressive caucus there. Reid needed to prove that a public option could not survive in the Senate, he needed to prove that the Baucus bill was the only acceptable legislation. The last month has made that clear. Given that the House has passed a health care bill the normal process would be for a House/Senate Conference Committee to reconcile differences between the chambers and return a compromise bill for final votes in each. I do not expect that to happen – rather I suspect that whatever passes in the Senate will be introduced in the House and approved unamended, thereby negating the need for a conference. Any other approach would introduce more delay and uncertainty. The White House and Democratic Leaders will exert tremendous pressure on progressive House members to grit their teeth and simply vote for the Senate bill, or risk getting no reform at all.
I would add that abortion remains a hurdle – but I suspect that it is one that will be overcome.