Nancy Pelosi and the White House's head health care honcho, Nancy-Ann DeParle, are both swearing up down, cross their hearts and hope to die, that, after they release a finalized health care proposal later this week, they'll finally have the votes to git 'r done. I didn't watch the Sunday shows on which they made their respective vows, so I can't say for sure, but I wouldn't be surprised if they both made their promises with their fingers crossed behind their backs.
Both Pelosi and the administration have a vested interest in at least seeming to be working towards passage, but any realistic analysis of the political and procedural obstacles suggests that it's all but impossible—and that's assuming that Pelosi can actually conjure up the votes in the first place. Right now, she doesn't have them, and, as an article in the New York Times over the weekend made clear, the holdouts are primarily abortion opponents and fiscal moderates who are deeply conflicted about the bill.
But even if Pelosi somehow put together a compromise measure that she could finagle enough support for, the rest of the passage process is still fairly daunting. In a long and detailed post, Keith Hennessey does the best job I've seen of laying out just how arduous the road to passage is likely to be.
As he explains, one of the major complications Democrats will have to resolve is the sequencing of the votes. Passing the bill will require votes in both chambers of Congress, but neither chamber wants to go first because neither chamber wants to take the risk that the other side will flake; with rare exceptions, the only thing worse than taking a politically difficult vote is taking a politically difficult vote and ending up with nothing to show for it. Hennessey is convinced that, in the end, the House will have to first: The Senate cannot pass an amending bill through reconciliation if the House hasn't actually passed a bill to be amended. That sounds right to me, but it's tough to say for sure; no matter what, the combination of procedure, policy, and inter-chamber trust issues won't be easy to navigate.
Even if Democrats do manage to get to the point of using reconciliation in the Senate, Republicans will do their best to turn it into a procedural torture session that's as long and painful as possible. In particular, Sen. DeMint has already threatened to exploit what The Hill calls a "loophole"—a rule allowing Senators to offer an infinite number of amendments—that could draw out the proceedings for a very, very long time. The Hill's article says that Democrats might respond by seeking "a ruling by the parliamentarian that Republicans are simply filing amendments to stall the process." But when I asked former Senate parliamentarian Robert Dove about this possibility on a conference call last week, he seemed skeptical that such a request would work (though he didn't flatly rule it out).
In other words, the procedural barriers are many—and in order to even begin the process of overcoming them, Nancy Pelosi will first have to come up with enough votes in the House. Until that happens, this bill isn't going anywhere, no matter how many times Pelosi and co. pinky swear it's ready to go.