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Senate Democrats managed to pass a comprehensive health care bill with a dramatic Christmas Eve vote, but the work to get health care reform through Congress is far from over. In fact, Democrats may now face the most challenging part of the process, as they attempt to merge the Senate bill with the legislation passed in the House of Representatives.
Congress has reached the fourth step of the health care reform legislative process, which CBSNews.com has been tracking for you with our Health Care Progress Report, shown below. However, given they have already missed their 2009 deadline to finish the bill, Democrats may reportedly skip the formal process of the fourth step -- the conference committee -- and rely on informal negotiations to get the job done expediently.
Formal Meeting or Backroom Negotiations?
Typically, to merge two different versions of a bill from the House and Senate, the Congress would appoint a "conference committee" to work out a compromise version. The Senate would have to take a series of votes to approve this process and select conferees, as explained in detail by David Waldman at Congress Matters.
But rather than subject the health care bill to more filibuster-prone votes, two senior Capitol Hill staffers say Democrats are "almost certain" to simply skip the formal negotiating process, reports Jonathan Cohn of the New Republic.
"It's time for a little ping-pong," one staffer reportedly said, referring to the process in which the House and the Senate "ping-pong" full bills back and forth to each other, until they have a bill both sides can agree on.
This game of ping pong, however, may not be so easy.
What Issues are On the Table?
At a constituent meeting on Sunday, Rep. Henry Waxman (D-Calif.), one of the House leaders in the health care debate acknowledged Congress will skip the formal conference committee because it "would need 60 votes [in the Senate] all over again," reports Dave Dayen of FireDogLake. Yet Waxman reportedly said he would press the Senate and White House negotiators to accept the House terms on issues pertaining to prescription drug reform.
"The president and the Senate made very poor deals with PhRMA," Waxman reportedly said, referring to President Obama's deal with the pharmaceutical industry, limiting its contribution to reform to $80 billion.
"I have said that I am not bound by that agreement," he reportedly said, adding he would tell the president, "Are we interested in protecting the profits of the drug companies or protecting seniors?"
Waxman also reportedly said he had "serious doubts" the final product would include a government-run insurance option, mirroring remarks from other House Democrats who have suggested they could concede on the issue of the public option.
A host of other serious issues will have to be debated between the House and the Senate, including abortion restrictions, the extension of the Children's Health Insurance Program and whether to establish one national or state-based health insurance exchanges. They will discuss other big issues, like whether to pay for it with a surtax on wealthy Americans or a tax on high-end insurance policies.
House Speaker Nancy Pelosi (D-Calif.) will meet with Waxman and the other House leaders in charge of health care -- Reps. Charlie Rangel (D-N.Y.) and George Miller (D-Calif.) -- Tuesday afternoon, CBS News Capitol Hill Producer Evelyn Thomas reports. On Thursday, the entire House Democratic caucus will meet, either in person or by phone for those currently outside of Washington, to discuss the legislation.
The Opposition Isn't Giving Up
Meanwhile, while Democrats could very well work out their differences, opponents of the plan have yet to give up their fight against it.
Even if the bill is ultimately signed by President Obama, some conservatives are prepared to take the matter up with the courts, the Washington Post reports, arguing that one of its fundamental components -- the individual mandate -- is unconstitutional.
Numerous Republican attorneys general are also threatening court cases, claiming elements of the bill are "constitutionally flawed."