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Dems Dealt Blow on Health Care Reconciliation

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Updated on Friday at 4:10 p.m. ET.

After more than a year of passionate and substantive debate, the fate of the Democrats' health care reform package may rest largely on technicalities.

Senate Republican sources say the Senate parliamentarian -- who essentially acts as the Senate referee -- has shot down the Democrats' latest strategy for passing a final bill, CBS News Capitol Hill Producer John Nolen reports.

Democrats were planning on bypassing Republican obstruction -- as well as reaching a compromise on the legislation within their own party -- with a multi-step process: The House would pass the health care bill already approved by the Senate. Then, both the House and Senate would pass a "fix it" bill that would amend the Senate bill. The "fix it" bill would pass the Senate via a process called reconciliation, which only requires 51 votes.

The strategy was complicated from the beginning, but according to Republicans, the Senate parliamentarian is now saying that President Obama would have to sign a health care bill into law before Congress can amend it with a reconciliation measure.

Senate Democrats had no immediate comment on the matter, Nolen reports.

The parliamentarian ruling could foil Democrats' plans to avoid signing into law the "sweetheart deals" that have tainted the Senate bill, such as Sen. Ben Nelson (D-Neb.)'s provision that exempts the state of Nebraska from having to pay for any expansion of Medicaid. Democrats are divided over a number of other issues, such as the Senate bill's tax on high-end insurance plans, which they planned to revolve through the reconciliation bill.

Before word of the parliamentarian's decision, White House spokesman Robert Gibbs was asked whether President Obama would sign the bill if it was sent to the White House. Gibbs said today that the White House wanted to wait for the details of the ruling, but also indicated that the president would sign the bill if sent his way.

"I don't see why we wouldn't," Gibbs said.

The House could still pass the Senate bill, but House Democrats unhappy with the Senate version wanted to ensure the reconciliation measure would not be abandoned. There was discussion of crafting a legislative procedure for the House to vote on a reconciliation measure that automatically passed the Senate bill, so that House members would not even have to vote on the separate, politically damaging Senate bill. (There has been little discussion of the Senate passing the House bill.)

From the start, it was clear that not all of the Senate bill's problems could necessarily be fixed through reconciliation. The process of reconciliation is meant exclusively for budget-related items, so it was questionable whether it could be used to amend the Senate bill's abortion language, for instance. A group of House Democrats wants to change the Senate bill so its abortion funding rules are more restrictive.

Aides to House Speaker Nancy Pelosi (D-Calif.) acknowledged today that there will be no abortion language in the reconciliation bill, CBS News Capitol Hill Producer Jill Jackson reports. There are still ways Democrats could amend the abortion language, however, such as including the changes as a rider to a separate bill.

Abortion rights advocates wanted to make the Senate language lessrestrictive -- specifically, they want to get rid of the Senate abortion provision that requires women who purchase insurance that covers abortion to write two checks. Rep. Jan Schakowsky (D-Ill.) said abortion rights legislators are talking over ways to fix the language later.

Democrats are still moving forward with the plan to pass a "fix it" reconciliation bill, even in light of the parliamentarian's ruling. The Congressional Budget Office is expected to give Congress a cost estimate for their proposed reconciliation bill by this weekend at the latest, Politico reports, and the House Budget Committee will discuss the bill on Monday.

Republicans have decried the Democrats' plans to use reconciliation, calling it "catastrophic," even though the process has been used on past health care measures, such as the Children's Health Insurance Program and COBRA health coverage for the unemployed.

Senate Majority Leader Harry Reid (D-Nev.) wrote a letter to Senate Minority Leader Mitch McConnell today defending the use of reconciliation and telling them they will have an opportunity to offer amendments to the reconciliation bill.

"In addition, at the end of the process, the bill can pass only if it wins a democratic, up-or-down majority vote," Reid wrote. "If Republicans want to vote against a bill that reduces health care costs, fills the prescription drug 'donut hole' for seniors and reduces the deficit, you will have every right to do so."

Update: There has been some question as to whether Republicans were misinterpreting the parliamentarian's ruling. At a press briefing on Friday, Pelosi acknowledged the ruling but said it should not be a problem.

"The Senate Parliamentarian, as you have said, said in order for them to do a reconciliation based on the Senate bill, it must be signed by the President," Pelosi told reporters. "So it isn't going to make any difference except maybe the mood that people are in, but the fact is that once we pass it in the House, it's going to be the law of the land."

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