What the health?

The magic number was supposed to be 60. It's how many senators the Democratic Party had in Congress for one full year. And  although many significant legislative accomplishments were made in that time, one important reform never happened: health care.

Then the state of Mass. voted to elect Republican Scott Brown to replace Sen. Ted Kennedy, and the prospects of passing health care reform seemed worse off than before. Democrats were left with only 59 standing senators.

A Washington Post-ABC News poll from Feb. 9 found that 63 percent of Americans still believe Congress should "keep trying" to pass a health care reform bill.

The bill currently stalled in the Senate has been watered down from what it once was. Instead of a public option (a national health insurance exchange) which would have the people power to compete against and bargain with insurance companies, the current version of the bill contains state health insurance exchanges and would be as effective in bargaining with the national health insurance companies.

A study by the Health Care for America Now organization found that due a variety of factors, but most predominantly the recession, insurance companies lost 2.7 million customers in 2009. And to make up for the lost profit, insurers raised premiums.

As reported by the New York Times on Feb. 15, just a few weeks ago Anthem Blue Cross, California's largest health insurance provider, raised their premiums an average of 25 percent, with some customers seeing increases as much as 40 percent. It is another sign that insurance companies will continue to raise premiums on customers unless Congress steps in and makes the much needed reforms.

But the issue is a deadlocked Congress, a fledgling majority party in the Senate, and a President unwilling to step in and take charge.

In his State of the Union Address on Jan. 27, President Obama said, "if the Republican leadership is going to insist that 60 votes in the Senate are required to do any business at all in this town -- a supermajority -- then the responsibility to govern is now yours as well."

But here's an open secret. It doesn't actually take 60 votes to pass a bill in the Senate. It only takes 51 votes, or 50 if the vice president decides to break the tie. The number 60 is derived from the number of senators it takes to get past a filibuster (a tactic used by obstructionist senators who use speeches to prevent a bill from being voted on).

A filibuster can only end with 60 votes in the senate. This process, called "cloture," brings the debate to an end and then a vote can finally take place on the actual bill. But in recent times just the mere threat of a filibuster is enough to scare the party in power into submission.

Now with the only 59 surviving Democratic senators, and no possible Republicans willing to vote with Democrats, the senate has only one other option to pass health care reform.

"Reconciliation" is a process that is not subject to a filibuster and only requires 51 votes to pass a bill in the senate. It was created to make changes to the budget, but in recent times has been used to include other provisions only slightly dealing with the budget.

In this case, health care reform would have an enormous effect on the budget. Its costs would definitely see an increase in spending, but Democrats hope to bring in enough revenue over the next ten years to pay for those costs.

The problem with reconciliation is that many important health care reform provisions would not be allowed to pass through reconciliation.

Mark Schmitt, a political scientist and author, wrote in The American Prospect on Jan. 11 that the problem with reconciliation is, "Provisions that don't directly affect the budget can't be included." He added, "Much of the fine detail of health-insurance regulation in the current bill would likely have been lost if pushed through reconciliation."

The final bill would end up being a series of rules and regulations determining the practices of health insurance companies, and not much would get accomplished in terms of making sure everyone has access to affordable health insurance.

Although the final outcome of health care reform remains uncertain, and even though those 40 million Americans may not get the affordable health insurance they had once hoped for, it's important that congress gets something accomplished before time runs out on this president and this congress.